Does Your Insurance Cover Bridgework?

Does Your Insurance Cover Bridgework?
Written By
Fraser Sherman
Fraser Sherman
Mar 8, 2013
2 minute read

When teeth fall out, dental bridges fill the gap. Bridges use the teeth on either side of the gap as an anchor for a false tooth in the middle. Installing a bridge is a major dental procedure that runs hundreds of dollars per replacement tooth. Dental insurance policies usually pick up some, but not all, of the cost.

Dental Services

Insurers typically break down dental services into three classes. Preventive services such as checkups and cleanings are 100 percent covered. Fillings and other basic services get 80 percent coverage. With major dental work, such as crowns or bridges, the best you get is usually 50 percent. This is not a universal law: Some insurers set a flat co-pay for bridgework and other procedures. Other factors, such as whether the dentist is in your insurer's list of providers, can affect the price.

Limitations

Like every other kind of insurance, dental comes with a deductible. This is typically an annual amount you pay before the insurance kicks in. Your insurer may pay for preventive services without invoking the deductible, reserving it for more expensive work. If your insurer uses a preferred provider organization, there's typically a maximum limit to your coverage, probably between $500 and $2,000. If your bridgework puts you above the limit, you start shelling out cash.

Provider Network

A PPO plan allows you to visit pretty much any dentist and get coverage. Health maintenance organizations aren't so flexible: they maintain a list of approved providers and you need to find a dentist on the list. An HMO can't stop you from going to a dentist outside the network, but it doesn't have to pay for your procedures. PPOs may cover you, but not as extensively as if you choose a preferred dentist.

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Check First

Bridgework isn't cheap, so do your homework before making the appointment. You should have an information packet from your insurer breaking down how much is covered for which services. If you can't find the paperwork, the information should be available from a helpline or the company's website. You can also ask the company for the names of dentists within the provider network, or ask your current dentist whether she accepts your insurance coverage.

Resources

Fraser Sherman

A Durham, NC resident, Fraser has written about law, starting a business, balancing your budget and fighting evictions, among other legal and financial topics.

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