Dentures are necessary, but they are also quite expensive. Many people feel they can’t afford to pay out of pocket to cover the cost, but they aren’t sure if insurance will pay for dentures. It’s important to find out before you’re to the point of needing them whether your insurance company will cover your dentures.
Full dental insurance
If you have a full dental insurance policy, they usually include restorative coverage. This means that some, or all, of your dentures would be covered by the insurance. In most cases, the plan will cover about 50% of the cost of the dentures. You would still have to pay regular deductibles and copays, however, so the cost is still likely to be rather substantial for you.
Employer provided dental packages
Some employer dental packages provide lower monthly costs, but they don’t include restorative coverage. This means that you’d have to pay the entire cost of the dentures yourself.
It’s also important to remember that many insurance companies have waiting periods that apply to new patients. This waiting period may range from six months to a year. During this time, the insurance would not cover the cost of the dentures, but after that time period, they would.
Some dental plans have an annual limit for coverage. This limit may be as low as $1,000. This limit also typically includes anything you might have done at the dentist, including fillings, extractions, crowns, root canals, cleanings and dentures. This means that if your policy includes an annual limit like this, and you’ve already had other work done on your teeth, your dentures may not be covered or may not be covered as fully as they would otherwise be.
Dental discount plans
Sometimes people have a dental discount plan, which is not the same as dental insurance. A dental discount plan has negotiated discounts and fixed prices for specific dental procedures with a focused list of providers in your area. If one of the procedures the discount plan has negotiated is dentures, you may save approximately 40-50% on your dentures by using a dental discount plan. However, it’s important to first confirm that the plan meets your needs (covers dentures), that you can find a local dentist that accepts the plan, and that you can get in to see that dentist in a reasonable amount of time.
While many, if not most, insurance plans will offer some kind of coverage for dentures, it’s important to check with your specific insurance provider. You can look through your policy documents, or call your insurance company and speak with a representative. In many cases, speaking with a representative will get you the most thorough answer, as they can not only tell you what’s covered, but go over any limits and work you’ve already had done that may change your coverage so you’ll have an exact figure. You can also speak with your dentist to see if they offer a payment plan to help you manage the costs if you need to pay it all yourself.