How Much Does a Crown Cost with Delta Dental?

Navigating dental costs can be confusing, especially when considering procedures like crowns. Wondering, “How Much Does A Crown Cost With Delta Dental?” The cost of a dental crown with Delta Dental insurance can vary significantly based on your specific plan, the type of crown, and where you live. At HOW.EDU.VN, we connect you with experienced doctors who can offer personalized guidance and help you understand your dental insurance coverage, including options for root canal treatment, dental implants, and ensuring optimal oral health.

1. Understanding Dental Crowns: An Overview

Dental crowns are a common and effective restorative dental procedure used to protect, cover, and restore the shape of a tooth when fillings aren’t sufficient. They can be necessary due to tooth decay, fractures, or after a root canal. Understanding the different types of crowns and their associated costs is essential for making informed decisions about your dental care.

1.1. What is a Dental Crown?

A dental crown is a tooth-shaped “cap” that is placed over a damaged or weakened tooth. It encases the entire visible portion of the tooth that lies at and above the gum line. Once cemented into place, the crown effectively becomes the tooth’s new outer surface. Crowns can be made from various materials, each with its own set of advantages and disadvantages.

1.2. Why Might You Need a Dental Crown?

There are several reasons why a dentist might recommend a dental crown:

Protecting a Weakened Tooth: Crowns can protect teeth from fracturing or hold together parts of a cracked tooth.
Restoring a Broken or Worn-Down Tooth: Crowns can restore the shape and function of teeth that have been broken or worn down over time.
Covering a Dental Implant: A crown is used to cap and complete a dental implant, providing a natural-looking tooth replacement.
Holding a Dental Bridge in Place: Crowns can anchor a dental bridge, which fills the gap left by one or more missing teeth.
Covering a Discolored or Poorly Shaped Tooth: Crowns can improve the appearance of teeth that are severely discolored or misshapen.
Protecting a Tooth After Root Canal Treatment: After a root canal, a crown is often necessary to protect the treated tooth from further damage.

1.3. Types of Dental Crowns

The material used to make a dental crown significantly impacts its cost, durability, and aesthetics. Here’s a breakdown of the most common types:

Porcelain Crowns:
- Pros: These crowns offer the most natural appearance and are ideal for front teeth. They closely match the color of surrounding teeth.
- Cons: Porcelain crowns are less durable than metal crowns and can chip or crack.
- Cost: Generally more expensive than metal or porcelain-fused-to-metal crowns.
Porcelain-Fused-to-Metal (PFM) Crowns:
- Pros: These crowns provide a good balance of strength and aesthetics. The metal base provides durability, while the porcelain overlay offers a natural look.
- Cons: The metal base can sometimes show as a dark line near the gum line. The porcelain can also chip or break off the metal.
- Cost: Typically less expensive than all-porcelain crowns but more costly than all-metal crowns.
Gold Alloys:
- Pros: Gold alloy crowns are highly durable and resistant to wear and fracture. They are also biocompatible, meaning they are less likely to cause allergic reactions.
- Cons: The gold color is not aesthetically pleasing for some patients, making them less suitable for front teeth.
- Cost: Can be expensive due to the cost of gold, but their longevity can make them a cost-effective option in the long run.
Base Metal Alloys:
- Pros: These crowns are made from non-noble metals and are very strong and resistant to corrosion. They are also the most affordable type of crown.
- Cons: They may have a metallic taste, and some people may be allergic to the metals used. Their appearance is not as natural-looking as porcelain crowns.
- Cost: The least expensive type of crown.
Zirconia Crowns:
- Pros: Zirconia crowns are incredibly strong and durable, making them suitable for any tooth in the mouth. They also offer a natural appearance, though not as translucent as porcelain.
- Cons: Can be more abrasive to opposing teeth compared to porcelain.
- Cost: Generally comparable to porcelain crowns in cost.
Composite Resin Crowns:
- Pros: These crowns are less expensive than other types and can be matched to the color of your teeth.
- Cons: They are not as durable as porcelain or metal crowns and are more prone to wear and fracture.
- Cost: The most affordable option, but may require more frequent replacement.

