Do You Need Dental Insurance For Implants
You dont have to have dental insurance that covers implants to receive treatment for one or more implants.
But dental insurance with implants coverage can help reduce the cost you pay for the care. Dental coverage can also cover preventive services like cleanings and pay for a percentage of other types of dental care.
Which Dental Plans Cover Implants
Now that you are educated on the basics of implant coverage, its time to start reviewing plans. There are many dental plans whose insurance benefits include implants. The below list provides examples of dental plans covering implants. Please make note that:
- This is not a exhaustive list
- Out-of-pocket costs and waiting periods may apply
- Always review the plan details to make certain implant coverage is still available
- Check to see if there is a waiting period before implant coverage is available for use
One last reminder – some plans listed may not be available in every region of the state in which its offered.
Expected Costs For A Dental Implant
Youll likely have to pay something out of pocket for your dental implants. In general, a dental implant for one tooth could cost between $4,300 to $6,500. That will change based on your insurance coverage, your needs and other factors. To determine the expected costs with dental implant insurance, speak with your clinician and your insurance provider and factor in:
- Your insurances annual maximum
- Coinsurance or copayments
- Your dental implant procedure deductible
Along with those insurance factors, youll have to think about your specific treatment needs. Whether or not you have insurance, these factors also influence the expected costs of a dental implant procedure:
- How many dental implants you need
- The type of dental implants your clinician uses
- How many teeth need to be replaced
- The type of artificial teeth your clinician uses
- The need for procedures, such as an extraction, prior to your implants
- What, if any, alternatives your clinician suggests
- Your location and your clinicians office location
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Dental Implants Have Many Benefits
Missing teeth is not a cosmetic issue. Missing teeth can lead to misalignment in your bite and jaw, making it more difficult to chew properly. Your face can look sunken or drawn if you have missing teeth. A dental implant can replace missing teeth or multiple teeth. There are many advantages to this procedure.
Does Medical Insurance Cover Implants
In some cases medical insurance will cover dental implants, but only the root portion of the implant, not the crown, bridge, or dentures. There must be a medical need for the dental implants, such as replacement for teeth lost due to oral cancer or another medical complication that may have resulted from tooth loss.
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What Percentage Of The Dental Implant Do They Cover
If your insurance provider covers dental implants, they will likely cover only a portion typically 50%. You will be responsible for the remaining cost. At most oral surgery practices, a single dental implant can cost well over a grand, even with 50% coverage. Thankfully, Dr. Puckett doesnt let insurance companies dictate what his patients need, and has a process for dental implant surgery that gets you the same quality, same process and same results, but with $300-$800 savings per dental implant.
How Quickly Can I Get A Replacement Tooth
After a thorough dental exam, Dr. Sheen will help to determine what your best missing tooth treatment option will be. Dr. Sheen offers dental implants in his Annapolis, MD dentist office for one or several missing teeth. After surgery, the dental implant typically requires 3 to 6 months to fully integrate with the jaw bone before we can secure the permanent restoration. Dr. Sheen may be able to provide a temporary crown while the implant heals.
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How Much Can A Dental Implant Cost
Even if your dental insurance does cover some cost for a dental implant, youll likely need to cover some portion of the cost. Out of pocket, one dental implant can cost anywhere from $4,300 to $6,500. Even with insurance, you can still end up spending almost $3000 per dental implant. It is an oral surgery, after all. And what if you need dental bone grafting if your jawbone isnt strong enough to accommodate a dental implant? That can also drive up the cost. If you should choose to do same day dental implants or get zirconia dental implants , this can further affect the cost as well. If you are looking at full mouth reconstruction or need to replace several teeth that are next to each other, you could get a dental implant bridge, which can make the procedure more affordable because it only involves two dental implants but replaces several teeth. However, if you can pull it off, holistic tooth replacement meaning tooth replacement that actually fuses with your body and functions like natural teeth is always your best option, because each tooth socket is important to the health of your jaw and surrounding teeth.
Does Your Provider Carry A Least Expensive Alternative Treatment Clause
A LEAT clause is when your provider requires you to go with the least expensive option, particularly if there is more than one solution to your dental problem. This could limit your options for zirconia dental implants, same day dental implants, or it may force you to consider a dental bridge or even dentures in place of dental implants.
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How To Find Dental Insurance That Covers Implants
If you are wondering how to get dental implants covered by insurance, and what dental insurance plan covers implants, the first steps are easy enough. You can go to Dentalinsurance.com, the online marketplace that lets you search for the best dental insurance plans in your area. Just click the link below and enter your zip code and date of birth to get started.
