Are you dreaming of a dazzling smile but dreading the dent in your wallet?
Demystify the perplexing world of dental aesthetics and insurance coverage.
Explore how veneers can transform your teeth and learn about their costs. This guide helps you understand whether insurance policies will save money.
Here is the bottom line. A few lucky patients can use medical or dental insurance to drive veneer costs down considerably. At the same time, the majority will need to find an alternative.
Please read our article to understand how insurance deals with necessary medical and dental treatments compared to cosmetic procedures.
Veneer Costs With Dental Insurance
The cost of veneers with dental insurance usually stays high, from full price to another hefty amount. Also, since few patients are eligible, this option is often not appealing.
Payment plans for dental veneers are the primary way most patients can afford a better smile. Even with dental insurance, you could still face high costs unless your plan has no annual limit.
Dental Coverage
Veneers usually cost full price with dental insurance, as these plans often don’t cover cosmetic work. To get coverage, you must show the treatment is necessary for oral health.
- A cosmetic procedure mainly aims to improve looks, self-esteem, or confidence.
- A necessary dental procedure effectively and appropriately corrects problems with natural teeth.
Cosmetic Veneers
Most people get veneers for these cosmetic reasons and usually pay full price without dental insurance coverage.
- Close diastema or gaps between teeth
- Hide stains resistant to whitening
- Extend short teeth
- Make crooked or uneven teeth appear straight or uniform
Necessary Veneers
Dental veneers can effectively treat bruxism when you grind or clench your jaw too much.
Treating bruxism is often necessary for oral health. Too much wear on the enamel can cause decay, make it hard to chew, and lead to chipped teeth or bite issues.
Ask your dentist to send your insurance company a letter listing your symptoms. This letter needs to clearly state why veneers are a better treatment choice for you than other options, like a crown.
Veneer Repairs
Your dentist takes off some enamel to put in veneers. Because veneers can break down and typically last 10 to 15 years, you might need repairs for your oral health.
For example, we found a group dental insurance plan that doesn’t cover putting in veneers but does pay for fixing them. This plan accepts two American Dental Association (ADA) billing codes.
| ADA Code | Service Description |
|---|---|
| D2910 | Re-cement or re-bond inlay, onlay, veneer, or partial coverage restoration – Limit 1 every 6 months after initial installation |
| D2983 | Veneer Repair necessitated by restorative material failure – Limit 1 every 12 months |
Source: Blue Cross Blue Shield Federal Employee Program
Dental Cost-Sharing
Most dental insurance plans offer limited savings on veneers through shared costs. These savings only apply if your plan covers cosmetic work or you can show the work is needed for oral health.
My insurance plan covers up to $2,500 annually and requires me to pay 40% of in-network costs. Use your numbers in the examples below to determine how much you would pay for treatment necessary for oral health.
Dental Per Tooth
For a single tooth, coinsurance is the main cost factor for veneers since dental insurance deductibles are usually small.
| Veneer Type | Median Price 1 Tooth | After Annual Max | Coinsurance @ 40% | Total Cost |
|---|---|---|---|---|
| Composite* | $900 | $0 | $360 | $360 |
| Porcelain* | $1,500 | $0 | $600 | $600 |
| Lumineers* | $1,300 | $0 | $520 | $520 |
| No-Prep** | $2,000 | $0 | $800 | $800 |
** Source: Mint Dental
The table shows that dental insurance coverage reduces the patient’s cost by 60% of the standard price.
Dental Partial Set
The annual benefit limit is the main factor affecting the cost of partial veneer sets, as the total cost for eight teeth often exceeds this limit.
| Veneer Type | Median Price 8 Teeth | After Annual Maximum | Coinsurance @ 40% | Total Cost |
|---|---|---|---|---|
| Composite | $7,200 | $3,033 | $1,667 | $4,700 |
| Porcelain | $12,000 | $7,833 | $1,667 | $9,500 |
| Lumineers | $10,400 | $6,233 | $1,667 | $7,900 |
| No-Prep | $16,000 | $11,833 | $1,667 | $13,500 |
You can split the treatment into two parts to double the annual maximum. If you treat four teeth in December and the other four in January, you can use two years’ benefits, saving $2,500.
Dental Full Set
Dental insurance’s annual maximum benefit often leads to high out-of-pocket costs for a complete set of veneers, resulting in patients paying nearly the total price for treatment of up to twenty-eight teeth at once.
| Veneer Type | Median Price 28 Teeth | After Annual Maximum | Coinsurance @ 40% | Total Cost |
|---|---|---|---|---|
| Composite | $25,200 | $21,033 | $1,667 | $22,700 |
| Porcelain | $42,000 | $37,833 | $1,667 | $39,500 |
| Lumineers | $36,400 | $32,233 | $1,667 | $33,900 |
| No-Prep | $56,000 | $51,833 | $1,667 | $53,500 |
Dental insurance plans without annual limits significantly reduce the final costs and are available. For example, the Federal Employee Dental and Vision Insurance Program (FEDVIP) includes several options with this coveted feature.
