Dental implants are high-quality replacements for missing or damaged teeth. They are often the top solution for missing teeth because they actually replace the tooth below and above the gumline. The procedure also helps to prevent bone loss and can help maintain the facial structure. There are many types of implants from implant supported dentures to all-on-four. Many patients want to know whether their dental insurance covers these restorations.
Very few dental insurance plans cover the entire implant process from start to finish, but you may receive partial coverage for some of the procedures involved.
Many insurers believe dental implants are cosmetic and reserve coverage for less expensive restorations like bridges and partial dentures. Even bridges and dentures only receive partial coverage in most cases.
This blog will explain which parts of the dental implant process may receive coverage and when your insurer may expect you to pay out of pocket.
Typical Coverage Areas
Following are the major steps in the dental implant procedure and an assessment of whether the insurer may cover each step:
If a damaged tooth is still present at the implant site, the dental insurer may cover the removal procedure in full or in part.
Bone grafts typically do not receive coverage from dental insurers, despite their importance to the process. If you need a bone graft due to lost bone mass in the area where your implant will reside, expect to pay for it out of pocket.
Dental Implant Surgery
Since implant surgery is a major procedure under insurance rules, the insurer may be able to cover up to 50% of the cost. This coverage varies greatly from insurer to insurer, so ensure you fully understand your policy before surgery.
Some dental insurers cover crowns at approximately 50% of the cost. They may not distinguish between a crown placed to alleviate tooth decay and one on top of a new dental implant.
Understanding Your Policy
Before beginning the dental implant process, consult your insurance company to determine your coverage levels for each step. The insurance coordinator at your dental practice will also be able to help you determine whether they can submit an insurance claim for all or part of your dental implant.
Situations Where Medical Insurance Can Help
In certain cases, such as when you have suffered dental trauma due to an accident, your health insurance company may pay part of the cost of dental implants to restore your teeth to their prior condition.
Working With Insurers
Sometimes, receiving dental insurance coverage for an implant procedure can feel like an uphill battle. Ensure you record all your expenses and your dentist’s recommendations to answer the insurer’s questions.
Call Total Dental Care
Dealing with insurance companies and navigating their coverage requirements can be a challenge. Our experienced insurance specialists can help you learn what to expect from your policy and help you maximize your benefits.
Please call our office at 240-813-9111 to speak to our office staff and schedule a dental implant consultation with one of our doctors.