At Dr. Judy Sturm & Associates, our patients often wonder what their dental insurance will cover. Most inquiries surround cosmetic treatments and whether they are eligible for coverage.
Well, it depends. The factors that affect coverage are the type of treatment, the reason for it, and your dental plan. In most cases, there needs to be a clear medical benefit.
Here are the cosmetic options that can be eligible for full or partial coverage …
n Bonding, crowns, & veneers – These treatments can be used to repair chipped, broken, or fractured teeth.
n Dental implants – If you have gaps in your smile, implants are the most durable, long lasting, and natural-looking option. But some insurance plans exclude them and offer alternatives such as partials or dentures.
n Orthodontics – When it comes to braces, coverage is usually only available for people under the age of 18. Adults often chose Invisalign® clear aligners to straighten their smiles. We’ve seen our patients’ plans cover $500 to $3,000 for this treatment.
One of the cosmetic options that rarely receives coverage is teeth whitening. That’s because it’s only done for looks. Insurance providers’ top priorities are pain, infection, restoring tooth structure, and oral health. Regular visits, cleanings, and fillings often receive full coverage.
What insurance covers depends on your plan. Oftentimes, cosmetic dentistry gets up to 50% coverage. More expensive plans tend to cover more. Fixed rate plans may offer coverage up to a specific dollar amount. And insurance plans reset each year, so as the saying goes … if you don’t use it, you lose it.
What about OHIP? While OHIP pays for many health services, only dental surgery in hospital is eligible for coverage. Ontario Works and the Ontario Disability Support Program do offer some support. Children under the age of 17 can access the government-funded Healthy Smiles Ontario program.
As your midtown dentist in Toronto, we want to help make it easier for you to benefit from our cosmetic options! That’s why we offer financing options at our practice. And did you know … you can receive up to 20% back in tax credits for certain treatments, if insurance doesn’t cover them?
To find out exactly what is and isn’t covered, call now! If there’s a treatment you’re interested in, but it won’t be covered, there may be another effective option we can recommend. Our friendly and knowledgeable team is ready to help!