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.

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.

Example:

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

What to Watch For:

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

Related Terms

Reasonable & Customary

Reasonable and customary refers to the typical fee charged for a particular service in your geographic area. Insurers use this standard to determine how much they will reimburse for eligible expenses. If a provider charges more than the reasonable and customary rate, you must pay the difference.

Recall Interval (Dental)

A recall interval specifies how often you can claim preventive dental services such as cleanings and exams. Common intervals are every six or nine months. Insurers use recall intervals to encourage regular maintenance while controlling unnecessary repeat treatments.

Reimbursement / Coinsurance

Reimbursement is the amount an insurance company pays back to the insured person or directly to a healthcare provider for eligible expenses covered under a policy. Coinsurance is the portion of the cost that the insurer agrees to pay, expressed as a percentage, with the remaining balance paid by the insured. Together, these terms describe how healthcare costs are shared between you and your insurer once a claim is approved.

Reinstating a Policy

Reinstating a policy refers to the process of restoring insurance coverage after it has lapsed due to non-payment of premiums or other policy violations. When a policy is reinstated, it becomes active again with the same or similar terms as before the lapse, subject to approval by the insurer. Most insurers allow reinstatement within a specific timeframe, typically up to one year after the lapse date, although the exact period depends on the policy type and the insurer’s rules.

Renewal Date

The renewal date is the day on which an insurance policy is scheduled to be reviewed and extended for another term. It marks the end of the current coverage period and the start of a new one, during which updated premiums, benefits, or policy terms may take effect. Renewal dates ensure that insurance coverage continues seamlessly as long as the policyholder meets all conditions, such as paying premiums and maintaining eligibility.

Have questions about your insurance coverage?

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