Does Dental Insurance Cover Teeth Whitening?

Approximately 50% of Americans with private insurance have dental coverage, but it generally does not cover any sort of cosmetic procedures, including teeth whitening. However, some dental plans may include a teeth whitening allowance that covers part of the procedure.

Dental insurance has a typical annual maximum amounting to a median of $1,500. It covers procedures strictly related to health and wellness, and it has a three-tier structure known as 100-80-50. These numbers indicate what percentage of a treatment's cost the insurance company will cover, with each number applying to a different category of treatment.

What Does Dental Insurance Typically Cover?

Dental insurance generally covers three tiers of dental care: preventive care, basic care, and major procedures. Each tier receives a different level of coverage from the insurance company. Whatever the insurance company does not cover must be paid out-of-pocket.

Most plans focus on preventive and basic care, and not all procedures are covered.

Preventive Care

Preventive care includes things like annual cleanings, x-rays, and sealants. This type of care is intended to prevent further dental problems. It is usually 100% covered by an insurance company as long as you use an in-network provider.

Basic Procedures

Basic procedures are intended to address minor dental problems before they become more significant. This can include common interventions such as fillings, extractions, and periodontal treatment for gum disease. An insurance company will typically cover 80% of basic procedures. Depending on your plan, you may have to meet your deductible before coverage will kick in at this level.

Major Procedures

Major procedures are substantial dental work intended to fix significant problems. This includes crowns, bridges, inlays, and dentures. These are typically covered at 50%. Depending on your plan, root canals can fall into either the basic or major category. Whether or not your plan will cover major procedures may depend on whether you have reached your maximum coverage for the year.

Dental Insurance Does Not Cover Cosmetic Procedures

Most dental insurance policies do not cover any costs for cosmetic procedures, such as teeth whitening, tooth shaping, veneers, and gum contouring. Because these procedures are intended to simply improve the look of your teeth, they are not considered medically necessary and must be paid for entirely by the patient.

What Constitutes Cosmetic Dentistry?

Cosmetic dentistry includes procedures that exist for the main purpose of improving the appearance of the patient’s teeth and smile. This includes:

• Whitening treatments
• Veneers
• Bonding
• Straightening procedures, such as Invisalign

These procedures, while widely known and quite popular, tend not to be covered by insurance and require the patient to pay the entire cost.

How Can I Pay for Teeth Whitening?

According to the Consumer Guide to Dentistry, in-office teeth whitening costs, on average, $650, compared with $400 for take-home trays and under $100 for over-the-counter bleaching trays or strips.

The price increases or decreases depending on location and office pricing. As insurance is not involved, there isn’t a usual and customary fee, which is why the pricing varies from office to office.

Because of the high price for cosmetic procedures, patients must research other payment options. While many cosmetic dental or orthodontic offices are familiar with offering their patients different payment plans, patients can also opt to charge their procedures to zero-interest or low-interest health care credit cards.

The Bottom Line

Dental insurance coverage typically falls into three tiers: preventive, basic, and major procedures, all of which are covered at different rates. Cosmetic procedures such as teeth whitening, however, are typically not covered by dental insurance.

Some plans may offer an allowance for cosmetic procedures, which also include things like Invisalign and veneers. In most cases, however, patients will need to pay for teeth whitening out of pocket. At-home whitening treatments can cost $50 or less. Whitening treatments done through a dental practice usually cost several hundred dollars.