Which Insurance Covers Dental Implants – Health insurance and dental coverage can be confusing, especially when it comes to covering certain dental procedures like dental implants. Many of our patients ask us if their dental insurance covers dental implants, and the answer is that it depends on your insurance and the type of implant treatment you receive. Dr. Mark Sowell of Sensational Smiles in Plano, TX will work with you and your insurance company to create a treatment plan that fits your needs and budget.
Many insurance companies consider dental implants to be a purely cosmetic procedure, and therefore not medically necessary. Most dental insurance plans, as a rule, do not cover cosmetic procedures because they are not considered medically necessary. However, anyone who is missing teeth knows that having them in place is vital to your oral health.
Which Insurance Covers Dental Implants
Medical and dental coverage may be required to cover your dental implant procedure, depending on why you need them. Review your insurance policy to determine if dental implants are covered in the coverages you were given when you started the policy. Before getting any procedure, it’s important to ask your insurance provider specific questions to make sure there are no surprises:
Dental Implant Dentist
The staff at your dentist’s office will be able to work directly with the insurance company to determine your coverage based on the treatment plan.
To find out if your insurance covers implants, it is important to know the different parts of the treatment and how much oral preparation is required. The amount of coverage also depends on whether you are getting a full arch of teeth replaced or just replacing one or two missing teeth.
Tooth Extraction: Depending on whether you are already missing a tooth or if the tooth needs to be extracted, this procedure will be part of your dental implant treatment. Most insurance companies cover most or all tooth extractions.
Bone grafting: Some patients need to strengthen their underlying spine before the implant procedure to ensure the implant stays in place. This part of the procedure may not be covered, despite being a critical step in the implant procedure.
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Placing the implant: The implant placement procedure is considered a “major” dental procedure. Don’t worry about using the word “major,” though—it’s a term used by insurance companies that doesn’t always reflect the severity of the treatment. Some plans cover up to 50 percent of major procedures.
Placing the artificial tooth: The artificial tooth – a crown – which is mounted on top of the implant gives the appearance and function of a natural tooth. This part of the process is also considered “big”. Some plans consider this the same as crowning a natural tooth and may cover more of the cost, so check directly with your insurance company.
We understand that working with insurance and a budget can be confusing. The Sensational Smiles staff works with you, your dentist, and your insurance company to offer you the best treatment based on your needs and budget—and a long-lasting smile. Schedule your free consultation with Dr. Sowell online or call (972) 382-6855 today. Short answer is – yes. Some insurance plans cover portions of dental implants. However, it’s important to understand what type of treatment you need and what your plan will pay for before moving forward.
Dental implants are artificial tooth roots made of titanium alloy. The shape is like a screw, and the implant is placed in your spine to connect it to your natural bone. Once the connection is created, the implant becomes a strong base to support one or more artificial teeth, called crowns.
Everything You Need To Know About Dental Implants
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The full answer depends on the specifics of your individual plan. There are many cost factors to consider when getting a dental implant, including:
All of these services and items can add to the final cost. Your plan may cover some of the costs, but you may pay out of pocket for what is covered.
Also, if you don’t need dental implants due to an accident, your plan may classify dental implants as a cosmetic procedure and deny coverage.
Types Of Dental Implants And Cost
Offers a wide range of dental plans with varying levels of coverage, many with low monthly premiums. Some of our plans also have no waiting periods, which means you could be covered in about 5 days. To see plans and prices in your area, check out our dental insurance page.
From budget-friendly monthly premiums to low copays for office visits, there’s a dental plan that’s sure to fit your needs. And the financial investment is significant, so finding ways to pay for it is important to the decision. The dreaded question of whether or not dental implants are covered by insurance can be difficult. Interpreting dental insurance benefits is often like navigating a minefield. When trying to find out when and if dental implants are covered by a plan, it can often be confusing even for people who are familiar with their benefits.
Dental insurance is good for covering patients and protecting them from the costs of preventive care like cleanings and x-rays, but that’s about it. Cleaning and maintenance are usually paid for twice a year, along with other procedures such as periodic filling. Dental implants are usually described as “cosmetic” and most insurance plans simply do not pay for cosmetic dentistry.
Most group or employer dental plans are structured to stay affordable and cover the basics. Once dental needs move to high-ticket items such as root canals, periodontal (gum) procedures, dentures, or implants, those costs are usually placed toward the patient’s deductible.
Are Dental Implants Covered By Dental Insurance?
Those shopping for dental insurance are likely to run into what are known as “waiting times”. A waiting period is just what it sounds like and is designed to reduce the insurance company’s costs. Insurers, in order to balance their surplus, require an individual to remain an active member for a certain period of time before opening certain benefits.
So, even when someone finds an affordable plan with a low deductible that covers dental implants, that plan may give them a 6 or 12 month waiting period before those benefits begin. If the missing tooth is causing dental or medical issues – not to mention the appearance of an incomplete smile – that can be a long time to wait.
Teeth become fragile as we age, and many Medicare recipients find themselves in need of reconstructive dental surgery. Medicare, like most major dental plans, does not reimburse the cost of dental implants. Medicare A and Part B only cover dental costs as they relate to pre-op visits for certain surgical procedures.
For any dental benefits, patients must enroll in a Medicare Advantage plan through a private insurance provider. Like most group, individual, or employer dental plans, they may find that their benefits don’t extend much beyond routine and preventive maintenance.
How Much Do Dental Implants Cost In Midtown Nyc?
Here’s the caveat: As with our examples above, patients may be able to find an Advantage plan with dental benefits that include cosmetic procedures like implants. They should expect some wait times though. Also, once they find that Advantage plan that happens to pay for cosmetic dentistry, they also need to find an experienced oral surgeon who accepts that particular insurance. One way to start the search is with our search tool. The Dental Health Association database is populated by dental professionals, including cosmetic specialists, across the country.
As any quick survey will show, dental implants can be very expensive. A dental implant for one tooth usually costs around $5, 000.
Getting a full set of teeth starts at around $8,500, depending on how extensive the tooth loss is. The more significant the loss of tissue and bone around the tooth, the more likely a bone graft will be needed. This just compares the cost and complexity of the procedure itself.
There are simple reasons and explanations for the high cost of dental implants, starting with the supplies themselves. An implant consists of three parts: the crown, the abutment, and the screw or post (which attaches to the thigh bone).
Does Insurance Cover Cosmetic Dentistry
The base of the implant itself is made of expensive titanium. Cheaper products don’t work as well, so there are only a few other options. That cost alone can be as much as $500 per crown. The abutment (the knot-like piece used to attach the crown to the implant) can cost anywhere from $100-200 per crown. If the dentist has to perform a bone graft or implant membrane before the implant itself goes in, that can cost an additional $200.
In addition to nearly $1,000 per tooth in hard supply costs, the dental office must invest in imaging and fabrication equipment that costs hundreds of thousands of dollars. Add to that renewal and access costs for the software, licensing and maintenance of that equipment. Of course, these are all rough estimates, but it at least shows how complex and refined the process is. A dentist, after all, makes a special, normal set of
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