Dental sealants and insurance
The age limits, tooth rules and replacement intervals that decide whether a plan pays for sealants.
Sealants are usually preventive, but they come with more conditions than most preventive services. MetLife's own description is a good example of what to look for.
Typical limits
- An age limit. MetLife says it covers sealants up to age 14 or 19, depending on the plan, after a six-month waiting period.
- Which teeth. MetLife covers first and second permanent molars that have no filling and no decay.
- How often. MetLife pays once per tooth every 60 months.
- Adults. MetLife says its plans typically don't list sealants for adults as a benefit.
Other insurers set their own ages and intervals, so read the patient's limitations for the exact numbers.
Before the visit
- Check the age limit against the patient's age on the visit date.
- Check which teeth qualify and when each was last sealed.
- Quote any tooth the plan won't pay at your full fee.
This is how plans usually work, not how every plan works. The patient's own plan documents and the insurer decide what's paid.
Codes you'll see
CDT is a registered trademark of the American Dental Association. Tabruns is not affiliated with or endorsed by the ADA. The descriptions here are our own plain-English summaries, not the ADA's official wording; use your current CDT manual or practice software for the official code set.
Terms on this page
Sources
Read November 11, 2026. Where a source describes one insurer's plans, we say so.
Get the patient's share in dollars, from the benefits page
Knowing how plans pay for sealants is half the job. Tabruns reads the coverage, deductible, yearly maximum, waiting periods and frequency limits from the insurer's portal and works out what the patient owes. Patient details stay on the office computer.
Not ready? Try the free patient portion calculator.