Picture this: you’re chatting with your dentist when they mention a dental crown for that chipped tooth. Your first thought? How much will this cost on a fixed income. If you’re a senior looking for dental crowns covered by Delta Dental for seniors, you’ve come to the right place.
In the next few minutes, we’ll walk through Delta Dental’s coverage details, how to estimate your out-of-pocket expenses, and tips to maximize your benefits. Let’s dive in, and by the end you’ll feel confident scheduling your crown procedure.
Understand coverage details
Delta Dental offers several plan types, from PPO to Dental HMO and discount plans. Each option has its own network, coverage tiers, and cost-sharing rules.
Plan types and tiers
- PPO plans let you choose in-network or out-of-network dentists, with lower costs for in-network care
- Dental HMO (DHMO) plans have no deductibles and set copays, but you must stay in network
- Discount plans, like Patient Direct, waive waiting periods and give you negotiated fees at time of treatment
Depending on your plan, you might see preventive services covered at 100% in year one, basic services at 80%, and major services (including crowns) at 50%. Some Advantage Plans even increase that major service percentage each year you stay enrolled.
Waiting periods and exceptions
Major services often carry a 6- to 12-month waiting period, though cases vary by plan. Good news—you may qualify for a waiting-period waiver if you had comparable dental coverage in the 30 to 60 days before enrolling. If you need crowns right away, consider a discount plan with no wait time.
Find an in-network dentist
Sticking with an in-network provider ensures you get the steepest discounts on crown procedures. Here’s how to find the right match.
Use the provider locator
Log in to your Delta Dental account and use the online directory to search by zip code, plan type, and provider specialty. You can filter for dentists who perform restorative work, including crowns and bridges.
Benefits of in-network care
- Lower copays and reduced fees for lab work
- No surprise balance bills beyond your share
- Access to Delta Dental tools like the Dental Care Cost Estimator, which projects your crown cost before you sit in the chair
If you’re curious how other insurers compare, check out restorative dentistry covered by Delta Dental, which outlines similar benefits under other major providers.
Estimate crown expenses
Even with insurance, crowns involve some out-of-pocket costs. Here’s how to pinpoint your share.
Cost factors to consider
- Crown material (porcelain, metal, resin)
- Complexity of tooth preparation (root canal, post and core)
- Geographic location and dentist fees
- Whether you choose in-network or out-of-network care
On average, you can pay between $1,100 and $2,000 for a permanent crown without insurance. With Delta Dental’s in-network discounts, you could save 20% or more.
In-network vs out-of-network
| Feature | In-network | Out-of-network |
|---|---|---|
| Dentist fee discounts | 10–50% off | No guaranteed discount |
| Balance billing risk | Low | High |
| Claim submission | Automated | You submit manually |
Getting a pre-treatment estimate
Before any work begins, ask your dentist for a pre-treatment estimate. This document outlines projected fees, covered amounts, and your expected copay. Armed with that info, you can budget and avoid surprises.
Maximize plan benefits
You’ve paid premiums all year—now let’s make the most of them.
Preventive services coverage
Delta Dental often covers two cleanings and exams at 100% annually. Keeping up with preventive care isn’t just about fresh breath—it helps you avoid more extensive crown work later.
Use HSA, FSA, HRA for costs
If you have a health savings account (HSA), flexible spending account (FSA), or health reimbursement arrangement (HRA), you can tap those funds to cover your copay or deductible. Just confirm that your crown procedure qualifies as an eligible expense under IRS rules.
Delta Dental even covers root canal and crown combos under certain plans—check delta dental covered root canal and crown to see if you can stack savings on a single treatment.
Choose crown materials
Crowns come in several materials, each with its own price tag and performance profile.
Porcelain
- Natural tooth color, great for front teeth
- Resistant to staining
- Higher lab costs
Metal and porcelain-fused-to-metal (PFM)
- Exceptional strength, ideal for molars
- PFM blends a metal base with a porcelain overlay
- May show a metal line at the gum
Resin
- Most affordable option
- Less durable, may wear faster
- Typically used as a temporary solution
Pros and cons table
| Material | Cost range* | Durability | Aesthetics |
|---|---|---|---|
| Porcelain | $$$ | High | Excellent |
| PFM | $$ | Very high | Good |
| Resin | $ | Moderate | Fair |
- Relative cost indicators: $ = low, $$$ = high
For more on porcelain options, see porcelain crown replacement covered by delta dental.
Follow treatment steps
The crown process usually spans two visits. Here’s what to expect.
First appointment prep
- Your dentist numbs the area and removes decay or old filling
- They shape (prepare) your tooth to fit the crown
- An impression (digital scan or putty mold) is taken
- A temporary crown is placed while the lab makes your permanent one
This visit runs about 60 to 90 minutes. Bring your insurance card and any rider details for smooth claims.
Temporary crown and care
- Avoid sticky or hard foods that might dislodge the temporary
- Brush gently around the gum line to prevent irritation
- Rinse with warm salt water if you feel sore
Final placement follow-up
At your second visit (often 2–3 weeks later), the temporary comes off and the permanent crown bonds to your tooth. Your dentist checks bite alignment and fit, making adjustments as needed. Schedule a quick follow-up if you feel any discomfort in the days afterward.
Key takeaways
- Delta Dental plans vary—review your PPO, DHMO, or discount option for crown coverage details
- Finding an in-network provider cuts fees and simplifies claims
- Use preventive visits, pre-treatment estimates, and an HSA or FSA to reduce out-of-pocket costs
- Choose crown materials based on durability, appearance, and budget
- The procedure spans two visits: tooth prep with a temporary crown, then permanent placement
Ready to restore your smile without the stress of surprise bills? Book a consultation with your Delta Dental dentist today and enjoy confidence in both coverage and care.
