Does Dental Insurance Cover Crowns?

Dental insurance covers crowns, but the percentage of the cost covered depends on the type of insurance plan you have. 

If you're considering dental insurance for major dental care like a crown, the good news is that you could be covered. The bad news is that the coverage probably isn't 100%. Does dental insurance cover crowns? That depends on your plan and the reason you're considering a crown. We breakdown the details below. 

What Does Dental Insurance Typically Cover?

Dental insurance coverage is typically divided into preventive care, basic care, and major procedures. Coverage often follows a 100-80-50 three-tier structure, covering 100% of preventive care, 80% of basic procedures like fillings and extractions, and 50% of major procedures like crowns, inlays, dentures, or bridges. Root canals may fall into either the basic or major category, depending on the plan and complexity of the procedure. 

If the crown is needed for medical reasons, it will be covered up to the standard maximum for your dental plan. Crowns are typically not covered by dental insurance for cosmetic reasons. 

Depending on your dental insurance plan, you may have to pay 50% of the cost of a crown. If you plan to sign up for dental insurance now, you must wait anywhere from a few months to a year to cross the waiting period to access coverage. Here’s more on the types of dental coverage you can get.

Preventive Care

Preventive care, as the name implies, includes regular dental care that can help prevent the need for more major dental procedures. Preventive care includes cleanings, X-rays, and sealants.

Basic Procedures 

Basic procedures are common, relatively easy, and low-cost. Examples include fillings, extractions, and periodontal treatment for gum disease. Most insurers cover up to 80% of these procedures. 

Major Procedures

Major procedures are both more expensive and time-intensive. Crowns, bridges, dentures, and implants are common examples of major procedures. Some plans might include orthodontic treatments like traditional metal braces or clear braces under the major procedures category. 

How Do Dental Crowns Work?

A dental crown is a tooth-shaped cap a dentist places over a decayed or broken tooth. It is used to restore a decayed, broken, weak, or worn-down tooth or to cover dental implants or root canal-treated teeth. Crowns can be made from various materials and, if well cared for, typically last between five and 15 years.

• Ceramic: One of the most common materials, it is lower cost and lasts 10 to 15 years. 
• Metal: Gold, silver, or other metal crowns are less common. The metal used determines the structural durability and cost, with gold crowns being the most durable and moderately costly. 
• Porcelain: Used on front teeth because it gives the most natural look. Higher cost than other options. 
• Porcelain-fused-to-metal (PFM): A balance of durability from metal and aesthetics, this is a lower-cost option. 
• Resin: All-resin crowns are used temporarily to protect the tooth or filling until the permanent crown is manufactured and placed.
• Zirconia: A strong new material, long-lasting, looks natural, and is moderately priced. 

How Much Do Dental Crowns Cost Per Tooth?

Dental crowns can cost between $500 and $3,000 per tooth, depending on the material used and the complexity of the crown. Here's a breakdown by common type:

• Porcelain: $800 to $3,000
• Gold: $600 to $2,500. 
• Porcelain-fused-to-metal (PFM): $500 to $1,500
• Zirconia: $800 to $3,000
• E-max crowns: $800 to $3,000

How Much Does a Dental Crown Cost With Insurance?

How much dental crowns cost with insurance depends on the cost of the crown and the level of dental coverage. It also often depends on whether you visit an in-network or out-of-network dental provider. If you pay an average of 50% out of pocket for a crown, you can expect to pay between $250 and $1,500 per crown with insurance. 

Which Types of Dental Plans Cover Crowns?

You can choose from various dental plans, including a dental HMO, PPO, or a dental discount plan. All offer some coverage. Here's what to know. 

Dental HMO

A DHMO is a lower-cost dental plan with no annual maximum coverage benefit. You need to have a primary care dentist and visit that dentist before seeing a specialist. However, any out-of-pocket dental costs, including for crowns, are predetermined and listed in your plan. 

Dental PPO

A DPPO is more flexible than a DHMO. There's a larger network, and you can visit an out-of-network dentist for covered procedures and receive reimbursement. Dental PPOs usually have a deductible or co-pay and annual limit. You don't need to see a primary care dentist and can visit specialists directly. You can check your plan to see how much dental crowns and annual limits are covered. 

Discount or Referral Plan

A dental discount plan or dental savings plan is a lower-cost alternative that gives you predetermined discounts for all dental care. You don't have to pay a monthly premium, but you'll need to pay all costs after the discount out of pocket. Find out more about whether dental discount plans are worth it and compare dental savings plans vs. insurance.

You can also choose a dental referral plan. If your friends or family members refer you to their dentist (and they have a referral program), they could get a discount or coupon — and you could, too. 

Compare the Top Dental Insurance Companies From Benzinga’s Best Providers

If you're ready to switch dental insurance plans, you can get free quotes and compare Benzinga's top providers here. 

What to Do if You Can't Afford a Crown

Dental crown costs are one of the most expensive dental procedures. They can cost between $500 and $3,000 or more without insurance. DHMO and DPPO plans plus dental discount plans can minimize out-of-pocket dental costs to help you access affordable dental care. You might be able to find plans with no waiting period to get coverage immediately.

If you need a crown and don't have insurance, consider these options:

• Payment plans: Some dentists offer payment plans that allow you to spread the payments over a few months to a year or more. 
• Affordable dental financing: Companies offer lower-cost loans to cover dental costs. 
• 0% APR credit card: A 0% APR offer on a new credit card gives you time to pay off the crown cost before the card issuer starts charging interest. To do this without hurting your credit score, aim to pay more than the minimum each month and pay it off before the introductory period ends. Also, check the total available credit and keep the balance below 30%. For a $3,000 crown, you'd need a $10,000 credit limit card to avoid dinging your credit score.   

Find Tips on Dental Crowns

While dental crowns are usually more of a necessity than a want, when you need dental care, you don't want it to jeopardize your financial health. Therefore, getting a reliable dental insurance plan is essential to ensure you can afford the treatment you need. 

To get started, check out average dental costs, compare dental insurance, including full coverage insurance, and then find our review for the best dental insurance providers. You can also find dental plans in the Government's Healthcare Marketplace. You can also purchase a plan individually or get dental insurance for self-employed professionals. 

Frequently Asked Questions