Is Dental Bonding Covered by Insurance? How to Use Your Insurance for Dental Bonding
October 17, 2023
Dental bonding is a versatile and popular cosmetic dentistry procedure where a tooth-colored composite resin is applied to repair decayed, chipped, fractured, or discolored teeth. Given its multifunctional nature, many individuals wonder whether dental insurance covers bonding and how they can make the most of their insurance for this procedure.
Unfortunately, insurance coverage for dental bonding can vary quite a bit. But it generally depends on whether the dental bonding is deemed cosmetic or functional. We’ll get into that and more below. This article provides a comprehensive overview of insurance coverage for dental bonding.
When Is Dental Bonding Covered by Insurance?
Dental bonding can serve various purposes, from cosmetic to functional, and insurance coverage often depends on the reason for the procedure.
- Functional or Restorative Bonding: If dental bonding is required to restore a tooth's function, such as filling a cavity or repairing a minor chip that affects chewing, insurance is more likely to cover a portion or the entirety of the cost.
- Cosmetic Bonding: When bonding is purely for cosmetic reasons, such as correcting a gap between teeth or improving a tooth's appearance, many insurance plans may not offer coverage. Cosmetic procedures often fall outside the purview of standard dental insurance.
Using Your Dental Insurance for Bonding:
Finding out if dental bonding is covered by insurance involves a combination of research, communication, and understanding the nuances of dental insurance policies. Here's a step-by-step guide to help you determine if your dental bonding procedure will be covered:
1. Understand the Purpose of Bonding:
Before diving into your insurance policy, know why you need dental bonding. Is it for a chipped tooth, decay, or purely cosmetic reasons? The reason plays a significant role in insurance coverage.
2. Review Your Policy's Summary of Benefits:
- Most dental insurance providers offer a "Summary of Benefits" to policyholders. This document will detail the treatments and procedures covered, along with their extent.
- Look for sections that discuss "restorative procedures," "fillings," or "cosmetic services." Dental bonding might be listed under one of these categories.
3. Contact Your Insurance Provider:
- For a clear and direct answer, call the customer service number on your insurance card.
- Ask them explicitly if dental bonding is covered under your policy and under what circumstances. Make sure to inquire about any deductibles, co-pays, or percentage of coverage related to the procedure.
4. Consult Your Dentist:
- Often, your dentist's office will be familiar with the intricacies of various insurance plans. After evaluating your dental needs, they can advise on the likelihood of insurance coverage.
- Some dental offices can also submit a pre-treatment estimate to your insurance. This procedure means the insurance company will provide a statement on what will be covered before the treatment starts.
5. Use Your Insurance Provider's Online Portal:
- Many insurance companies offer online portals for members. Once logged in, you can often see your coverage specifics, including details on dental bonding.
- Some online tools even allow you to estimate the out-of-pocket costs for various procedures, giving a clearer idea of potential expenses.
6. Check for In-network vs. Out-of-network Providers:
- If your dentist is in-network (part of the insurance company's preferred providers), the chances of having the procedure covered, and at a higher rate, increases. Out-of-network providers may be covered at a lower rate or not at all.
- Consider switching to an in-network dentist for the procedure if it leads to better coverage.
7. Read Policy Exclusions and Limitations:
- Some insurance policies might exclude specific procedures or have limitations. For instance, they might cover bonding for a chipped tooth but not for closing gaps between teeth. Knowing these exclusions can help you manage your expectations.
8. Stay Updated:
- Dental insurance policies can change, especially when you renew. Stay updated on any changes to your policy, particularly if you're planning on having a dental bonding procedure in the future.
While navigating dental insurance can feel overwhelming, understanding your policy and maintaining open communication with both your dentist and insurance provider will simplify the process. With research and proper consultation, you can determine if your dental bonding procedure will be covered, allowing you to plan your treatment and finances effectively.
If Insurance Doesn't Cover Bonding:
- Payment Plans: Many dental practices offer payment plans, enabling patients to spread out the cost of treatment over time, making procedures like bonding more affordable.
- Discount Dental Plans: While not insurance, discount dental plans can offer reduced rates for various treatments, including bonding. These plans involve paying an annual or monthly fee in exchange for discounted dental services.
- Explore Other Financial Avenues: Consider utilizing Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs), which allow individuals to set aside money, pre-tax, for medical and dental expenses.
- Alternative Treatments: If bonding isn't covered and is too costly, discuss with your dentist about other potential treatments that might serve the same purpose and have better insurance coverage.
In conclusion, while dental insurance may cover bonding under specific circumstances, it's essential to be informed and proactive. Familiarize yourself with your policy, maintain open lines of communication with both your insurance provider and dentist, and consider alternative financial solutions if necessary. Being well-prepared can ensure that you receive the dental care you need without undue financial strain.
How SuperBill helps with dental bonding reimbursement
Whether you’re a patient with out-of-network benefits or a dental practice or specialized dental biller, SuperBill may be able to help! SuperBill verifies patients’ dental benefits, then files and tracks their out-of-network claims. We will provide updates on the status of claims at every interval, and do everything in our power to get them reimbursed. We even help with bill negotiation!
You can jump through all the hoops to make sure you get your dental bonding covered by insurance, OR you can let SuperBill for insurance handle it. We have worked with countless dental patients, practices, and billers to take the reimbursement burden off their plates.