Dental insurance companies are responsible for covering dental procedures depending on your premiums and package. The amount of coverage depends on several factors such as the company's policies and the dental emergency at hand. Usually, before receiving dental insurance, your company reviews your dental procedure and the circumstances that lead to the dental procedure. Once all the paperwork is reviewed, the company goes ahead to cover the dental procedure or decline it. Dental Insurance companies usually cover medically necessary dental procedures. This means that the dental procedure needs to be an emergency and one that is medically necessary. Dental insurance companies also cover cosmetic dental procedures, but they are covered differently than those that are medically necessary.
The reason why these companies cover cosmetic dental procedures differently is that they are an elective form of surgery. Cosmetic dental procedures are done to improve the general appearance of a person or enhance their appearance. This means they are not necessary and can be done away with. Most dental insurance companies do not cover cosmetic procedures especially if they are not necessary. However, there are different situations in which a cosmetic dental procedure can become a medical necessity. This is because most cosmetic surgeons use restorative procedures that are a necessity. Some of these procedures include dental implants, porcelain crowns, and tooth veneers.
For instance, dental implants can enhance a person's smile, but they are also a medical necessity to avoid future teeth problems. Getting dental implants can protect one from getting misaligned bites and loss in the jawbone volume. In such cases, dental insurance companies have to review the cosmetic dental procedure to determine if it needs to be done or not. If the cosmetic dental procedure involves the repair of injured tissue in the tooth, it will be covered. On the other hand, the cost of cosmetic dental procedures that purely rely on enhancing aesthetics will not be covered in any manner. There has to be an underlying issue that is medically threatening such as tissue damage or impairment or tooth decay for the cosmetic dental procedure to be ruled as medically necessary.
