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Does dental insurance cover dentures?

Dentures are common among seniors who have lost their teeth as they have aged; but many times they are also needed by younger people. Dentures, or false teeth, are not just important for a beautiful smile but they also help with digestion by aiding in proper food chewing.

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Alternative options to dentures are dental implants, but both options can be pricey unless your dental insurance covers dentures. Whether you have dental insurance or a dental plan, if your dental insurance includes oral prosthesis then you will be able to get your dentures at a reduced rate.

Deciding on Dentures or Dental Implants Regardless of Dental Insurance

Whether the dental insurance you have covers dentures or not, if you need tooth replacement you will need to consult a dentist. While you are discussing your options with your dentist you should ask about both dentures and dental implants. Dental implants are more expensive, but they are a more permanent fixture than dentures.

Dentures are false teeth that are custom made for your mouth. Using dental adhesive, you temporarily affix the dentures to your gum line during the day so that you can have teeth. At nighttime you remove the dentures and soak them in a cleansing solution. This is the classic picture many people think of when they hear the word dentures: teeth soaking in a glass of water on a nightstand.

Since dentures are not permanently attached, some people find annoyances with them. They can become displaced during the day and need to be adjusted or reaffixed; or you may feel inconvenienced by not having them in place during unexpected moments, such as if you remove your dentures and then receive an unexpected guest at the door. You will most likely greet your visitors with a toothless smile.

Dental implants, on the other hand, are false teeth that are permanently attached to your gum line. It is a surgical procedure that some people may be hesitant about, however the implants are never removed and you will always have your teeth in place. The procedure is more expensive, but many people find the cost worthwhile for the lifelong convenience, especially if the dental implants are covered by dental insurance.

Dentures Covered by Dental Insurance

Dental insurance varies on benefit levels just as health insurance varies. Every month you pay a premium for your dental insurance for a pre-defined set of dental benefits. If you have group dental insurance and you are not sure if your benefits include dentures, then you can check with your human resources director. If you have private dental insurance and you cannot find the benefit in your policy, call your insurance agent to inquire.

Many standard dental insurance plans cover dentures. If your dental insurance covers major dental services, then there is a good chance that your dentures will be covered by the plan. Another term to look for on your dental insurance policy is prosthetics, since dentures are considered oral prosthetics.

If you have coverage for dentures, the amount of your benefit will also vary by the type of plan you have. The most common dental insurance that covers dentures will pay 50% of the dentures and have some type of maximum payout that renews every five years or so.

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Dentures Covered by Dental Plans

Unlike dental insurance, dental plans do not provide dental procedure benefits. Instead, they offer pre-negotiated discounted rates on dental procedures. Depending on your dental plan, you may be able to receive a discount on your dentures or dental implants. Check your dental plan to see what procedures are discounted to determine if you have coverage.

You will only receive the discounted rate if the dentist you choose participates in the network setup by your dental plan. Before committing to getting your dentures, make sure your dentist accepts your dental plan and then confirm the cost of the procedure.

If you need dentures but don’t have insurance, you may be able to postpone getting your dentures until after you sign up for dental insurance or a dental discount plan.
With both dental insurance and dental plans, there is usually a waiting period from the time you sign up for the insurance to the time you can actually receive a benefit that includes dentures. The waiting time can range anywhere from half a year to two years so, investigate your options closely to determine what plan works best in your situation.

For example, if you can find dental insurance that will cover dentures in as little as six months from the time you enroll and you can safely and comfortably wait for six months to get your dentures, then it is probably worth your while to sign up for the dental insurance and wait out the waiting period.

However, if the plan you find has a two year waiting period, then you may not be able to wait that long and you will need to find alternative financing for your dentures. The best thing to do is to shop around for different plans and find out who has what benefits and what the waiting time is for each plan.

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