The cost of a crown for a tooth with insurance will depend on the type of crown being used and the individual’s specific insurance coverage. Generally, most dental insurance plans cover between 50% and 75% of the cost of a crown, up to an annual or lifetime limit. The remaining balance may also be covered by additional supplemental dental insurance, if applicable. Some in-network providers offer discounted rates, which could reduce the overall out-of-pocket costs.
Contents:
- Determining Eligibility for Insurance Coverage
- Estimating the Cost of a Crown with No Insurance Coverage
- Explaining How Much is Typically Covered by Insurance
- Understanding Variations in Price Depending on Material Used
- Examining Extra Costs Beyond Teeth Cleaning and Crowns
- Considering Possible Financing Options
Determining Eligibility for Insurance Coverage
In order to understand the cost of a crown with insurance, one must first determine whether or not they are eligible for coverage. Insurance plans vary, so it is important to check with your provider directly before proceeding with any course of treatment that could be covered. With some providers, coverage for crowns may require a referral from your primary care dentist, as well as a co-pay depending on the specific plan you have selected.
Some individuals may also need pre-authorization from their provider if they want their insurance policy to cover any part of the procedure. This process requires additional paperwork and may take several days or weeks to complete; however, it can often lead to significant savings when paying for expensive dental procedures like crowns. Many dentists offer payment plans which enable individuals to pay off their medical bills over time instead of all at once if they don’t qualify for full insurance coverage.
While most people think that they will automatically get reimbursed after receiving treatment under an insurance policy, this isn’t always the case. It is important to verify eligibility requirements with your provider beforehand in order to ensure that you don’t end up footing more than necessary out-of-pocket expenses in the event that you aren’t actually eligible for reimbursement on a particular service.
Estimating the Cost of a Crown with No Insurance Coverage
For those patients without insurance, the cost of a crown can be difficult to estimate. One factor in the price is the type of material used for the crown; porcelain-fused-to-metal and all-ceramic are two popular choices. Porcelain fused to metal costs between $800 and $1700 per unit, with all ceramic crowns being more expensive at $900 to over $2000 each. Other factors that can influence the overall price include where the procedure will take place – in a dentist’s office or an offsite dental lab – as well as any additional preparatory work that may be necessary before placing a new crown (e.g. extraction or root canal).
The type of practitioner performing the service is also important; depending on their skill level and experience, they may charge varying rates for their services. Extra fees such as laboratory fees or anesthesia fees could apply. In most cases, it’s best practice to get quotes from several different dentists before going ahead with any kind of treatment. That way you can compare not only prices but also services offered by different practitioners and make an informed decision about what’s best for you and your financial needs.
Financing options can help patients without insurance cover some of these expenses. Dental practices often offer payment plans which allow them to spread out payments over time until everything is paid off in full, sometimes even at no interest rate if paid within a certain timeframe. Patients should research their own individual options carefully prior to selecting one plan over another.
Explaining How Much is Typically Covered by Insurance
Most insurance companies include basic dental coverage in their health insurance plans, which typically cover preventive care and some routine restorative treatments such as a crown. However, the amount of coverage you get for these procedures is often limited to the cost of an inexpensive “preferred provider” option or a few hundred dollars towards any procedure regardless of your dentist’s fees.
It’s important to remember that all dental work will have different associated costs depending on the type of materials used, complexity of the procedure, and individual dentists pricing policy. While most comprehensive or major services are eligible for partial coverage from dental insurance policies, it may not always be enough to make costly treatments affordable.
If your plan includes $500 worth of major service coverage per year with up to 80% reimbursement for preferred providers, then you can expect around $400 off a crown that costs $800 at one such provider. That being said, many people find themselves paying out-of-pocket if they choose a more expensive treatment from an non-preferred dentist that bills more than what is covered by their plan – leaving them stuck with additional expenses even after insurance has been applied.
Understanding Variations in Price Depending on Material Used
When considering how much a crown for a tooth costs with insurance, it is important to understand the type of material being used. Generally speaking, gold and ceramic crowns will cost more than metal alloys or porcelain-fused-to-metal (PFM) crowns. Gold crowns tend to be the most expensive option due to its solid construction and durability; however, their price tag can often make them less desirable because they do not appear as natural looking in comparison to other materials. Ceramic crowns are also considered a high end material, but can provide an aesthetically pleasing result that closely mimics the color of one’s existing teeth – making them an attractive choice for many patients.
On the other hand, some dentists recommend using PFM or metal alloy crowns because they offer strong protection at a more affordable price point when compared to gold or ceramic options. The downside to these choices is they are usually easily distinguishable from real teeth due to their darker coloring and can look unnatural when viewed up close. Nevertheless, depending on what is available through one’s insurance provider and taking into account which type of material looks best on an individual basis, either choice could potentially provide adequate coverage without breaking the bank.
No matter which option you choose when it comes to getting a crown for your tooth with insurance, it is important to be aware of what you are getting before agreeing on any treatment plan. Be sure speak with your dentist about any questions you may have about prices and ask for clarification if there is anything you do not understand before signing off on services rendered so that you know exactly what you are paying for upfront.
Examining Extra Costs Beyond Teeth Cleaning and Crowns
No one likes going to the dentist, but it’s often necessary for everyone to stay healthy and keep their teeth looking great. Beyond basic cleaning, many dental procedures require extra expenses that may catch a person off guard if they are not prepared. A crown for a tooth can be particularly pricey, especially when insurance is involved. While insurance does significantly reduce the cost of many dental procedures, it does not always cover everything associated with receiving a crown on your tooth.
First, it is important to consider any out-of-pocket costs associated with getting a crown placed on your tooth such as co-pays or deductibles depending upon the coverage provided by the individual’s insurance plan. While typical insurance plans cover a majority of the crown itself, additional materials used in placing and affixing the crown might be considered “out of network” or an “unusual procedure” that could lead to greater expense not covered by insurance.
There may also be costs incurred due to temporary fixes needed before receiving your new crown such as fillings or other temporary solutions while you wait for a permanent fix. Depending upon what type of these temporary measures need to be taken and how soon you can get them done can determine whether or not this part of your treatment is covered under some form of insurance at all as well as any applicable payments beyond what will already be paid for treatment after receiving the actual replacement crown itself.
Considering Possible Financing Options
When tackling large-scale dental procedures, it is important to consider all possible financing options. While insurance can help reduce the cost of care, not every patient is eligible or has the right coverage for a procedure like crowning a tooth. If that is the case, it may be worth exploring other payment plans that work with one’s budget and lifestyle.
For instance, many dentists offer no interest financing programs that allow patients to pay over time without additional charges such as interest fees. These flexible repayment plans are often convenient for people who need more time to cover their costs but don’t want to take on additional debt from a loan or credit card charge. In addition to no interest payment plans there are also competitively priced third party lenders which can provide competitive rates so that people know exactly how much they will owe each month over the life of their loan agreement.
No matter what type of plan an individual chooses it is always smart to make sure they understand any terms and conditions of the financial arrangement before signing anything. This way one will know what payments are due when in order to prevent facing late fees or having poor credit scores down the line. With thorough research and planning ahead of time getting the necessary treatments needed for good oral health doesn’t have to break one’s bank account too badly.
