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Medical insurance for dental implants


What Is the Cost of Implant Treatment?

Since dental implant treatment is the only tooth replacement option that preserves bone, the health of adjacent teeth, and the integrity of facial structures, an investment in dental implant treatment is an investment in overall health, appearance and well-being.

There are a number of factors that impact the actual fee for dental implant treatment, including the number and type of dental implants being placed, the number and location of missing teeth, the design of the replacement teeth, and whether any ancillary procedures are required to achieve the desired esthetic and functional result.

Many people assume that there is a set fee for each implant placed. This is somewhat of a misconception, as professional fees are typically calculated based on the amount of the surgical specialist and restorative dentist expect to spend providing treatment, as well as the estimated cost of the dental implants, other implant components. The cost of other materials necessary to complete treatment, such as bone grafting materials, is a consideration when calculating the treatment fee, as is the fee charged by the dental laboratory technician.

Initially, the fee is comparable to other tooth replacement options, or even slightly higher. However, dental implant treatment is much more cost effective than other treatment options, such as bridges, which need to be replaced every 10 years, removable partials and dentures that sometimes last only 5-7 years.

Is Dental Implant Treatment Covered by Dental Insurance?

Individual insurance policies determine the amount of coverage for dental implant treatment, although dental benefits usually have an annual maximum of $1, 000 to $1, 500 per year. Since the amount of coverage is determined strictly by what is spent on the policy, there are many limitations on most plans.

Dental insurance companies design plans to cover routine maintenance, emergencies and basic care. Statistical date is used to determine the most commonly used procedures. The insurance companies determine their own “usual and customary fee” schedule for procedures, based on the cost of the plan. This also dictates the specific restrictions and limitations for each plan. Since most plans are only intended to cover basic care, the annual maximum benefit for most plans is $1, 000-$1, 500 per year.

Many companies exclude dental implants as a covered benefit, although they will pay for the lowest cost alternative treatment option (partials and dentures) and some of the tooth extractions and diagnostic records. Even if an insurance plan includes dental implants as a covered benefit, it is still limited to the policy’s annual maximum.

Does Medical Insurance Cover Implant Treatment?

Medical insurance plans are beginning to cover procedures such as bone grafting, although processing claims for this procedure has become more complicated. There are also some instances when medical insurance coverage is available for people who have medical complications as a result of complete tooth loss. Benefits are solely dependent upon the individual policy.

Injuries related to work and some types of accidents are sometimes covered by medical insurance. There is no Medicare benefit for dental implant treatment. Since coverage is pretty rare, it is probably safe to assume that there is no medical insurance coverage available when calculating the overall out of pocket costs for dental implant treatment.



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