Does dental insurance cover gum grafting?
Gum grafting is usually covered when it's a medically necessary periodontal treatment for gum recession or disease — but it falls under the plan's 'major' tier and is excluded when done purely for appearance.
What flips the answer
- Covered when
The graft treats gum recession, root exposure, or periodontal disease, and your plan includes major/periodontal services and you've met the waiting period.
- Not covered when
The procedure is purely cosmetic gum reshaping on healthy tissue.
- Not covered when
You've already used up the annual maximum on other dental work this year.
A gum (gingival) graft is periodontal surgery that adds tissue where the gums have receded, protecting exposed roots and stabilizing teeth. When it treats recession, root exposure, or periodontal disease, dental plans that include major restorative or periodontal services generally cover it.
Coverage is partial and capped. The plan typically pays a percentage of the allowed amount after any waiting period and deductible, with the total limited by your annual maximum — so an involved case across several teeth can outrun the yearly benefit. Some plans also require documentation that the graft is necessary rather than elective.
Grafting done solely to reshape a healthy gumline for looks is treated as cosmetic and excluded. The line between medically necessary periodontal surgery and cosmetic gum contouring is drawn in your plan's covered-services and exclusions list.
That's the general answer. Yours is written in your actual policy.
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