1.4. Factors Affecting the Cost of a Dental Crown

Several factors influence the overall cost of a dental crown, including:

Type of Crown Material: As mentioned above, the material used for the crown significantly impacts the cost.
Location of the Tooth: Crowns for front teeth, which require a more aesthetic appearance, may be more expensive than those for back teeth.
Complexity of the Case: If additional procedures like a root canal or extensive preparation are needed, the cost will increase.
Geographic Location: Dental costs vary by region, with urban areas typically having higher prices than rural areas.
Dentist’s Experience and Expertise: Highly experienced dentists may charge more for their services.
Dental Insurance Coverage: The extent of your dental insurance coverage will play a significant role in your out-of-pocket expenses.

2. Delta Dental Insurance Coverage for Crowns

Understanding how Delta Dental insurance covers dental crowns is crucial for estimating your out-of-pocket costs. Delta Dental offers various plans, each with different levels of coverage.

2.1. Types of Delta Dental Plans

Delta Dental offers several types of dental insurance plans, including:

Delta Dental PPO (Preferred Provider Organization):
- Features: This plan allows you to visit any dentist, but you’ll typically pay less when you see a dentist within the Delta Dental PPO network.
- Coverage: Offers a balance between cost savings and flexibility in choosing a dentist.
Delta Dental Premier:
- Features: This plan provides access to a broad network of dentists. While you can visit out-of-network dentists, your costs will be lower when you stay in-network.
- Coverage: Generally offers comprehensive coverage with a wide selection of dentists.
DeltaCare USA (DHMO – Dental Health Maintenance Organization):
- Features: This plan requires you to choose a primary care dentist from the DeltaCare USA network. You must visit your primary care dentist for all your dental needs or get a referral to see a specialist.
- Coverage: Typically has lower premiums and out-of-pocket costs but less flexibility in choosing a dentist.
Delta Dental Individual & Family Plans:
- Features: These plans are designed for individuals and families who do not have dental insurance through an employer.
- Coverage: Coverage levels vary depending on the specific plan chosen, with options for basic, intermediate, and comprehensive coverage.

2.2. How Delta Dental Covers Dental Crowns

Delta Dental typically classifies dental crowns as a major restorative service. This means they are usually covered at a lower percentage than preventive or basic services. Here’s what you can generally expect:

Coverage Percentage: Delta Dental plans often cover 50% to 80% of the cost of dental crowns, after you’ve met your deductible. The exact percentage depends on your specific plan.
Deductibles: You’ll likely need to meet an annual deductible before your Delta Dental coverage kicks in. Deductibles can range from $50 to $200 or more, depending on the plan.
Annual Maximums: Most Delta Dental plans have an annual maximum benefit, which is the total amount the plan will pay for your dental care in a year. This maximum can range from $1,000 to $3,000 or more. Once you reach your annual maximum, you’ll be responsible for 100% of the remaining costs.
Waiting Periods: Some Delta Dental plans may have a waiting period before you’re eligible for major restorative services like crowns. This waiting period can range from 6 to 12 months.
In-Network vs. Out-of-Network: Visiting an in-network dentist will typically result in lower out-of-pocket costs, as these dentists have agreed to contracted rates with Delta Dental. Out-of-network dentists may charge higher fees, and you may be responsible for the difference between the dentist’s fee and Delta Dental’s allowed amount.

2.3. Example Scenario: Crown Cost with Delta Dental

Let’s illustrate how Delta Dental coverage might work with an example:

Procedure: Dental Crown (Porcelain-Fused-to-Metal)
Dentist’s Fee: $1,200
Delta Dental Plan: PPO with 50% coverage for major restorative services
Annual Deductible: $100 (already met)
Annual Maximum: $1,500 (plenty of coverage remaining)

Here’s the breakdown of your out-of-pocket cost:

Delta Dental Pays: 50% of $1,200 = $600
Your Responsibility: $1,200 – $600 = $600

In this scenario, your out-of-pocket cost for the dental crown would be $600.

