What is downgrading I need a filling I prefer white but my insurance will downgrade to silver filling benefit?

Answer 1

The term "downgrading" is not commonly; what you are referring to is the dental insurance policy provision called "LEAT" or "Least Expensive Alternative Treatment." The "white" filling you refer to is a "composite" material which some studies have found may not the most durable--especially for the teeth in the back of your mouth that you use for chewing. Most insurance policies pay for "silver" which are amalgam fillings in back teeth which is the "Least Expensive Alternative Treatment." So if you decide that your preference is "white," rather than denying your claim as that is not the benefit provided in the policy, the insurer applies the "LEAT" provision and pays you (or your dentist) the amount that is allowed for the silver filing. Then you pay the difference in cost between the "silver" filling benefit and the "white" filling as that was your preference. (NOTE: According to a recent study the average cost difference for your "white" filling is 18.6% more than the "silver" filling.) Basically LEAT is a cost saving provision that makes the amounts that insurance pays for certain procedures, like fillings, more predictable and ultimately makes the premiums more affordable. If insurance just paid for everyone's preferences, white fillings, gold fillings, grills, etc. would proliferate, costs would be highter and premiums would go out of sight. Evelyn F. Ireland, CAE

Executive Director

National Association of Dental Plans