Jane Dotson
Dental insurance is designed to help you offset the cost of dental care and maintain good oral health. Most dental insurance plans cover fillings, which are considered a basic restorative service. However, the extent of coverage varies depending on the type of insurance plan and insurance company. Some plans may cover fillings partially, while others may cover a larger percentage or even the full cost. It's important to carefully review your dental insurance plan to understand what is covered and what costs may be involved.
| Characteristics | Values |
|---|---|
| Dental insurance coverage | Most dental insurance plans cover fillings, but the amount covered varies. Basic dental insurance plans may cover fillings at 80% after the annual deductible is met. |
| Types of fillings covered | Most insurance plans cover amalgam (silver) fillings. Composite (tooth-coloured) fillings may be covered at a lower rate or not at all. |
| Out-of-pocket costs | Even with insurance, you will likely have to pay some fees out-of-pocket for fillings. |
| Frequency of fillings | Some insurance plans may have restrictions on how often a filling can be replaced. |
What You'll Learn
Dental insurance plans
Dental insurance is designed to help you offset the cost of your dental care and to help you maintain good overall oral health. Most insurance companies sell a separate dental insurance policy or dental policy. This is insurance that specifically covers dental work and typically costs extra on top of health insurance.
Dental plans typically fall into one of three categories: employer-based, self-purchased, or “riders” attached to medical insurance policies. Dental insurance plans can also be categorised as indemnity plans and managed-care plans. Indemnity plans, often referred to as "fee-for-service" plans, offer a broad choice of dental care providers and typically involve the policyholder paying upfront and being reimbursed a portion of the cost. Managed-care plans, which include Dental Health Maintenance Organizations (DHMOs) and Preferred Provider Organizations (PPOs), usually limit provider choices to a network of dentists who agree to offer services at lower costs.
The emphasis of dental insurance is on preventive coverage and sharing the costs of other procedures. As such, dental insurance will usually cover:
- 100% of routine preventive and diagnostic care such as cleanings and exams.
- 80% of basic procedures such as fillings, root canals, and tooth extractions.
- 50% of major procedures such as crowns, bridges, and dentures.
Preventive care such as routine cleanings is usually covered without out-of-pocket costs. Dental cleanings (up to 2) are usually covered by your insurance (depending on your annual maximum). Most plans typically cover 80% of the costs for certain procedures, including fillings. This cost applies after the annual deductible is met, which also varies by plan.
What May Not Be Covered
While it differs from plan to plan, some dental insurance may not cover select procedures such as orthodontia or cosmetic procedures like teeth whitening. Some policies don’t cover certain pre-existing conditions such as missing teeth. If you had a condition before you got your dental plan, you may be required to pay treatment costs out-of-pocket.
Additional Plan Information
There are some additional limitations that may apply to your dental insurance:
- Waiting period: This is the period of time before you are eligible to receive benefits for all or certain dental treatments.
- Other restrictions: Your plan may require time limits between services like fillings, crowns, and bridges on the same tooth, or fluoride treatments for children.
- Annual maximum: This is the total amount your dental insurance will pay for your coverage during a 12-month period. For instance, if your annual maximum is $1,500, you pay for all additional costs after your dental insurance has paid $1,500 for your care.
- In-network dentist: Dentists who have agreed to accept pre-established costs for services, saving you money over an out-of-network dentist.
Choosing a Dental Insurance Plan
When selecting a dental insurance plan, it's important to understand the different types available and make an informed decision. Here are some things to consider:
- Whether your dentist and any specialists you may need are in-network
- Total costs for the plan each year, including premiums, co-pays, and deductibles
- Out-of-pocket limit, if any
- Limitations on pre-existing conditions
- Coverage for braces, if needed or anticipated
- Emergency treatment coverage, including treatment if you’re away from home
- Whether you can choose your own dentist
- Who controls treatment decisions -- you and your dentist, or the dental plan
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Composite fillings
However, composite fillings are generally more expensive than amalgam fillings and are occasionally not covered by some insurance plans. They also have a shorter lifespan than amalgam fillings and may need to be replaced more often.
The cost of a composite filling depends on the severity of the problem and can range from $163 to $450.
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Silver fillings
However, one of the disadvantages of amalgam fillings is that they are not natural-looking, especially when the filling is near the front of the mouth. Additionally, dentists may need to remove more tooth structure to place an amalgam filling compared to other types of fillings. Despite safety concerns due to the presence of mercury, amalgam fillings are considered safe by organisations such as the FDA, ADA, and the World Health Organization.
