November 28, 2023

What Insurance Covers Dental Implants?

Not all insurance plans cover dental implants, while some partially cover the cost of treatment. Before starting, know the type of treatment you need and what your plan covers. Dental implants consist of titanium posts that replace tooth roots and durable prosthetic crowns that look, feel, and function like natural teeth. We’ll look at what insurance covers dental implants, what it can include, and how to choose the right dental insurance plan.

About Dental Insurance Plans

The coverage can vary considerably from one plan to another. Depending on the plan, it may cover consultations, X-rays, pre-surgical treatments (tooth extractions, bone grafts, etc.), anesthesia, and the replacement crown. If your plan doesn’t cover everything, you’ll have to pay out-of-pocket for some services. Some insurers will only cover dental implants after an accident and not for cosmetic purposes.

Cost of Implants With and Without Dental Insurance

An insurance plan that covers dental implants will pay for specified coverage, minus the deductible, only up to maximum coverage limits. If the plan covers 50% of the treatment and you’ve exceeded your annual deductible, you’ll pay the remaining amount. For example, if a procedure costs $3,000, you’ll only be required to pay $1,500 out-of-pocket. However, there may be additional costs and fees that aren’t covered by insurance.

However, without dental insurance that covers implants, you may pay $3,000 to $6,000 per implant and up to $45,000 or more for a complete arch.1  Different steps of treatment, such as tooth extractions, bone grafts, or a sinus lift, have their own costs.

Insurers That Cover Dental Implants

A few insurance providers cover implants. For a closer look at what insurance covers dental implants, here’s a list of some of them.

  • Humana: Humana offers various dental plans with different levels of coverage. Some feature no waiting periods, so you can get covered in as little as five days after you apply.
  • Cigna: Cigna offers two group plans for employers, which cover implants. A dental discount plan is also available and can help you save at participating providers.
  • Delta Dental: Available nationwide, coverage can be tailored to meet your needs and includes PPO, HMO, and Direct Dental plans. However, the waiting period is often up to 12 months.
  • Denali Dental: Its plans can be tailored to your needs and cover implants; coverage amounts increase annually. However, the coverage limit is $6,000 and is not available in every state.
  • Ameritas: The coverage limit is $2,500 but plans for major procedures are available and there is no waiting period.
  • Aflac: Aflac’s dental insurance covers implants, periodontics, anesthesia, and other services. There’s no waiting period for preventative and basic services.

How to Choose a Dental Insurance Plan

Comparing plans from different providers helps in finding the best dental insurance. When comparing them, you’ll want to consider the following:

  • The overall cost of coverage
  • How much of the implant cost is covered
  • Reimbursement rate for dental implants
  • Pre-existing conditions that exclude you from coverage
  • The policy deductible
  • Maximum coverage amounts
  • Cost of out-of-network care
  • Waiting period for dental implants

Some dental insurance policies have a waiting period for implants, while others don’t. Other plans exclude policyholders from coverage if, for example, a tooth an implant is replacing was extracted before you purchased the plan. To learn whether an insurer covers dental implants and for how much, research coverage options on company websites. Some Medicaid and Medicare Advantage plans include dental insurance; like most plans, they’ll cover implants only if they are medically necessary.

When narrowing down insurance plans, choose one with the following in mind:

  • The type of plan and what it includes
  • The ease of the sign-up process—online applications are the simplest
  • Geographic availability of coverage
  • Whether a plan can be customized based on what you need

What to Do If Your Dental Insurance Doesn’t Cover Implants

If you’re considering dental implants and your insurance doesn’t cover them, or you can’t afford a plan that does, there are options. One is a dental discount plan that provides discounted rates for treatment within a network of dentists. Just present your membership card to participating a dentist for a reduced rate. Or, check your health insurance plan, which may cover dental implants if they’re needed for medical reasons. 

Another option is to negotiate the cost with your dentist. Some dentists and oral surgeons are more willing to negotiate than others, or they may offer a flexible payment plan or in-house financing. They could also refer you to a third-party lender that can provide the funds needed and that you pay back over time.

Learn Your Financing Options at Implants 4 Life

At Implants 4 Life, Dr. E provides high-quality dental implants and in-house lab services. We also offer several financing options to help you afford treatment. You can use cash, credit, or insurance while payment plans and financing from outside lenders are available. To schedule an appointment and learn about your options, our dental implant services, and what insurance covers dental implants, call (818) 495-8983 today.

Source:

https://getimplants4life.com/affordable-dental-implants/ 

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Dr. Ebrahimian and Team

Southern California's Premier Implant Center

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13949 Ventura Blvd., Suite 250
Sherman Oaks, CA 91423
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