2.4. How to Verify Your Delta Dental Coverage

To get an accurate estimate of your out-of-pocket costs, it’s essential to verify your Delta Dental coverage details. Here’s how:

Review Your Plan Documents: Your Delta Dental plan documents provide detailed information about your coverage, including coverage percentages, deductibles, annual maximums, and waiting periods.
Contact Delta Dental Directly: Call Delta Dental’s customer service line or visit their website to access your account information. You can ask specific questions about your coverage for dental crowns.
Ask Your Dentist’s Office: Your dentist’s office can submit a pre-treatment estimate to Delta Dental on your behalf. This estimate will outline the expected cost of the procedure and how much Delta Dental is likely to cover.

3. Average Cost of Dental Crowns Without Insurance

If you don’t have dental insurance, the cost of a dental crown can be a significant expense. Understanding the average costs without insurance can help you budget and explore alternative payment options.

3.1. National Average Costs for Different Types of Crowns

Here are the national average costs for different types of dental crowns without insurance:

Porcelain Crowns: $800 – $3,000 per tooth
Porcelain-Fused-to-Metal (PFM) Crowns: $500 – $1,500 per tooth
Gold Alloy Crowns: $600 – $2,500 per tooth
Base Metal Alloy Crowns: $500 – $1,500 per tooth
Zirconia Crowns: $800 – $2,000 per tooth
Composite Resin Crowns: $300 – $1,000 per tooth

These costs can vary depending on your location, the dentist’s fees, and the complexity of your case.

3.2. Regional Cost Variations

Dental costs can vary significantly by region. Here are some examples of how costs might differ:

Urban vs. Rural Areas: Urban areas typically have higher dental costs due to higher overhead and demand.
Coastal vs. Inland States: Coastal states often have higher costs of living, which can translate to higher dental fees.
Northeast vs. Southeast: The Northeast and Mid-Atlantic regions tend to have higher dental costs compared to the Southeast and Midwest.

3.3. Additional Costs to Consider

In addition to the cost of the crown itself, you may encounter other expenses, such as:

Consultation and Examination Fees: The initial consultation and examination can cost between $50 and $200.
X-Rays: X-rays are necessary to assess the condition of the tooth and surrounding structures. They can cost between $25 and $250.
Root Canal Treatment: If the tooth requires a root canal before the crown can be placed, this can add significantly to the cost, ranging from $700 to $2,000 per tooth.
Core Buildup: If the tooth is severely damaged, a core buildup may be needed to provide a stable base for the crown. This can cost between $150 and $500.
Temporary Crown: A temporary crown is often placed while the permanent crown is being fabricated. This can cost between $100 and $300.

4. Strategies to Reduce the Cost of Dental Crowns

Even with Delta Dental insurance, the out-of-pocket cost for a dental crown can be substantial. Here are some strategies to help reduce your expenses:

4.1. Utilize Delta Dental In-Network Dentists

As mentioned earlier, visiting an in-network dentist can significantly lower your costs. In-network dentists have agreed to contracted rates with Delta Dental, which are typically lower than out-of-network fees.

4.2. Explore Payment Plans and Financing Options

Many dental offices offer payment plans that allow you to spread the cost of your treatment over several months. Additionally, you can explore financing options through third-party lenders like CareCredit or LendingClub. These lenders offer low-interest or interest-free financing for healthcare expenses.

4.3. Consider Dental Schools or Community Clinics

Dental schools and community clinics often offer dental services at reduced rates. These facilities are staffed by dental students or recent graduates who are supervised by experienced faculty members. While the treatment may take longer, the cost savings can be significant.

4.4. Look for Discounts and Specials

Some dental offices offer discounts or specials on certain procedures, including dental crowns. Check the websites of local dental practices or inquire about any available promotions.

4.5. Prioritize Preventive Care

Preventive care, such as regular check-ups and cleanings, can help prevent dental problems that may require more extensive and costly treatment in the future. Delta Dental typically covers preventive services at a high percentage, making it a cost-effective way to maintain your oral health.

