Is a full lower denture covered by insurance?
Usually yes, as a major service at around 50%, after the deductible and inside the annual maximum. A full lower denture (code D5120) is the removable plate that replaces every tooth on the bottom arch. Plans treat it like the upper one: one per arch every 5 to 10 years, with a waiting period for new members on many plans.
50%
Major, its own clock from the upper
Own 5 to 10 years
Upper and lower run on separate clocks. A new upper last year does not block the lower, but the lower's own last delivery date does.
12 to 36 months
That is the usual reline window (D5751) most plans allow after a lower denture, and never inside the first 6 months.
Implants excluded
Patients who ask about snapping the lower onto implants (D6010) usually find implants are not a covered benefit. Quote that before the question comes up.
1 max for 2 arches
An upper and lower in one year share one annual maximum, and 50% of two dentures usually exceeds it. The check shows what is left before you book the second.
What would a real check show for this patient's D5120?
Pick a sample plan and type your fee. This is the visibility a real-time check gives the desk for every actual patient, in under a second.
Eligibility readout · D5120
Sample- Coverage
- Active, major covered at 50%
- Frequency
- One per arch / 5 years, lower tracked separately
- Patient share
- Type your fee to see it
Estimate from a sample plan. A real check reads the actual plan in under a second.
When D5120 is the right code
- Every lower tooth is missing or being removed first
- Removable plate resting on the lower ridge
- Not attached to or snapped onto implants
- Placed after healing, not on extraction day
Documentation payers expect
Notes listing the missing lower teeth and extraction dates, the delivery date of any earlier lower denture, and a pre-treatment estimate where the plan wants one.
Why lower dentures get denied
What happens after the lower denture
Lower dentures tend to shift more than uppers, so the follow-up comes faster: adjustments (D5411) in the first months that most plans bundle into the denture fee, then a lab reline (D5751) as its own claim once the plan's 12 to 36 month window opens. Many patients then ask about implants to hold it in place (D6010), which most plans exclude. Add an upper made the same year and the annual maximum is gone. Knowing the remaining maximum and the reline window before delivery day keeps those conversations calm.
D5120, quick answers
Does insurance cover a full lower denture?
Most plans cover D5120 as a major service at around 50%, subject to the deductible, the annual maximum and any waiting period.
Is the lower denture on the same clock as the upper?
No. Each arch has its own replacement window, typically 5 to 10 years, counted from that arch's last denture delivery date.
Will the plan pay for implants to hold the lower denture?
Usually not. Implants (D6010) are excluded on many plans, and where they are covered they share the same 50% major percentage and annual maximum.
When can a lower denture be relined on insurance?
Most plans allow a lab reline (D5751) once every 12 to 36 months, and not within the first 6 months after delivery.
Can an upper and a lower be done in the same year?
The plan allows it, but both come out of one annual maximum. Check the remaining maximum before scheduling the second arch.
More questions? Schedule 15 minutes with us and bring your toughest plan.
Every lower denture, checked against the plan before the lab bill.
First month free, then $2.50 a check. No seat fees, no contract.
Book 15 minutes, demo or onboarding
Pick a time, then tell us on the form whether it is a demo or an onboarding call.
CDT is maintained by the American Dental Association. This page is Valian's own plain-English summary for front-desk teams, not official CDT descriptor text, and is not billing or clinical advice. Coverage patterns are common plan behaviors; every plan differs. Verify benefits before treatment.