Does Blue Cross Blue Shield pay for crowns?

Asked by: Henri Wilderman  |  Last update: March 23, 2025
Score: 4.9/5 (31 votes)

Dental Insurance Coverage on Crowns Crowns are considered a major restorative service and are classified as Class C Major in your Blue Cross Blue Shield FEP Dental benefits brochure. Discuss with your dentist about sending a treatment plan in for a pre-estimate and call customer service if you have any questions.

Are crowns ever covered by insurance?

Dental insurance does cover crowns, but only when they are medically necessary. The coverage for a crown is usually 50% of the cost of the procedure, with the patient liable for the rest.

Do dentists do payment plans for crowns?

Yes, many dentists offer payment plans to help patients spread the cost of treatment over time. These plans are often interest-free (for a specified period) or have low interest.

What is the most dental insurance will cover?

Understanding Dental Insurance Coverage
  • 100% for preventive care including cleanings, exams, and X-rays.
  • 80% for basic procedures, such as fillings.
  • 50% for major procedures, such as crowns and dentures.

What is not covered by dental insurance?

Common exclusions are aesthetic services such as teeth whitening and braces (orthodontics). The reason these services aren't covered is because they are more about your appearance than your health.

Blue Cross Dental Coverage for Employees

37 related questions found

Does Blue Cross Blue Shield cover dental?

BCBS FEP Dental offers more benefits that make you smile:

Preventive care is paid in full, including up to three cleanings a year, when you use a dentist in our network. A large nationwide network with over half a million dentists and their locations. No deductible for services like fillings and root canals.

How do I know if my insurance covers dental?

You can see which plans include dental coverage when you compare them. If a health plan includes dental, the premium covers both health and dental coverage. Separate dental plans: In some cases, separate dental plans are offered. You can see them when you shop for plans in the Marketplace.

Does dental insurance cover 100%?

Depending on the plan, comprehensive dental insurance may cover annual checkups and cleanings for you and your family along with other services such as crowns and root canals. However, comprehensive dental plans do not cover 100% of the costs, and there may still be a deductible, copays, and coinsurance.

Why is dental work so expensive even with insurance?

Overhead costs for dental practices, which can account for 60% to 80% of patient charges, include many expenses such as rent, payroll, insurance, taxes, supplies, and advanced technology. The repayment of student loans from dental schools also plays a role in the overall costs.

What happens if I can't afford a crown?

If you can't afford a crown, it's wise to discuss your financial situation with your dentist. They may be able to work with you to find alternative treatment options or recommend resources for financial assistance, such as dental schools or clinics that offer reduced-cost services.

How to get insurance to pay for crowns?

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.

Why do dentist charge so much for crowns?

Dental crowns are an expensive investment due to the intricate process involved, such as the materials used, laboratory fees, and the dentist's expertise required to ensure a perfect fit and long-lasting results. Rest assured, the quality and durability of dental crowns justify their cost in the long run.

Why won't my insurance cover my crown?

Most crowns are placed due to tooth decay or damage but occasionally one is placed for cosmetic reasons. Most insurance companies will not cover crowns for this reason.

How long does it take insurance to approve a crown?

Major dental work: Major work may have a three-month to one-year waiting period. Major work generally includes crowns, bridges, and dentures.

What makes a dental crown medically necessary?

To Replace A Large Worn-Out/Damaged Filling

If you have an old filling that is more than 2/3 the width of your tooth, or a filling that is damaged or failing, it may be a good idea to replace it with a dental crown. Crowns provide better protection than fillings and can prevent cracking and other similar complications.

What can I do if I cannot afford a root canal?

Public Dental Clinics

Many charge low, fixed prices or sliding fees based on how much you can afford. Most clinics offer exams, cleanings, X-rays, root canals, fillings, crowns, and surgical tooth extractions. Some may have emergency dentists on call.

Is it cheaper to pull a tooth or root canal?

While both procedures aim to address dental health issues, they vary significantly in terms of treatment approach and financial impact. A root canal usually costs between $800 and $1,500 per tooth, whereas a tooth extraction ranges from $135 to $500 or more, depending on complexity.

Do I need a crown after a root canal?

Needing a crown after a root canal depends highly on the location of the tooth in the mouth—teeth towards the back of the mouth like molars and premolars are needed more for chewing, and generally require crowns, where incisors or canines which aren't needed for chewing don't always require crowns.

Does Blue Cross Blue Shield cover root canals?

Both our high-option and standard-option plans offer the comprehensive dental benefits you and your family need, including: in-network covered preventive care paid in full, including up to three cleanings a year. no deductible for in-network services, such as fillings and root canals.

Which insurance has the best dental plan?

Best Dental Insurance Companies for January 2025
  • Best Overall and Best for Braces, Implants, and Older Adults: Delta Dental.
  • Best Overall Cost-to-Value: Physicians Mutual.
  • Best for No Annual Maximum: MetLife.
  • Best for No Waiting Period: Anthem Blue Cross Blue Shield.
  • Best for Customer Satisfaction: DentaQuest.

How often does dental insurance cover crowns?

For example, some plans will only pay for a new dental crown every 5 years or a deep cleaning every 36 months. Some procedures will only be covered once in a lifetime. To avoid an expected dental bill, investigate these restrictions in advance.

How can I fix my teeth if I don't have money?

Community health clinics or dental schools sometimes provide low-cost or free services. Delaying treatment for a severe infection can lead to more serious health risks. Speak to a healthcare professional immediately if you're in pain.

Are crowns covered by medical?

Medi-Cal Dental provides free or low-cost check-ups every six months for members under age 21 and once every 12 months for members over age 21. *Crowns on molars or premolars (back teeth) may be covered in some cases. **Permanent molar sealants are covered for kids and teens up to age 21.

What is the recovery time for a root canal?

Recovery and Outlook

Typically, it takes less than a week to recover from a root canal. Call your healthcare provider if your treated tooth hurts for more than a week.