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Are Dental Implants Covered by Dental Insurance?

Team Dental Implants

Are you considering tooth replacement options? Between dental implants, bridges, and dentures you have a variety of options. If you have a missing tooth or one that is too damaged or decayed to be restored, a dental implant is considered to be the best option for most patients.

Of course the best option comes with the highest price tag, which leads to the question at hand: are dental implants covered by dental insurance?

Sometimes dental insurance covers part of the cost of dental implants. Sometimes part of the cost is covered by medical insurance. It all depends on each individual situation.

What is a dental implant and how does it work?

In order to understand insurance coverage of dental implants, it’s helpful to know what exactly a dental implant is and how it works, especially if you’re considering the procedure for yourself.

A dental implant is an artificial tooth and root system. The artificial root, consisting of a titanium post that resembles a screw, is surgically placed in your jaw bone in place of the old tooth. Titanium, being biocompatible, bonds with the jaw bone to form a secure anchor for the crown. The crown is the part that attaches to the implant root, sits atop the gums, and looks and functions like a natural tooth.

This complete tooth and root replacement system, when placed successfully, can last a lifetime.

How does dental insurance coverage for an implant work?

If you have a dental insurance plan that includes coverage for dental implants, it will usually only cover a portion of the cost. Sometimes it’s only 50% or less of the total. Some dental insurance plans include a deductible that must be met before insurance coverage goes into effect. The only way to know for sure what your dental insurance plan covers is to review your plan benefits or contact your insurance provider directly and ask.

How does medical insurance coverage apply to a dental implant?

In some cases, depending on the reason the implant is needed, medical insurance will cover the implant root portion of the dental implant. Sometimes both medical and dental insurance will pay a portion of the cost of an implant.

Can accident insurance cover a dental implant?

If the reason you need an implant is due to a dental trauma of some kind, such as an accident that knocks out or breaks a tooth that cannot be restored, accident insurance policies sometimes cover a portion of the cost of a dental implant.

How to Make the Most of Your Insurance Coverage

Insurance coverage can make the cost of dental implants more affordable. To make the most of your coverage, consider the following tips:

  • Split the cost between calendar years. If your insurance plan has an annual limit or maximum for coverage, consider splitting the different parts of the dental implant procedure between two calendar years. For example, you could have the implant root placed in December, and the crown attached in January of the next year when your coverage limit renews. Or if you need multiple implants, have the procedures done during different years.
  • Utilize all types of insurance. Dental insurance is just one type of insurance that may cover a portion of your implant. Don’t forget to check your medical insurance as well and accident insurance if you have it. You may also be able to access flex spending and health savings accounts if your plan includes or allows for them.
  • Find out what conditions are required for your plan to cover an implant. Insurance providers often have very specific guidelines for what procedures they will cover and why. Find out what the requirements or conditions are for your plan to go into effect and to provide the greatest possible amount of coverage. Then speak to your dentist or the dental office’s insurance specialist and ask them to work within your insurance parameters.

Dental Associates Will Work With Your Insurance

At Dental Associates of Farmington, CT we will do our best to work with your insurance company to access the most coverage possible for your dental implant procedure and any other services we offer. We can provide you with estimates of the cost of procedures based on your insurance coverage, but the estimate is not a guarantee. You will be responsible for any balance remaining after insurance, but we offer financing options to make your portion affordable. We recommend CareCredit for low or no interest financing.

Call 860-677-8666 today to schedule a consultation or request an appointment. We strive to help you get the most insurance coverage possible for the dental care you need.