Is Crown Lengthening Covered By Insurance

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Post on Nov 07, 2024

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Is Crown Lengthening Covered by Dental Insurance? A Comprehensive Guide

Have you been told you need crown lengthening? This procedure can be a lifesaver for teeth that are too short or have gum recession, but it can also be a costly one. So, a natural question arises: is crown lengthening covered by dental insurance?

The short answer is: it depends. There are several factors that influence whether your insurance will cover crown lengthening, and it's important to understand them to make an informed decision about your treatment.

What is Crown Lengthening?

Before diving into insurance coverage, let's clarify what crown lengthening actually is. It's a surgical procedure where a dentist removes gum tissue and sometimes bone to expose more of the tooth structure. This is often necessary when:

• Teeth are too short for crowns or other restorations: If a tooth is too short, it's impossible to place a crown or other restorative material without it being prone to failure.
• There's gum recession: When gums recede, the tooth appears longer and more sensitive. Crown lengthening can expose more of the tooth to allow for proper cleaning and prevent further recession.
• The tooth is severely damaged: In some cases, a damaged tooth can be saved with crown lengthening and a crown.

Factors Affecting Insurance Coverage

1. Your Insurance Plan: Different insurance plans have different coverage limits and exclusions. Some plans cover "routine" dental procedures but not "major" procedures like crown lengthening. Others might have annual maximums for coverage, meaning you could be responsible for exceeding those limits.

2. The Reason for Crown Lengthening: The reason for the procedure is crucial. If it's medically necessary to prevent further damage, infection, or tooth loss, insurance might cover it. However, if it's aesthetically motivated, like improving a smile's appearance, coverage is less likely.

3. Pre-Authorization: Many insurance companies require pre-authorization for procedures like crown lengthening. This means your dentist needs to submit a request to your insurance company before the procedure to determine coverage.

4. The Dentist: Your dentist's relationship with your insurance company might also play a role. Some dentists have better negotiating power with insurance companies, making it easier to secure coverage for patients.

How to Get Coverage:

• Check Your Plan: Review your insurance plan's details carefully. Look for specific coverage for periodontics, gum surgery, or crown lengthening.
• Ask Your Dentist: Speak to your dentist about their experience with insurance claims for this procedure. They can help you understand your options and any pre-authorization requirements.
• Get a Pre-Authorization: If needed, request a pre-authorization from your insurance company before scheduling the procedure. This can avoid surprises with your bill.

Alternatives to Crown Lengthening:

If your insurance doesn't cover crown lengthening, your dentist might recommend alternatives like:

• Gum Grafting: This procedure involves transplanting gum tissue from another area of the mouth to cover exposed roots.
• Crowns on Implants: If the tooth is too damaged or the gum recession is extensive, an implant might be a better option.

The Bottom Line:

While crown lengthening can be costly, it's essential to understand the reasons for the procedure, your insurance coverage, and your options. By doing so, you can make informed decisions about your treatment plan and manage costs effectively.