Major dental procedures include crowns, bridges, dentures, root canals, oral surgery, dental implants, and periodontal surgery. Coverage is typically 50%.
Insurance typically pays 50% of crown costs after deductible. With crowns costing $800-$1,500, insurance may pay $400-$750.
Yes, root canals are covered as major or basic procedures (plan-dependent) typically at 50-80%. Front teeth root canals may be classified differently than molars.
Major dental work typically has 6-12 month waiting periods. Some plans extend this to 24 months for certain procedures like crowns or bridges.
Yes, bridges are typically covered at 50% as major restorative work. Coverage may have frequency limits (one every 5-10 years) and material restrictions.
Dentures are covered as major procedures, typically at 50%. Plans may limit frequency (one set every 5-10 years) and may not cover upgrades like implant-supported dentures.
Oral surgery coverage varies: simple extractions 80% as basic, surgical extractions and wisdom teeth 50-80%, complex procedures 50%.
Some plans limit certain procedures by age: orthodontics (under 19-26), wisdom teeth removal (under 26), and may not cover procedures deemed age-inappropriate.
Yes, splitting treatment across plan years lets you use two annual maximums. Discuss timing with your dentist to maximize benefits.
Commonly excluded major procedures: dental implants, cosmetic work, experimental treatments, and services exceeding frequency limits or deemed unnecessary.