Does Dental Insurance Cover Crowns?

Are crowns covered by dental insurance?

Since medically necessary crowns are considered a major restorative procedure, most dental insurance plans cover 50% of the cost.³ Some plans, such as Aflac dental insurance, may offer increasing coverage if you maintain your plan for several years. However, you must also meet your plan’s deductible before coverage starts. Furthermore, you may have to pay the remainder out of pocket if you reach your annual maximum. You may have to pay the total cost out of pocket if you only want a crown for cosmetic reasons.

Types of dental insurance plans 

Here are three dental plans and details on their coverage for dental crowns:

Preferred provider organization (PPO) plan 

PPO plans tend to cost the most in premiums but maximize flexibility. While they come with a network of dentists, you may get partial coverage for out-of-network providers. Plus, you can seek specialist care directly without a referral from a general dentist.

To cover crowns, you’ll first need to meet your deductible. This is the amount that you’re responsible for before coverage kicks in. You may also have to pay coinsurance, which is a share of the procedure’s cost. After that, the plan offers significant coverage, such as 50% of the cost of the crowns. You must pay extra if you exceed your annual maximum benefit for coverage.

Dental health maintenance organization (DHMO) plan

DHMO plans require you to see in-network dentists to get coverage. Plus, you must get a referral from a general dentist to see a specialist. Therefore, you’ll have to go to an in-network provider to get your crown if you need help with the cost. However, these tend to be more affordable than PPO plans. Most DHMOs don’t have a deductible. Instead, the plan sets predetermined fees for procedures, such as crowns. You can pay that fee, and the insurer will pay the rest.

Discount or referral dental plan

Discount and referral plans are not technically insurance policies. Instead, they are annual memberships offering a network of insurers who agree to provide services at reduced costs to plan members. Therefore, these can simply lower the cost of crowns. However, they don’t come with comprehensive coverage, such as covering the full cost of routine care. This type of plan may work well if you think you’ll only need routine care but want an affordable safety net.

How much crowns cost with and without dental insurance

Crown costs vary widely depending on the provider, materials, and the tooth. However, on average, crowns tend to cost around $1,000 to $1,300 without insurance.² As mentioned earlier, many dental plans cover 50% of the cost of crowns. With insurance, you might pay $500 to $650 after deductibles, copays, or coinsurance. This means you can save hundreds on crowns while maintaining dental coverage for just a few dollars a month.

Get a dental insurance quote

Crowns restore the appearance and function of your teeth but can be expensive when paid out of pocket. The right dental insurance policy can put this treatment within financial reach, helping you get the care you need without breaking the bank.

Aflac offers dental insurance with rates and terms to help suit your dental care needs and budget. Speak with an agent today to learn more and get a quote.