The cost of silver fillings typically ranges from $50 to $200 with insurance, and from $150 without insurance. The exact cost will depend on factors such as the number and size of cavities, the location of the teeth being filled, and any additional treatments required. Most dental insurance plans cover fillings as a basic restorative service, but the extent of coverage can vary. Some plans may cover 80% of the cost of fillings, while others may have different levels of coverage for different types of fillings, such as amalgam or composite fillings.
It is important to note that removing intact amalgam fillings is not recommended, as it can result in unnecessary loss of healthy tooth structure and potential exposure to mercury vapour. If you are considering getting your amalgam fillings replaced, it is crucial to consult with a dental professional to weigh the pros and cons of alternative materials.
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Gold fillings
The cost of gold fillings can range from $250 to $2,000 or more, depending on various factors such as the size of the filling, the location of the damaged tooth, and the market value of gold. Gold fillings are typically more expensive than other filling materials due to the cost of gold as a precious metal. Additionally, the procedure for placing gold fillings typically requires multiple dental visits, which can contribute to the overall cost.
When considering gold fillings, it is important to weigh the benefits against the potential disadvantages. While gold fillings offer superior durability and longevity, they may not be aesthetically pleasing to everyone due to their distinctive gold color. Additionally, gold fillings may require more tooth removal compared to other filling materials, potentially weakening the tooth structure. Furthermore, placing gold fillings next to silver amalgam fillings can sometimes result in galvanic shock, causing an unpleasant electric current in the mouth.
In conclusion, gold fillings are a durable and long-lasting option for dental restorations, but they come with a higher price tag and may not be suitable for everyone. It is essential to consult with a dentist to determine the best treatment option for your specific needs and to review your insurance coverage to understand the extent of financial assistance available for gold fillings.
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Out-of-pocket costs
Silver Amalgam Fillings
Silver amalgam fillings are the most common and affordable type of filling. The cost without insurance typically ranges from $50 to $200 for one or two teeth, and $150 to $400 for three or more teeth. With insurance, these fillings can cost between $50 to $150 per filling.
Composite Resin Fillings
Composite resin fillings are designed to match the colour of your teeth and are less noticeable than silver fillings. Without insurance, they usually cost between $90 to $250 for one or two teeth, and $200 to $550 for three or more teeth. With insurance, you can expect to pay around $191 per filling.
Gold Fillings
Gold fillings are durable and long-lasting but are less common nowadays. Without insurance, gold fillings can cost between $300 to $1,000 for one or two teeth, and $450 to $1,800 for three or more teeth.
Porcelain Fillings
Porcelain fillings, also known as inlays or onlays, are the most expensive option. They require a longer procedure and are made in a lab. Without insurance, porcelain fillings can cost anywhere from $300 to $4,500 per procedure.
Insurance Coverage
Most dental insurance plans cover about 80% of the cost of fillings, but this can vary depending on the plan and the insurance provider. It's important to check with your insurance company to understand the specific coverage and out-of-pocket costs. Additionally, using an in-network dentist may help lower your out-of-pocket costs.
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Frequently asked questions
Most insurance companies sell a separate dental insurance policy that covers dental work. This typically includes regular check-ups, cleanings, fillings, root canals, and sealants. However, different policies cover different types of fillings and filling procedures. For example, some policies may cover silver amalgam fillings but not tinted composite fillings.
There are several types of fillings, including silver (amalgam), gold, and composite resin. Silver fillings are the cheapest option, while gold fillings are one of the most durable types but also the most expensive. Composite resin fillings are popular as they can be matched to the colour of teeth, but they are more expensive than silver fillings.
The cost of fillings varies depending on the type of filling, the number and size of cavities, the location of the tooth, and whether you have insurance. Without insurance, silver fillings can cost upwards of $150, gold fillings between $300 and $1,800, and composite fillings around $250. With insurance, silver fillings can cost between $50 and $200, and composite fillings around $200.
When choosing a dental insurance plan, it's important to consider your specific needs and budget. Factors to consider include whether your dentist is in-network, the total costs of the plan, out-of-pocket limits, coverage for braces, emergency treatment coverage, and whether you can choose your own dentist. It's also important to understand what types of procedures are covered and whether there are any waiting periods or annual maximums.
