Is Teeth Whitening Covered By Insurance?

Hand written by Dr David Chen, an actively practicing dentist and avid writer. #doctorswrite

Teeth whitening is rarely ever covered by dental insurance. In fact, we’ve personally never seen a single insurance plan that had coverage for it at our own dental practice. Nonetheless we’ll keep our fingers crossed and update you if we ever do find this unicorn in the forest.

opalesence whitening gel in a tube

Based on how dental insurance works and what it typically covers, it is highly unlikely that you’ll get coverage for whitening. It is a cosmetic procedure after all and that goes against what your insurance is meant to be for.

What does dental insurance usually cover?

The purpose of dental insurance is to cover preventative care and also necessary treatment.

The preventative care is typically covered at 100% which means there will be no out of pocket cost for you. Procedure which fall under this category are dental cleanings, exams, and x-rays. Basically your insurance will reward you by giving you full coverage if you go to the dentist twice a year for your check ups.

Cigna dental insurance - benefits breakdown by category
Example of Cigna’s copay per category

The necessary treatments are for if a problem occurs with your teeth such as a cavity that develops. Cavities will progress through each sequential stage of decay when left untreated.

Treatment tends to be less complex and less expensive when you treat them promptly. However if you leave it untreated and let the problem fester, treatment will grow in complexity as well as cost.

Usually for the earlier stages of tooth decay, only fillings are necessary. Dental fillings fall under the basic category and insurance typically covers around 80% of the procedure. That leaves a 20% copay which you are responsible for.

Small cavities that are left unattended will progress to big ones and you may need a root canal if that happens. Even worse is if the tooth can’t be saved and it needs to be extracted and replaced by an implant. These procedures fall under the major category and insurance coverage drops to 50% That means you’re now responsible for half of the cost.

In case you didn’t notice, we’ll point out an important observation. That is dental insurance rewards those who go to the dentist regularly. However if you’ve been naughty, avoiding the dentist, and letting your problems grow, your insurance punishes you by decreasing the coverage percent. That is clearly observable by how preventative has 100% coverage but major is down to 50%.

Teeth whitening is a cosmetic procedure

Whitening your teeth is neither a preventative, basic, nor major procedure because it is a cosmetic one. That means it does not fall under any of the “covered” categories. For that reason, none of the whitening procedures have any coverage.

Therefore if you were hoping that your in-office whitening such as ZOOM or KoR would have any coverage, you’re out of luck. You will be fully responsible for 100% of the cost if you were to get it done.

Kor Whitening take home kit

This also applies to over the counter products. That means you can’t use your dental insurance to purchase whitening strips, pens, LED lights, nor trays. You will once again be responsible for the full cost of the OTC products.

Why are cosmetic procedures not covered?

Please remember what the purpose of dental insurance is. It is there to help you pay for treatment if something happens to your teeth.

There is absolutely nothing wrong with yellow teeth. They still function normally because you can eat, chew, and speak with them just fine. It does not decrease the quality of your life by any means. Overall, yellow teeth are still considered healthy.

The only reason you want them whitened is because you don’t like their color. Aside from their appearance, there is nothing about them that bothers you nor prevents you from functioning.

Basically your dental insurance will not cover it because there is nothing wrong with your teeth.

It makes sense if you compare it to your car insurance. Only accidents or damages to your car will be covered. If you ask your car insurance for a new paint job and nothing is wrong with the car, they won’t cover a single dime. The same exact concept applies to your teeth and trying to get them less discolored.

Cost of teeth whitening with no insurance

Since there is practically no insurance coverage for whitening your teeth, you should expect to bear the full brunt of the cost. Of course the pricing will vary greatly depending on where you live because the area’s cost of living has a big influence on the cost.

The price for teeth whitening with no insurance is anywhere from $262-$1180 for an in-office session. These numbers were from the American Dental Association survey of national fees.

  • The average for the 10% percentile was $262
  • The average for the 90% percentile was $1180
  • The national average was $594.24

These numbers were based on all of the dentists who responded to the survey. It is certainly not all inclusive of every dental office in the country but it gives you a general idea of the cost.

Can it cost less?

The fees for the whitening procedure are set by your dentist. If they want to charge less, they have the ability to do so.

If you look around we’re sure you can probably find something for less than what we’re listing above. If finances are very tough for you, you can always look at OTC options such as whitening strips.

Can it cost more?

Of course it can cost more than even our highest price that is listed above. If you go to a very luxurious and high end office such as ones that cater to high profile clients like celebrities, you can expect to spend more.

Not that it would whiten your teeth more effectively. Although you most likely would get superb customer service and be pampered the entire time that you’re getting them whitened.

Takeaway

Your insurance will most likely not cover any portion of your teeth whitening because it is a cosmetic procedure. Insurances will often cover treatment for teeth problems but having yellow teeth is not a problem. They are still healthy because they have full function.

Therefore if you’re looking to get your teeth whitened at the dentist, you should expect to pay the sticker price in full.

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