4.6. Discuss Alternative Treatment Options

In some cases, there may be alternative treatment options that are less expensive than a dental crown. For example, a large filling or an onlay may be sufficient to restore a damaged tooth. Discuss all available options with your dentist to determine the most cost-effective solution for your needs.

5. Understanding Delta Dental’s Cost Estimator Tool

Delta Dental offers a cost estimator tool on their website that can provide you with an estimate of the cost of various dental procedures, including crowns. This tool can be helpful in planning for your dental expenses.

5.1. How to Use the Delta Dental Cost Estimator

To use the Delta Dental cost estimator, follow these steps:

Visit the Delta Dental Website: Go to the Delta Dental website and navigate to the cost estimator tool.
Enter Your Location: Provide your zip code to get cost estimates specific to your geographic area.
Select the Procedure: Choose “Dental Crown” from the list of procedures.
Specify the Crown Type: Select the type of crown you’re interested in (e.g., porcelain, PFM, gold).
View the Estimate: The tool will provide an estimated cost range for the procedure based on your location and the type of crown.

5.2. Limitations of the Cost Estimator

While the Delta Dental cost estimator can be a useful tool, it’s important to understand its limitations:

Estimates Only: The costs provided are estimates only and are not a guarantee of payment or benefits. Your actual cost may be higher or lower for various reasons.
Plan Variations: Estimates may vary depending on your specific Delta Dental plan.
Individual Circumstances: The cost estimator cannot account for your unique dental circumstances or the decisions made by you and your dentist regarding your treatment.
Out-of-Network Costs: Cost estimates for out-of-network dentists are based on submitted claims data and may not reflect the actual charges of a specific dentist.

5.3. Best Practices for Accurate Cost Estimates

To get the most accurate cost estimate, follow these best practices:

Verify Your Coverage: Confirm your Delta Dental coverage details, including coverage percentages, deductibles, and annual maximums.
Contact Your Dentist: Ask your dentist’s office to submit a pre-treatment estimate to Delta Dental on your behalf.
Consider All Costs: Factor in additional costs such as consultation fees, x-rays, and any necessary pre-treatment procedures.
Discuss Payment Options: Inquire about payment plans or financing options offered by your dentist’s office.

6. Long-Term Considerations: Crown Maintenance and Replacement

Dental crowns are durable, but they are not indestructible. Proper maintenance and care are essential to prolong the life of your crown and avoid costly replacements.

6.1. How Long Do Dental Crowns Last?

The lifespan of a dental crown can vary depending on the material used, your oral hygiene habits, and the forces placed on the crown. On average, dental crowns last between 5 and 15 years.

6.2. Tips for Maintaining Your Dental Crowns

To maximize the lifespan of your dental crowns, follow these tips:

Practice Good Oral Hygiene: Brush your teeth at least twice a day and floss daily to remove plaque and bacteria.
Use a Soft-Bristled Toothbrush: Avoid using a hard-bristled toothbrush, as it can damage the crown and surrounding teeth.
Avoid Abrasive Toothpaste: Choose a non-abrasive toothpaste to prevent scratching or damaging the crown.
Limit Sugary and Acidic Foods: Sugary and acidic foods can contribute to tooth decay and damage the crown.
Avoid Hard or Sticky Foods: Chewing on hard or sticky foods can cause the crown to chip, crack, or come loose.
Wear a Mouthguard: If you grind your teeth at night or participate in contact sports, wear a mouthguard to protect your crown.
Schedule Regular Dental Check-Ups: Visit your dentist for regular check-ups and cleanings to monitor the condition of your crown and address any potential problems early on.

6.3. Signs That Your Crown Needs Replacement

Be aware of the following signs that your crown may need to be replaced:

Pain or Sensitivity: Persistent pain or sensitivity around the crown can indicate decay, infection, or a loose crown.
Loose Crown: If the crown feels loose or wobbly, it may need to be re-cemented or replaced.
Chipped or Cracked Crown: A chipped or cracked crown can compromise its structural integrity and may need to be replaced.
Receding Gums: Receding gums around the crown can expose the margin and make it more susceptible to decay.
Dark Line Near the Gum Line: A dark line near the gum line of a PFM crown can indicate that the metal base is becoming visible.

