Which dental treatments does health insurance cover, at a glance?
Health insurance applies to treatment that cures disease and restores function, while improving appearance or choosing a better material is not covered by insurance. I've organized this around the questions I get most often in the treatment room.
| Treatment | Eligibility and conditions | Notes |
|---|---|---|
| Scaling | Age 19 and over, once a year (January to December) | Tartar removal as part of gum treatment is separate |
| Gum treatment | When gum disease is diagnosed | Root planing, periodontal curettage, etc. |
| Cavity fillings | Amalgam, glass ionomer (GI) | Light-cured composite only for permanent teeth in children aged 12 and under |
| Root canal treatment | Any tooth that needs it | The crown placed afterward is mostly not covered |
| Extraction | Routine extractions, including impacted wisdom teeth | Diagnostic imaging included |
| Sealants | Age 18 and under, cavity-free first and second molars | 10% patient copay |
| Implants | Age 65 and over, 2 in a lifetime | 30% patient copay |
| Dentures | Age 65 and over, once every 7 years | 30% patient copay |
How many times a year does insurance cover scaling?
If you are 19 or older, you can have scaling covered by health insurance once a year, and the year runs from January 1 to December 31. Even if you had it last November, it is covered again from January this year. A second preventive scaling in the same year is not covered by insurance, but tartar removal done as part of gum treatment after a gum disease diagnosis is covered regardless of how many times. I've covered scaling intervals in How often should I get scaling? and when gum treatment is needed in Is scaling enough, or do I need gum treatment too?
Who is eligible for implant and denture coverage?
If you are 65 or older, health insurance covers 2 implants in a lifetime and dentures once every 7 years, with a 30% patient copay. The copay is lower for groups such as near-low-income households.
- Implants: Covered for a jaw that still has some natural teeth, up to 2 in a lifetime for upper and lower jaws combined. Some additional procedures, such as bone grafting, may cost extra as they are not covered by insurance.
- Dentures: Both complete and partial dentures qualify, once every 7 years for each of the upper and lower jaw.
- Coverage applies as soon as you turn 65, so if your birthday is coming up, it can make sense to plan the timing around it.
Once you've used the 2 insured implants, you can't get them again, so it's a good idea to discuss first where to use them.
Up to what age are sealants covered by insurance?
Insurance covers cavity-free permanent molars (first and second molars) for those aged 18 and under, with a 10% patient copay. It's a treatment that prevents cavities by sealing the deep grooves on the chewing surfaces of the molars with a thin layer of resin, and it's best done as early as possible after the permanent molars come in. When it's needed and its limits are covered in Do I really need sealants?
What about treatments not covered by insurance, and private insurance claims?
Treatments for appearance and treatments that involve choosing a material are mostly not covered by insurance. Typical examples are whitening, Brinate and porcelain veneers, orthodontics, adult composite fillings, inlays, and crowns, and implants for those under 65. Private indemnity insurance (silbi) varies by policy, but usually you can claim the patient copay for covered items, while uncovered dental treatment is often not reimbursed except in cases such as injury from an accident. Dental insurance is a separate private product, so you'll need to check the covered items and waiting periods with your insurer.
How we do it at Wonjin Dental
At Wonjin Dental, we provide root canal treatment, extractions, sealants, health-insurance implants, panoramic X-rays, annual scaling, gum treatment (tartar removal, root planing, periodontal curettage), and glass ionomer fillings under health insurance. To help when you're choosing among the parts not covered by insurance, I've also listed the fees for frequently asked uncovered items.
| Item not covered by insurance | Fee |
|---|---|
| Uncovered scaling (after the once-a-year covered one) | ₩60,000 |
| Premolar composite filling / molar composite filling | ₩100,000 / ₩150,000 |
| Ceramic inlay | ₩350,000 |
| Back-tooth zirconia crown | ₩500,000 |
| Osstem implant SA / BA / SOI | ₩300,000 / ₩500,000 / ₩800,000 |
As of September 2026; cosmetic treatments include VAT. A treatment confirmation or general medical certificate for private insurance claims is ₩10,000. See the full fee list for all fees.
Frequently asked questions
Is wisdom tooth extraction covered by insurance?
Yes. Impacted wisdom teeth buried in the gums are also covered by health insurance, and if the roots are close to a nerve, additional diagnostic imaging may be taken. If there is inflammation severe enough that swelling makes it hard to open your mouth, we may first let the inflammation settle and then extract.
Are composite fillings for cavities covered for adults?
Light-cured composite is covered only for permanent teeth in children aged 12 and under; for adults it is not covered by insurance. For adults, amalgam or glass ionomer fillings are covered.
If I have root canal treatment, is the crown covered too?
Root canal treatment is covered, but for adults the crown placed afterward is mostly not covered by insurance. For insured implants for those 65 and over, the crown is included in the insured implant.
