What dental insurance covers: preventive, basic and major care

It depends on the carrier. MetLife lists some root canals as basic care, Cigna lists them as basic restorative care, and Guardian and UnitedHealthcare list root canals among major services. The tier decides your share and whether a waiting period applies, so ask your plan how it classifies the exact code.

Usually as major care. MetLife, Guardian, Cigna and Humana list crowns as major, and Anthem describes them among major procedures at the lowest coinsurance level. That usually means a smaller plan share, a possible waiting period and a draw on the annual maximum. Ask for a written estimate that lists the buildup and any post.

Often as major care, though it varies. MetLife, Guardian, Cigna and Humana list dentures as major. Original Medicare does not cover them, according to the Centers for Medicare and Medicaid Services. Check waiting periods and the annual maximum, and ask whether the plan pays for a reline or a replacement.

Sometimes, and rarely in full. UnitedHealthcare says a basic plan typically will not cover implants and plans with major coverage may pay part. Guardian says a higher-level plan can help. Many plans exclude them or cap them. Ask the plan for its written position on the specific codes before surgery.

Some plans do, and many do not. UnitedHealthcare says some plans cover braces and orthodontic work but most do not. Cigna says plans that cover it may have age limits and annual limits. Look for an orthodontic benefit in the schedule of benefits and read its age limit and lifetime maximum.

Usually not. Delta Dental says whitening is rarely covered by any dental insurance. Anthem says some plans may include whitening or composite fillings, so a few do. Veneers placed for appearance are commonly excluded. A plan may file a restoration for a damaged tooth differently, so ask with the diagnosis in hand.

Anthem and others use it to describe a common coinsurance structure for PPO plans: the plan pays at the highest level for preventive care, a middle level for basic care and the lowest for major care. The actual percentages, the deductible and the annual maximum come from your plan, so confirm them before treatment.

Cigna says most plans limit cleanings to two per calendar year and limit certain X-rays to one every few years. Other carriers describe similar limits, and some plans have age limits. Ask whether periodontal maintenance visits count against the cleaning limit, since that changes how often you can go.

Because it pays a share of the allowed amount, not of the dentist's charge, and only after a deductible, and only up to the annual maximum. An out-of-network dentist may bill the difference. A pretreatment estimate shows what the plan expects to pay, and you can compare it with the office's quote.

Yes, for larger work. Ask the dental office to send the plan a pretreatment estimate, or ask the plan directly for its position on each code. MetLife recommends a pretreatment estimate for larger treatment and says actual payment may vary once annual maximums, deductibles and frequency limits apply.

Frequency limits cap how many times the plan pays for a service in a set period, such as two cleanings a calendar year, according to Cigna. They exist alongside the annual maximum. Ask your plan which services have limits and whether a periodontal maintenance visit counts against the cleaning limit.

Coverage depends on the plan. UnitedHealthcare lists emergency treatment for dental pain among basic services subject to the deductible and coinsurance, and MetLife says network offices give instructions for emergency care at any hour. Your policy defines what counts as an emergency. For trouble breathing or swallowing, call emergency services.