While you’re browsing the marketplace, you’ll also find short videos with helpful tips for finding the best dental insurance plan for you. Plus, you can call to speak with one of their helpful licensed agents.
What Insurance Covers Dental Implants
Look for dental plans that specify they cover major services, including implants. These can give you the support you need for various procedures and might even help you save up to 50%. Considering how expensive implants can be, you may save hundreds or thousands with a policy that covers them.
Remember, several steps are involved in getting an implant, so you need to think about more than just the cost of the procedure, anesthesia and the implant itself. In addition to exams, you might need X-rays, a bone graft, gum treatment or tooth extraction. If you want to get as much support as possible in most or all of these areas, it’s best to enroll in a comprehensive plan that covers a range of basic and major services. Insurance plans that cover dental implants are essential.
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What Types Of Dental Implants Exist
There are a handful of different types of dental implants. The type your dental professional recommends for you depends on the condition of your mouth and surrounding teeth and overall health:
- Endosteal dental implants are the most common type, where small titanium screws are placed in the jawbone.
- Subperiosteal dental implants are placed under the gums, and are used for patients who do not have a healthy enough jawbone to support the new roots.
- Mini dental implants, also called narrow diameter implants, are smaller than the more common implants and are mostly used to stabilize dentures.
- Immediate load dental implants are also called Teeth in a Day as they involve the placement of a temporary tooth or teeth immediately following the placement of the implants. This is only recommended for patients who have enough natural bone to support immediate pressure on the jawbone.
- All-on-4 is an alternative procedure to a full set of dental implants, where four implants are placed in available bone with special abutments for placing a set of temporary replacement teeth the same day. Once the tissues and bones heal, permanent teeth will replace the temporary set.
Certain procedures may also need to be done prior to placing the dental implants to ensure the replacement roots and teeth are durable, including:
Will My Insurance Cover Dental Implants
Getting clear answers about whats covered by health insurance and dental coverage can be confusing, especially for specialty procedures like dental implants. Patients often ask whether their insurance will cover the cost of dental implants, but it all depends on what insurance you have and what type of implant treatment you receive.
East Lancaster, CA dental provider Smile Dental Group will work with you and your insurance to create a treatment plan that will compliment your needs and your budget.
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When Are Dental Implants Necessary
Dental implants are needed when you have missing teeth that cannot be replaced with traditional bridges, crowns, or dentures.
There are many benefits to dental implants, including:
- Improved speech when helping replace missing teeth
- Better comfort when wearing dentures
- Improved appearance and self-esteem
- Restored ability to eat and chew
- Improved oral health
- Support for facial muscles and surrounding teeth
- Bone loss prevention
Are Dental Implants Worth It
The quality of dental implants is far superior to other tooth replacement options for a variety of reasons:
- Natural function. Once they have fused with the bone in your jaw, dental implants provide a naturally functioning tooth that allows you to chew effectively. You also brush and floss a dental implant just like a natural tooth.
- Natural appearance. A dental implant attaches to your jaw the same way a natural tooth would, and with a porcelain crown it blends in with the rest of your teeth.
- More secure dentures. Traditional dentures can slip out of place when you talk and eat, but implant supported dentures stay put.
- No damage to healthy teeth. A traditional bridge consists of two crowns that fit over your healthy teeth on either side of the missing tooth with an artificial tooth suspended between them. For these crowns to be placed, the healthy teeth must be filed down to make room for the crowns, which causes permanent loss of enamel.And the bite force exerted on the healthy teeth can sometimes cause damage. A dental implant or implant supported bridge allows you to avoid all of that.
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Typical Dental Insurance Coverage And Exclusions
Its crucial to look closely at the fine print of a dental insurance plan and understand whats covered.This will allow you to make a more informed decision about dental implant treatment and your expected out-of-pocket costs related to implants. Learn more about each of the following, and contact your dental insurance company about any of these factors that arent clear:
- Waiting period for specific types of care, including dental implants.
- Percentage limits, such as 50%, of dental implant care.
- Annual or lifetime maximum benefits.
- Higher costs if you can get care outside of your dental plans provider network.
- Plans dont generally cover cosmetic procedures.
- Look for any pre-existing conditions restrictions, such as if your tooth was missing before your dental plan was in place.
- Usual, customary and reasonable fees. If your dental plan determines that implant-related fees are not UCR, they may not cover or reimburse it fully or partially.
