What does dental insurance cover?
Most dental plans follow a 100/80/50 pattern — fully covering preventive care, paying a large share of basic work, and a smaller share of major work — but everything is bounded by waiting periods and an annual maximum.
What flips the answer
- Covered when
You're getting preventive or basic care — cleanings, exams, X-rays, and fillings are the most reliably covered services.
- Not covered when
The service is cosmetic (whitening, appearance-only veneers) — most plans exclude it.
- Not covered when
You need major work but haven't cleared the waiting period, or you've hit the annual maximum.
Dental plans typically sort care into three tiers. Preventive services (cleanings, exams, routine X-rays) are usually covered at or near 100% with no waiting period. Basic services (fillings, simple extractions) are covered at a high share. Major services (crowns, bridges, dentures) are covered at a lower share and often after a waiting period.
Two limits shape what you actually collect. There's an annual maximum — a cap on what the plan pays per benefit year — and, for major work, waiting periods before coverage kicks in. Orthodontics, when offered, is a separate benefit with its own lifetime maximum.
Common exclusions include purely cosmetic work (like whitening or veneers for appearance) and, on some plans, a 'missing tooth clause' for teeth lost before enrollment. The exact percentages, caps, and exclusions live in your plan's certificate of coverage — the tiers above are the general pattern, not a guarantee.
That's the general answer. Yours is written in your actual policy.
Drop in your policy or benefits document and get the answer for your exact coverage — with the clause it comes from. Nothing is stored.
Check my policy →