Some people are unpleasantly surprised to find that their dental insurance does not cover dentures. These same insurance companies often consider dentures "cosmetic dentistry," and therefore will not foot the bill for you to have them. Here are three reasons why your dental insurance company may view dentures this way.
You Still Have Many of Your Natural Teeth Left
If you still have several of your natural teeth left, dentures may be considered cosmetic because you still have some teeth left with which to chew. The insurance company looks at the expense of adding fake teeth to your existing real teeth and does not consider it a necessity. Even if you are missing all of your teeth on the top jaw or all of your teeth on your lower jaw, the insurance company might not consider dentures medically necessary.
There Are Several Ways You Can Still Consume Nutrients
The harsher argument of some insurance companies who may deny your claim for the payment of dentures may do so because you can get your nutrition and nutrients in other ways. The basic assumption might be that because you can drink your caloric needs or consume a pulverized or pureed diet that you do not really need teeth. This frequently applies to patients who are already tube-feeders (patients who consume nothing by mouth-NPO, have gastric or nasogastric bypass feeding tubes, etc.), which denies the patient the ability to have as normal an appearance as possible, despite the tube feeding connections.
The Dentures Are Made of a More Expensive Material That the Company Will Not Cover
If your dentist suggests that you should have dentures made of high-grade porcelain because you have TMJ or past signs of bruxism, you may also be denied by the insurance company. Since these higher-grade dentures are made to look very pretty and sparkling, glossy white, they may be considered cosmetic and therefore not covered. You may initially have to pay for your dentures out-of-pocket (very expensive, indeed) and then sue the dental insurance company. Your dentist may be able to provide substantial proof as to why he/she made your dentures from these materials rather than from the traditional polyresins used to make dentures. By proving that they are medically necessary on one or more levels, you may be able to force your dental insurance company to pay for your "cosmetic" dentures, or at least pay you back a fraction of what they cost you.