Are Dental Crowns in Mobile Covered by Insurance?

Are Dental Crowns in Mobile Covered by Insurance?, Dr. James Whatley, Mobile, AL, Cosmetic Dentistry, Restorative Dentistry

Dental crowns are often part of routine dental care, known for their restorative and cosmetic functions, but how often are they included in insurance coverage? If you’re dealing with a damaged tooth, you might be concerned about the financial implications of getting a dental crown in Mobile. 

Here, we’ll explore the nuances of insurance coverage for dental crowns and empower you with the knowledge to manage this aspect of your dental health.

What Are Dental Crowns?

Dental crowns are a standard procedure that can help restore your teeth to their natural function and appearance. A crown acts as a cap placed over your existing tooth, protecting it from further damage or decay. There are many different types of crowns available, from porcelain to metal, and each one has its unique benefits. 

Generally, we can use dental crowns on a tooth with damage beyond repair, such as from decay or a large cavity. By placing a crown over the damaged tooth, we can prevent further problems from developing while also improving the look and function of your smile. If you think you might need a crown, talk to us about your options and the best treatment for your situation, including insurance considerations.

Understanding Dental Insurance

It can help to grasp how dental insurance functions and what it typically covers. Dental insurance, unlike medical insurance, often operates on the principles of a plan that emphasizes preventive care to avoid more extensive and costly treatments down the line. It usually falls into three categories: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Indemnity Plans (or Fee-for-Service Plans).

Each dental insurance type comes with distinct levels of flexibility and coverage. Generally, dental insurance policies include preventive procedures (such as cleanings and X-rays), essential treatments (like fillings and root canals), and major services (including bridges and dental implants). The details, however, can vary widely between plans and providers.

Coverage for Dental Crowns

The coverage you can expect for dental crowns will hinge on several factors, but the most influential may be your type of dental insurance. Dental crowns bridge the gap between restorative treatments and cosmetic procedures, blurring the line between what is strictly necessary and what is elective. Because of this, their coverage falls into a gray area for some policies.

For instance, some dental insurance plans might consider crowns to be a major service, which would affect both the extent of coverage and the out-of-pocket expenses the policyholder would need to pay. However, given the functional importance of crowns in maintaining oral health, they often receive better coverage than purely cosmetic procedures.

Navigating the specifics of your dental crown coverage requires thoroughly understanding your insurance policy and its terms. It is not uncommon for two individuals with policies from the same provider to have different coverage levels due to variations in their specific plans or deductibles.

Navigating Insurance Policies

Becoming versed in the language and scope of your dental insurance policy is invaluable. Here are some tips to help you comprehend and use your insurance more effectively:

  • Please request a copy of your dental insurance policy and review it thoroughly. Understand its definitions, exclusions, and limitations. It might sound tedious, but you’ll appreciate this knowledge when filing a claim.
  • Pay attention to the annual maximum benefit, the top dollar amount a dental plan will pay within one year. You will be responsible for the overage if your treatment surpasses this limit.
  • Check the waiting periods. There may be a waiting period after the plan starts before you can get coverage for major procedures like dental crowns.
  • Look for any stipulations regarding pre-authorization for dental crowns. Failing to secure the necessary approvals can result in significantly reduced coverage or outright denials of benefits.

Understanding the fine print of your policy can save you from unpleasant surprises and ensure you get the maximum benefit from your insurance.

We Make Insurance Easy

We understand that dealing with dental insurance and its associated paperwork can be overwhelming. This is why we work diligently to accept a wide range of insurance providers and strive to ensure that our patients can access the coverage they are entitled to. Our experienced team is committed to taking care of the insurance details so you can focus on your dental health without added stress.

We process most insurances and are always available to answer questions and guide you. If you need a dental crown, we will work with your insurance provider to effectively manage the coverage and claims process.

Steps Involved in Placing Dental Crowns

Knowing what to expect can alleviate apprehension and ensure the process goes as smoothly as possible if you decide to undergo the dental crown procedure. 

Step 1: Consultation and Examination

The initial meeting with Dr. Whatley sets the tone for your treatment. During this step, you’ll receive a thorough oral health assessment and discuss why a dental crown might be necessary. We will consider various factors, such as the tooth’s condition, your bite, and aesthetic goals.

Step 2: Tooth Preparation

Before we can place the crown, we need to prepare your tooth. This involves reshaping the tooth to create a proper base for the crown to fit securely.

Step 3: Impression Taking

With your tooth prepared, it’s time to take an impression. This is used as a mold to create your custom dental crown.

Step 4: Crown Fabrication

The temporary crown is a pause in the process as the permanent crown is meticulously crafted to your tooth’s newly prepared shape. This step redefines your crown procedure as uniquely yours. 

The impression of your tooth is sent to a dental laboratory where the permanent crown is custom-made. Skilled technicians use the impression to fabricate a crown that perfectly fits the prepared tooth. This process can take a couple of weeks, during which you’ll wear the temporary crown.

Step 5: Crown Placement

The last significant step of the dental crown is the permanent crown placement. This step involves fitting and bonding the crown to your tooth permanently.

We will remove the temporary crown and clean the tooth thoroughly. They’ll also check the fit of the permanent crown before bonding it in place.

Aftercare and Maintenance

Knowing how to care for your crown is crucial after we place it. Proper aftercare can prolong the life of your crown and maintain the health of your teeth and gums.

We will provide you with post-placement instructions, including how to care for the crown and what to expect in the days following the procedure. This may include advice on chewing, cleaning, and when to follow up for another exam.

Dental Crowns in Mobile

The relationship between dental crowns and insurance is not always straightforward, but with the proper knowledge and support, you can confidently address any dental concerns. You can access the care you need by understanding the details of your coverage and working with a dental practice that prioritizes insurance navigation.

Whether your insurance offers robust coverage for dental crowns or if there are stipulations that require careful management, it’s always best to be informed. Remember, knowing what your insurance covers regarding dental crowns can significantly impact your dental care management and budget planning.

Don’t hesitate to contact us for questions about your insurance coverage. With clarity on your insurance specifics, you can take the best approach to manage your dental health and ensure a vibrant smile for years. Schedule a consultation today with Dr. James Whatley to explore dental crowns or any restorative dentistry services, such as dental implants in Mobile, Alabama. We also offer gum therapy, dentures, and more.