Restorative (Minor/Major)
Restorative dental care repairs and replaces damaged or missing teeth. It is divided into two categories: minor restorative, which includes fillings and simple repairs, and major restorative, which covers crowns, bridges, dentures, and complex work.
Plans generally cover minor restorative at higher reimbursement rates (around 80 percent) and major restorative at lower rates (around 50 percent). Waiting periods and pre-determination requirements often apply for major treatments.
Example:
If your plan covers 80 percent for minor restorative and you receive a $250 filling, the plan pays $200 and you pay $50.
What to Watch For:
Major restorative work usually requires pre-approval from the insurer. Submit treatment estimates early to confirm coverage before proceeding.