During the open season, sign up for coverage if you have a dental necessity for a complete set of veneers. The following groups are eligible to purchase FEDVIP family coverage:
- Most federal civilian employees
- Annuitants
- Retired uniformed service members
Veneer Costs With Medical Insurance
With medical insurance, dental veneer costs can range from the total retail price to almost nothing. However, although the potential savings are significant, only a few patients will meet the criteria.
Medical Coverage
Dental veneers can be almost free if your medical insurance covers them and your plan does not require coinsurance. Filing a claim is unlikely to succeed, but the savings can be huge if it does.
Health insurance covers medically necessary dental procedures that treat an illness, injury, or symptom. Because the industry considers veneers cosmetic, getting insurance coverage is often problematic.
Your health insurance may cover dental veneers if needed due to another illness that is also covered. For example, your insurance might consider veneers to repair enamel damage from Acid Reflux, Celiac Disease, or Hypoplasia as medically necessary.
Medical Cost-Sharing
Most medical insurance plans have cost-sharing features that can make dental veneers more inexpensive. However, this affordability only applies if you can prove that the veneers are medically necessary, which is rare.
The Affordable Care Act prohibits annual maximum benefits that cap yearly health insurance payouts. However, you might still encounter these cost-sharing features:
- Deductible: the amount you pay out-of-pocket before your insurance contributes.
- Copayment: a fixed amount you pay for a covered service.
- Coinsurance: the share of healthcare costs you pay, usually a percentage.
My plan has a $1,500 deductible and 20% coinsurance. If your plan includes a different deductible and coinsurance rate, use those numbers to calculate your costs for medically necessary treatments in the following three examples.
Medical Per Tooth
Dentists price veneers using a per-tooth formula. In this hypothetical example, we project the out-of-pocket costs after my health insurance covers the medically necessary treatment of one tooth.
| Veneer Type | Median Price | Deductible Applied | Remaining Balance | Coinsurance @ 20% | Total Cost |
|---|---|---|---|---|---|
| Composite | $900 | $900 | $0 | $0 | $900 |
| Porcelain | $1,500 | $1,500 | $0 | $0 | $1,500 |
| Lumineers | $1,300 | $1,300 | $0 | $0 | $1,300 |
| No-Prep | $2,000 | $1,500 | $500 | $100 | $1,600 |
As you can see in this single-tooth illustration, the deductible plays a dominant role in determining out-of-pocket costs.
Medical Partial Set
Dentists are more likely to install a partial set of veneers. In this hypothetical example, we project the out-of-pocket costs after my health insurance covers the medically necessary treatment of eight teeth.
| Veneer Type | Median Price for 8 Teeth | Deductible Applied | Remaining Balance | Coinsurance @ 20% | Total Cost |
|---|---|---|---|---|---|
| Composite | $7,200 | $1,500 | $5,700 | $1,140 | $2,640 |
| Porcelain | $12,000 | $1,500 | $10,500 | $2,100 | $3,600 |
| Lumineers | $10,400 | $1,500 | $8,900 | $1,780 | $3,280 |
| No-Prep | $16,000 | $1,500 | $14,500 | $2,900 | $4,400 |
As you can see in this partial-set example, coinsurance is dominant in determining out-of-pocket costs.
Medical Full-Set 1
Most adults have twenty-eight teeth after removing their third molars. In this hypothetical example, we project the out-of-pocket costs after my health insurance covers the medically necessary installation of a full set of veneers.
| Veneer Type | Median Price for 28 Teeth | Deductible Applied | Remaining Balance | Coinsurance @ 20% | Total Cost |
|---|---|---|---|---|---|
| Composite | $25,200 | $1,500 | $23,700 | $4,740 | $6,240 |
| Porcelain | $42,000 | $1,500 | $40,500 | $8,100 | $9,600 |
| Lumineers | $36,400 | $1,500 | $34,900 | $6,980 | $8,480 |
| No-Prep | $56,000 | $1,500 | $54,500 | $10,900 | $12,400 |
As you can see in this complete set example, a plan with a 20% coinsurance results in considerable savings because the insurance pays 80% of the remaining balance after the deductible.
Medical Full-Set 2
Many patients have medical insurance plans with copayments instead of coinsurance. In this hypothetical example, we project the out-of-pocket costs after a different plan with a $50 copayment covering the medically necessary installation of a full set of veneers.
We assume four trips to the dentist to complete treatment, meaning the patient must make four copayments of $50.
| Veneer Type | Median Price for 28 Teeth | Deductible Applied | 4 Copayments | Total Cost |
|---|---|---|---|---|
| Composite | $25,200 | $1,500 | $200 | $1,700 |
| Porcelain | $42,000 | $1,500 | $200 | $1,700 |
| Lumineers | $36,400 | $1,500 | $200 | $1,700 |
| No-Prep | $56,000 | $1,500 | $200 | $1,700 |
When the copayment is only $50, the patient’s total cost is just a bit more than the deductible. Repeating a small charge four times is considerably less than 20% of a more significant number.
This full-set example shows that if you prove a procedure is needed for health reasons, medical insurance may cover it, and you can save tremendously. Complex tasks often come with substantial rewards.
It also highlights how crucial it is to know your insurance plan details. Whether you have a copayment or coinsurance can dramatically change what you pay out of pocket.
