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.

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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.

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Example:

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If your plan covers 80 percent for minor restorative and you receive a $250 filling, the plan pays $200 and you pay $50.

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What to Watch For:

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Major restorative work usually requires pre-approval from the insurer. Submit treatment estimates early to confirm coverage before proceeding.