Unfortunately, delta dental does NOT cover teeth whitening and that includes in office treatment as well as take home kits. That means there is 0% coverage for it and you’re expected to pay for the whole treatment on your own dime.
However, we wish to emphasize that this doesn’t make delta dental a bad insurance because we’ve never seen any dental insurance cover it. That means Aetna, Cigna, Guardian, Metlife, and etc also do NOT cover teeth bleaching.
We will explain why this cosmetic procedure isn’t really covered in the dental industry. Although we should start with what the dental billing code for this procedure is and show you proof of zero coverage.
Dental code for whitening
The ADA dental code for billing out teeth whitening is D9972. Technically that is only to be used for professional in office whitening with your dentist but most offices will use it for take home kits as well. There is a separate code for the at home kits, D9975 but since most insurances deny it or don’t recognize it, no one really bothers.
Reasons to whiten teeth:
- Improve your smile by brightening them.
- American culture favors white teeth over yellow teeth.
- Improves the confidence of your smile.
In office whitening involves a single bleaching session at your dentist’s office. It utilizes a very high concentration of hydrogen peroxide and requires a gum barrier. The barrier is to protect the gingiva from irritation and becoming bleached. It is the fastest way to whiten your teeth.
Professional take home kits involve making a customized whitening tray that fits your mouth. The gel provided by your dentist is also of a higher concentration than OTC products. It’ll usually come with a desensitizing agent to help lessen the discomfort.
Delta dental coverage for teeth whitening
On average, the coverage for teeth whitening with delta dental insurance is 0% which means there is no coverage for this treatment at all. In other words, you’ll be responsible for paying the entire treatment cost on your own with no help from your insurance.
Below is an example of a typical benefits breakdown for this procedure from one of our patients. It shows as you guessed 0% coverage which is what we typically see.
Most of the time whenever, we search for benefits for procedure code D9972, the above is what comes back. It literally says, “This procedure is not a benefit of most delta dental plans. The fee is the patient’s responsibility.”
In summary, do not expect any coverage for whitening treatments if you have delta dental or any other dental insurance for that matter. We’ve never seen a single dental insurance have teeth bleaching coverage!
Cost of teeth whitening with delta dental
The average cost of teeth whitening is $594.24 with delta dental and that is with zero coverage. Since it doesn’t cover the procedure, the average cost would be what your dentist’s private UCR fees would be.
The table below shows the national average as well as the range of fees based on the ADA survey of fees. These numbers are based on dentist offices who responded to the survey so it is not 100% inclusive of every office in the US.
| Cost | |
|---|---|
| Average cost | $594.24 |
| 10th percentile cost | $262 |
| 90th percentile cost | $1180 |
The average fee of $594.24 is a rough estimate because it can be significantly more than the listed 90th percentile cost if you go to a super luxurious dental office that caters to celebrities.
Ultimately, what you can expect to pay would be determined by the cost of living in your neighborhood. Are you in a high cost of living area or a low cost of living one? Use your judgement and adjust the figures to your personal situation.
Why don’t insurances cover whitening?
The main reason why dental insurances don’t cover whitening is because its purely a cosmetic procedure. This rule applies to ALL of the dental insurance carriers and is not limited to nor specific to delta dental. All of the carriers seem to share the same treatment philosophy.
The purpose of insurance in general is to fix a problem when something goes wrong. If you don’t like the color of your dentition, there isn’t actually something wrong with it. That tooth is still fully functional because you can eat and speak with it without any problems. The only thing that is wrong with it, is your perception of its color.
Insurances will not pay for procedures and treatments that aren’t “necessary”. This applies to every type of insurance such as health insurance and even auto insurance.
- Does your health insurance pay for your plastic surgery face lift?
- Does your car insurance pay for a new paint job just because you don’t like the color?
The answer is no to the above two questions. Your car insurance will only pay for auto work if you get into an accident. If the car is still functional and otherwise nothing wrong with it, you will not get any help from the insurance. Your dental insurance works in exactly the same way.
Takeaway
We’ve never seen teeth whitening covered by delta dental nor any other dental insurance carrier. It’s gotten to the point where we don’t even bother asking the insurance companies if they have coverage for it because the answer is always no.
We’ve yet to see an approval but if you do manage to get one, please let us know. We’d love to figure out why you have such an amazing insurance. Nonetheless, you should definitely take advantage of it and get it done because your next insurance will most likely not cover it!
Key points:
- Most likely, there will be zero coverage for it.
- The average cost with no coverage is about $600.
- The primary reason for insurances to deny whitening is because it’s a cosmetic treatment that does not improve the function of your teeth.
Even if delta doesn’t cover your cosmetic needs, it doesn’t mean you shouldn’t get it. If you don’t like the color of your teeth then by all means bleach them until you’re happy. Just make sure you don’t overdo it and end up with extreme teeth sensitivity. For that reason, we recommend consulting your dentist prior to using any products.