If you experience any of these signs, contact your dentist promptly for an evaluation.

7. Exploring Alternatives to Dental Crowns

While dental crowns are often the best solution for severely damaged or weakened teeth, there are alternative treatment options to consider.

7.1. Dental Fillings

Dental fillings are used to repair small to medium-sized cavities or areas of decay. Fillings are typically made from composite resin, amalgam, or gold. While fillings are less expensive than crowns, they are not suitable for teeth with extensive damage or structural weakness.

7.2. Dental Onlays and Inlays

Dental onlays and inlays are similar to fillings but are used to restore larger areas of damage on the chewing surfaces of teeth. Onlays cover one or more cusps (points) of the tooth, while inlays fit within the cusps. Onlays and inlays are typically made from porcelain or composite resin and offer a more durable and natural-looking alternative to fillings.

7.3. Root Canal Treatment

If the damage to the tooth extends to the pulp (the inner part of the tooth containing nerves and blood vessels), root canal treatment may be necessary. During root canal treatment, the infected pulp is removed, the tooth is cleaned and disinfected, and the tooth is filled and sealed. A crown is often placed on the tooth after root canal treatment to protect it from further damage.

7.4. Tooth Extraction

In some cases, if the tooth is too severely damaged to be restored with a crown or other treatment, tooth extraction may be the only option. After tooth extraction, you can consider tooth replacement options such as dental implants, bridges, or dentures.

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9. Frequently Asked Questions (FAQs) About Dental Crowns and Delta Dental

Here are some frequently asked questions about dental crowns and Delta Dental coverage:

How much does a dental crown cost with Delta Dental insurance?
- The cost of a dental crown with Delta Dental insurance varies depending on your specific plan, the type of crown, and your location. Delta Dental typically covers 50% to 80% of the cost of a dental crown after you’ve met your deductible.
What types of dental crowns are covered by Delta Dental?
- Delta Dental typically covers all types of dental crowns, but the coverage percentage may vary depending on the material used.
Do I need a referral to see a specialist for a dental crown with Delta Dental?
- It depends on your specific Delta Dental plan. Some plans, like DeltaCare USA, require you to choose a primary care dentist and get a referral to see a specialist. Other plans, like Delta Dental PPO, allow you to see any dentist without a referral.
What is the waiting period for dental crowns with Delta Dental?
- Some Delta Dental plans may have a waiting period before you’re eligible for major restorative services like crowns. This waiting period can range from 6 to 12 months.
How can I find a Delta Dental in-network dentist?
- You can find a Delta Dental in-network dentist by visiting the Delta Dental website and using their online provider directory.
Can I use the Delta Dental cost estimator to estimate the cost of a dental crown?
- Yes, Delta Dental offers a cost estimator tool on their website that can provide you with an estimate of the cost of a dental crown in your area. However, keep in mind that the estimate is not a guarantee of payment or benefits.
What should I do if my Delta Dental claim for a dental crown is denied?
- If your Delta Dental claim for a dental crown is denied, you can appeal the decision by following the instructions provided in the denial letter. You may need to provide additional documentation or information to support your claim.
Are there any alternatives to dental crowns that Delta Dental covers?
- Delta Dental may cover alternative treatments to dental crowns, such as fillings, onlays, or inlays, depending on your specific plan and the extent of the damage to your tooth.
How often should I replace my dental crown?
- Dental crowns typically last between 5 and 15 years. If you experience any problems with your crown, such as pain, sensitivity, or looseness, contact your dentist promptly for an evaluation.
Does Delta Dental cover temporary crowns?
- Yes, Delta Dental typically covers temporary crowns that are placed while your permanent crown is being fabricated.

10. Call to Action: Get Expert Dental Advice Today

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