Dental implants are a common and successful method of restoring missing teeth. They provide a more permanent and natural-looking solution than other solutions for missing teeth replacement. Cost is a major concern for many individuals when it comes to dental implants. The question of whether Medicare covers dental implants is a concern for many individuals. However, providing a straightforward answer to “does Medicare cover dental implants?” is not so simple.
In this blog, we’ll delve into the details to help you familiarize yourself with the nuances of Medicare coverage and understand the specific criteria and limitations.
What are Dental Implants?
Dental implants refer to surgically placed artificial tooth roots into the jawbone. The surrounding bone grows as the implant heals over a few months, providing a secure foundation. A metal connector is then attached to the implant to support the replacement teeth, filling the gap left by missing teeth.
How Much Do Dental Implants Cost?
On average, a single dental implant can cost between $2,000 to $3,000 for the implant alone. However, additional expenses for the abutment and crown are not included in this cost. Therefore, the total cost for a single tooth implant can go up to $6,000 or more once these additional expenses are considered.
Does Medicare Cover Dental Implants? – Explained
According to Kaiser Family Foundation, “Approximately 24 million people (nearly half of the medical beneficiaries) aren’t covered under dental coverage. However, this situation may change soon as, Democratic lawmakers have proposed adding dental coverage to Medicare, which does not cover routine dental care, including dental implants.
If passed, this change would benefit the 62.7 million people who rely on Medicare as their primary health coverage, providing much-needed relief for those who cannot afford dental care.
Typically, routine dental care, procedures, and supplies are not covered by Original Medicare, which the federal government oversees. It means that individuals with Medicare coverage are responsible for covering the entire cost of services like cleanings, fillings, extractions, and dentures.
However, Medicare Part A covers certain medically necessary dental services administered during a hospital stay. For example, if you have a sudden injury to your teeth or jaw, Medicare will cover the hospitalization and necessary procedures for medical care and recovery procedures.
How Can I Obtain Medicare Cover for Dental Implants?
While Original Medicare does not cover routine dental care, Medicare Advantage plans often include this benefit. In fact, according to the KFF, a nonprofit health policy organization, almost all Medicare Advantage plans (97%) offer dental benefits, and some may even cover services related to dental implants.
Private, Medicare-approved insurance companies provide these plans and can offer additional benefits beyond what is covered under Part A and Part B. If you are considering dental implants and are interested in a Medicare Advantage plan, carefully comparing plan benefit details is important. Not every plan offers dental coverage, and the specifics and costs of coverage will vary among plans.
Additionally, it’s important to note that while Medicare Advantage plans may cover more than Original Medicare, they may require a higher premium for coverage beyond routine dental care. Furthermore, beneficiaries are typically responsible for approximately 50% of the cost of the implant process, even if they have dental coverage.
What Dental Insurance Options are Available?
There are a few options available for those seeking dental insurance coverage for dental implants:
Private Dental Insurance
Certain private dental insurance plans may offer coverage for dental implants, but they can be costly and may impose waiting periods or other limitations.
Medicare Advantage Plans
These plans, also known as Medicare Part C, are provided by private insurance companies and serve as an alternative to Original Medicare. Some medicare advantage plans may offer coverage for dental implants.
Discount Dental Plans
Discount dental plans may provide reduced rates for dental procedures, including dental implants. However, coverage may be limited and may require the use of specific dentists.
How to Pay for Dental Implants?
If you require dental implants but lack insurance coverage, there are a few options for covering the cost:
Financing
Some dental offices may offer financing options, such as payment plans or credit lines, to help you pay for the implants over time.
Dental Savings Plans
Dental savings plans function as membership programs, providing discounts on dental procedures – including dental implants – for a monthly or annual fee.
Health Savings Accounts (HSAs)
If your health insurance plan has a high deductible, you may qualify for an HSA. These accounts enable you to set aside pre-tax funds for qualified medical expenses, including dental implants.
What Insurance Covers Dental Implants?
At Valley Ridge Dental, we accept nearly all types of private insurance, such as Delta Dental Medicare dental coverage, Aetna Medicare dental coverage, Humana Medicare dental coverage, and many more.
Will Medicare Cover Dental Implants Medications Before or After Implant Surgery?
If you undergo dental surgery in the hospital, Medicare Part A generally covers any medications related to the surgery while hospitalized. However, prescription medication related to dental services is typically not covered under Original Medicare.
Suppose you have a Medicare Part D Prescription Drug Plan or a Medicare Advantage prescription drug plan. Your plan may cover prescription drugs such as antibiotics, pain medication, or other medications your doctor prescribes before and after your dental implant procedure. You can review your plan’s formulary to ensure that the medicines for your dental implant are covered.
Please note that any descriptions of products and services provided on eHealth Insurance’s web pages are not intended to be offers to sell or solicitations for any product or service. The availability of products may vary depending on your location, and all products are subject to relevant laws, rules, and regulations.
Bottomline
The simple answer to ‘does Medicare cover dental implants’ is No, as Original Medicare does not cover dental care. However, some Medicare Advantage plans may offer dental benefits that may cover services related to dental implants. If you require dental implants but lack insurance coverage, or financing, dental savings plans or Health Savings Accounts (HSAs) may help you pay for the implants over time. Valley Ridge Dental provides financing options and senior discounts and accepts all types of insurance. If you’re considering having dental implants, you can count on our implant specialists. Book an appointment today.