Are Dental Implants Covered By Basic Dental Policies
Typically, basic dental policies dont cover dental implant surgeryor any procedures deemed cosmetic. Unfortunately, many basic policies consider dental implants just thatcosmetic. Implants are so much more than cosmetic though. Dental implants save your jawbone and prevent further dental problems due to missing teeth.
You will want to search for a policy that offers a cosmetic dentistry rider to cover implants. Most riders will cover only a portion of the cost of dental implants. Some could be as much as 50%, others as little as 20% or less.
Sometimes, medical insurance policies will cover a portion of dental implant procedures as well. It just depends on your policy. If you dont have dental insurance on your policy, you can purchase a standalone policy. Some discount dental programs offer some assistance for implants.
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Other Ways To Pay For Dental Implants
Dentists understand that funding your new smile can be difficult, which is why many of them offer financing options. Some of them partner with third-party companies like CareCredit that can help you set up a low-to-no interest payment plan. As a more affordable alternative to traditional dental insurance, some dentists have an in-house savings plan. For a flat yearly fee, you can receive FREE preventive care and discounts on other services, including dental implants.
Dental Insurance Plans That Cover Dental Implants:
Looking for a dental insurance package that does cover dental implants? The financial site The Balance recommends:
Best Overall: Delta Dental Insurance
Best for No Waiting Periods: Spirit Dental
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Best for Convenience: Renaissance
Best Group Benefits: Cigna Dental Insurance
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When Are Implants Covered By Insurance
If you currently have a dental and medical policy you should check your coverages to see if cosmetic dentistry is covered. If it does cover dental implants youll want to research the following important factors:
- Annual maximum coverage: Insurance companies usually institute a cap on how much they will pay out in dental care annually. This is called your annual maximum coverageany dental care costs above that are out of your pocket.
- Pre-existing conditions: Most insurance policies dont cover conditions that existed before your policy was active. So, if you get a policy this month, it wont cover a problem that originated before the policy active date. You should check with your provider to see if there are any pre-existing conditions they will cover.
Find What Your Insurance Covers
The type of health insurance you have will determine the extent of dental care which is covered by it. Several insurance providers offer health insurance whose benefits include dental healthcare, but with certain limitations.
On the other hand, buying a comprehensive dental insurance plan is more effective as it offers incredible flexibility and extended coverage.
Some of the most common dental procedures covered by leading health insurance providers include:
- Basic Restorative Care To fit crowns or for fillings
- Preventive Care For routine visits to the dentist and professional dental cleaning services
- Oral Surgery For dental surgical procedures, such as tooth extraction, drainage of bacterial infections, fixing dental implants and tissue biopsy
- Endodontics For root canal procedures
- Orthodontics For fixing retainers, aligners, braces and palatal expanders
- Prosthodontics For installing bridges, dentures and dental implants
- Periodontics For root planing, scaling, periodontal surgery, gum grafting and placement of dental implants that have been certified for implant placements
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Requirements & Leat Clause
There are two main requirements you should consider.
First is the missing tooth clause. This condition states that if the tooth was missing prior to the plan’s effective date, the policy will not pay for any treatment used to replace the missing tooth. This clause is not seen as often anymore, but it does still exist and you should check for it, especially if you have any missing teeth.
The second clause has to do with insurance downgrades and is called the LEAT clause. LEAT stands for Least Expensive Alternative Treatment. In regards to replacing missing teeth – whether by an implant or a dental bridge – the plan could downgrade the treatment to a partial denture in some cases.
For example, let’s say you’re missing #29, but you are also missing #20. Each of these teeth are on the lower arch – one on the left and one on the right. Instead of paying for an implant or bridge on each side, your insurance is going to downgrade to a partial denture since you could have replaced both of those teeth with the denture. This can be a little confusing, but it is common practice across all insurance companies.
Is Paying For Dental Implant Insurance Worth It
Paying for dental insurance with the hope of getting coverage for dental implants can be worth it, but it all depends on your unique situation and how much dental work you need. With annual maximums on policies coming in as low as $1,000 in some cases, its important to make sure you select a dental insurance plan that offers enough coverage to actually help with the cost of dental implants. Many policies cover only a percentage of major services, so youll need to be prepared to pay for the rest of your implant surgery yourself.
Having some coverage is usually better than having none. Plus, dental insurance can kick in to pay for preventive care like cleanings and X-rays, as well as any fillings work you need to be done over the course of the year.
Before you pay for a dental insurance plan, make sure to shop around among plans to find the best deal. You should look for a plan with a high annual maximum coverage amount, low copayments and out-of-pocket costs, and a monthly premium you can afford.
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