When it comes to dental care, crowns are often recommended for a variety of reasons, including protecting a weakened tooth, restoring a damaged tooth, or improving the appearance of a tooth. However, the cost of a crown can vary greatly depending on several factors, including the type of crown, location, and the specific dental insurance plan you have. For those who have Delta Dental insurance, understanding how much a crown will cost and how it is covered by your insurance plan is crucial. In this article, we will explore the factors influencing the cost of a crown with Delta Dental, as well as provide a breakdown of the pricing and coverage details.
What Is A Dental Crown?
A dental crown is a cap that covers a damaged or decayed tooth, restoring its shape, size, and function. Crowns are typically made from various materials, including porcelain, ceramic, metal, or a combination of materials. They are used to provide structural support to teeth that have been weakened by decay or injury, and they also improve the aesthetics of a smile.
Crowns can be recommended for various reasons:
To protect a tooth that is weakened by decay or a large filling.
To restore a tooth that has been broken or severely worn down.
To improve the appearance of a discolored or misshapen tooth.
To hold a dental bridge in place or cover a dental implant.
Factors Influencing the Cost of a Dental Crown
The cost of a dental crown can vary depending on several factors, including:
Type of Crown: Crowns are made from different materials, and the material you choose can significantly affect the cost.
For example:
Porcelain or Ceramic Crowns: These are often the most expensive option, as they are aesthetically pleasing and can mimic the appearance of natural teeth.
Metal Crowns: These are usually more affordable but less commonly used for front teeth because of their appearance.
However, they are incredibly durable and are often used for back teeth.
Porcelain-Fused-to-Metal Crowns: These offer a balance between durability and aesthetics but are generally more expensive than metal crowns alone.
Location: The cost of a crown can vary by geographic location. Dental procedures tend to be more expensive in urban areas or regions with a higher cost of living.
Dentist’s Experience: The experience and expertise of your dentist can also influence the cost. Highly skilled or specialist dentists may charge more for their services.
Complexity of the Procedure: If additional procedures are required (e.g., root canals or impressions), the cost of the crown will increase.
Insurance Coverage: Dental insurance can greatly reduce the out-of-pocket costs for a crown, but the level of coverage depends on your specific insurance plan.
How Much Does A Crown Cost with Delta Dental?
The cost of a crown with Delta Dental varies depending on the factors mentioned earlier, but generally, you can expect the following price ranges for crowns:
Porcelain Crowns: Typically cost between $1,000 to $2,500 per crown without insurance. With Delta Dental PPO insurance, you may be responsible for 20% to 50% of this amount, depending on your plan’s coverage.
Porcelain-Fused-to-Metal Crowns: These generally cost between $1,000 and $2,200. With insurance, your out-of-pocket cost could range from $200 to $1,000, depending on your plan’s coverage.
Metal Crowns: These are usually the least expensive option, with prices ranging from $800 to $2,000. Your out-of-pocket cost may be lower with Delta Dental insurance, especially if you have a PPO plan.
It’s important to remember that the total cost of a crown will also include any other necessary treatments, such as exams, X-rays, and preparation for the crown. These additional costs can increase the total amount you will pay out-of-pocket.
Delta Dental Insurance Plans and Crown Coverage
Delta Dental is one of the largest dental insurance providers in the United States, offering a range of dental plans with varying levels of coverage. The coverage for dental crowns depends on the type of Delta Dental plan you have. Delta Dental offers two main types of plans: PPO (Preferred Provider Organization) and DHMO (Dental Health Maintenance Organization).
PPO Plans
With a Delta Dental PPO plan, you have the flexibility to see any dentist, though you will pay less if you choose a dentist who is in the Delta Dental network. PPO plans generally provide more coverage for dental procedures, including crowns, compared to DHMO plans.
The coverage for crowns under a PPO plan typically works as follows:
Preventive Care: Many PPO plans offer full coverage for preventive services, such as cleanings and exams, but crowns are usually classified as major restorative services, meaning they are subject to a deductible and co-payment.
Deductible: Most PPO plans require you to meet a deductible before coverage for crowns begins. This deductible can vary depending on your specific plan.
Co-insurance: After the deductible is met, PPO plans typically cover a percentage of the cost of the crown, with the patient being responsible for the remaining balance. For example, Delta Dental PPO plans often cover 50-80% of the cost of a crown, depending on the specifics of your plan.
Annual Maximums: PPO plans usually have an annual maximum limit for coverage. This means there is a cap on how much the insurance will pay per year for dental care. Once this maximum is reached, you will be responsible for paying the full cost of any additional dental work, including crowns.
DHMO Plans
Delta Dental DHMO plans tend to be more affordable with lower premiums, but they offer less flexibility in choosing a dentist. Under a DHMO plan, you must choose a primary care dentist who will coordinate your care, and you will need a referral for any specialist procedures.
The coverage for crowns under a DHMO plan generally works as follows:
Lower Out-of-Pocket Costs: DHMO plans often have lower co-payments for dental procedures, including crowns, compared to PPO plans. In some cases, crowns may be fully covered with a minimal co-payment.
No Deductible: DHMO plans usually do not have a deductible, meaning that you won’t need to meet a specific out-of-pocket amount before your insurance coverage kicks in.
Limited Network: Since DHMO plans require you to see a dentist within the network, this may limit your options for choosing a dentist who performs crown procedures.
How to Maximize Your Delta Dental Coverage
To make the most of your Delta Dental insurance and minimize your out-of-pocket costs for a crown, consider the following tips:
Choose an In-Network Dentist: If you have a PPO plan, choosing a dentist within the Delta Dental network can help reduce your costs, as in-network providers have agreed to lower fees.
Check Your Annual Maximum: Be aware of your plan’s annual maximum and make sure you plan your treatments accordingly to avoid unexpected out-of-pocket expenses.
Request a Pre-Treatment Estimate: Before undergoing any dental procedures, including crowns, ask your dentist to submit a pre-treatment estimate to Delta Dental. This will give you an idea of how much your insurance will cover and what you will need to pay.
Ask About Payment Plans: If you are concerned about paying for your crown, ask your dentist if they offer payment plans or financing options to make the procedure more affordable.
Conclusion
The cost of a dental crown with Delta Dental varies depending on your insurance plan, the type of crown, and other factors such as your location and the dentist you choose. PPO plans typically offer more flexibility and coverage, while DHMO plans may have lower out-of-pocket costs but fewer choices for providers. By understanding the details of your Delta Dental plan, you can make informed decisions and reduce the financial burden of dental crowns.
