Does Dental Insurance Cover Crowns?

Dental insurance can help you keep your teeth and mouth healthy while reducing the costs of various procedures, from routine care to major treatments. Crowns may be one of the many procedures that dental insurance helps cover. However, different plans offer unique coverage amounts and structures. Let’s dive deeper into how dental insurance and crowns work, along with how much crowns can cost with and without insurance.

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Table of Contents

How dental insurance works and what it covers

Dental insurance is a supplemental insurance policy that helps policyholders pay for dental care costs. Premiums tend to be affordable, although exact rates vary by insurer and policy type.¹ Dental insurance from Aflac can help cover the following types of care:

Preventative care
Basic procedures
Major procedures

How dental crowns work

Dental crowns are custom-made caps designed to permanently replace weak, damaged, or decayed teeth. These devices fit snugly over the target tooth, restoring its appearance and function. They help you eat and speak normally while preventing further damage and decay. Plus, they restore your smile by mimicking natural teeth. Dentists can make crowns with various materials, each offering benefits and considerations:²

Porcelain: These mimic the tooth’s natural look, making them suitable for front teeth. However, they can chip and crack if not careful.
Porcelain-fused-to-metal (PFM): These combine metal’s durability with porcelain’s natural look for a higher price. However, the porcelain can chip away over time and wear down enamel on opposing teeth.
Ceramic: These look more natural than porcelain but are less durable.
Metal: Metal is more durable but doesn’t blend in as well. These may work best for less visible back teeth. Dentists may use gold, palladium, nickel, or chromium to make metal crowns.
Resin: Resin is less expensive than other types but can wear down and fracture. Dentists often use this material for temporary crowns.
Zirconia: Zirconia is a newer, more advanced ceramic. It’s one of the most expensive materials, combining metal’s durability and porcelain’s look with fewer drawbacks than PFM.

The dentist may remove a small amount of enamel during the procedure to ensure proper fit before bonding the crown to the tooth.

Are crowns covered by dental insurance?

Since medically necessary crowns are considered a major restorative procedure, most dental insurance plans cover 50% of the cost.³ Some plans, such as Aflac dental insurance, may offer increasing coverage if you maintain your plan for several years. However, you must also meet your plan’s deductible before coverage starts. Furthermore, you may have to pay the remainder out of pocket if you reach your annual maximum. You may have to pay the total cost out of pocket if you only want a crown for cosmetic reasons.

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Types of dental insurance plans 

Here are three dental plans and details on their coverage for dental crowns:

Preferred provider organization (PPO) plan 

PPO plans tend to cost the most in premiums but maximize flexibility. While they come with a network of dentists, you may get partial coverage for out-of-network providers. Plus, you can seek specialist care directly without a referral from a general dentist.

To cover crowns, you’ll first need to meet your deductible. This is the amount that you’re responsible for before coverage kicks in. You may also have to pay coinsurance, which is a share of the procedure’s cost. After that, the plan offers significant coverage, such as 50% of the cost of the crowns. You must pay extra if you exceed your annual maximum benefit for coverage.

Dental health maintenance organization (DHMO) plan

DHMO plans require you to see in-network dentists to get coverage. Plus, you must get a referral from a general dentist to see a specialist. Therefore, you’ll have to go to an in-network provider to get your crown if you need help with the cost. However, these tend to be more affordable than PPO plans. Most DHMOs don’t have a deductible. Instead, the plan sets predetermined fees for procedures, such as crowns. You can pay that fee, and the insurer will pay the rest.

Discount or referral dental plan

Discount and referral plans are not technically insurance policies. Instead, they are annual memberships offering a network of insurers who agree to provide services at reduced costs to plan members. Therefore, these can simply lower the cost of crowns. However, they don’t come with comprehensive coverage, such as covering the full cost of routine care. This type of plan may work well if you think you’ll only need routine care but want an affordable safety net.

How much crowns cost with and without dental insurance

Crown costs vary widely depending on the provider, materials, and the tooth. However, on average, crowns tend to cost around $1,000 to $1,300 without insurance.² As mentioned earlier, many dental plans cover 50% of the cost of crowns. With insurance, you might pay $500 to $650 after deductibles, copays, or coinsurance. This means you can save hundreds on crowns while maintaining dental coverage for just a few dollars a month.

Get a dental insurance quote

Crowns restore the appearance and function of your teeth but can be expensive when paid out of pocket. The right dental insurance policy can put this treatment within financial reach, helping you get the care you need without breaking the bank.

Aflac offers dental insurance with rates and terms to help suit your dental care needs and budget. Speak with an agent today to learn more and get a quote.

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