Do Medicare Advantage Plans Cover Dental Implants
While not all Medicare Advantage plans cover dental implants, some do!
To find out if your current MA plan or a plan youâre considering offers dental implant coverage, you will need to look at the specifics of your plan.
Not all MA plans are the same, even within the same company. If you don’t know where to begin, ! Here at Medicare Allies, our services cost nothing to you, and we can find plans in your county.
Dental Implants: Where To Go Next
If youre considering dental implants, you have many options to choose between for coverage. The main thing to keep in mind is that you will not be covered by Original Medicare, and will have to find an alternative way to get your procedure covered. Although Medicare may cover parts of your procedure, this is an outlier condition that you shouldnt expect.
Whether you end up choosing a Medicare Advantage plan, a private dental plan, or simply an alternative to dental implants that you can pay for out of pocket, there are a lot of options on the table. Because of this, its important to understand your options, priorities, and financial resources before you start looking for plans, so that you find an option that works perfectly for you.
How Much Do Dental Implants Typically Cost
The cost of each dental implant can vary, depending on the persons needs. If you have a tooth thats gone missing or needs to be replaced, the cost can range from about $3,200-$7,000.
According to Real Self, the average cost of dental implants is $7,375. This amount is based on the average price their community members paid.
While a single implant for a replacement tooth can cost between $1,000 $3,000, related fees or the need to replace multiple missing teeth with implants can drive your total cost up to $29,500.
Don’t Miss: Does Medicare Cover Dental In Ny
Where Do I Look In My Plan For Dental Implant Information
Dental implants are usually done by prosthodontists or oral surgeons. That means this service can show up in your insurance information as prosthodontics or oral surgery.
Prosthodontics is the practice of removing and replacing damaged teeth. It also deals with crowns, dentures, and bridges.
Dental implant information is also frequently listed separately on your explanation of benefits. To make sure implants are covered, you need to thoroughly review your coverage for one of these three options to make sure you donât miss something that could cost you money down the line.
Which Medicare Advantage Plans Cover Dental Implants
PayingForSeniorCare is committed to providing information, resources, and services free ofcharge to consumers that help seniors and their families make better decisions about senior living and care.
We may receive business-to-business compensation from senior care partnerships and/or website advertising. This compensation doesnt dictate our research and editorial content, nor how we manage our consumerreviews program. PayingForSeniorCare independently researches the products and services that oureditorial team suggests for readers. Advertising and partnerships can impact how and where products,services, and providers are shown on our website, including the order in which they appear, but theydont determine which services or products get assessed by our team, nor which consumer reviews getpublished or declined.
PayingForSeniorCare.com awards some companies with badges and awards based on our editorial judgment. We dont receive compensationfor these badges/awards: a service provider or product owner may not purchase the award designation orbadge.
Learn moreabout our mission and how we are able to provide content and services to consumers free of charge.
You May Like: Will Medicare Pay For Drug Rehab
When Can Aetna Medicare Advantage Plans Pay For Dental Implants
One major factor that can determine if your dental implants are covered by an Aetna Medicare Advantage plan is whether the implants are considered cosmetic or medically necessary. If cosmetic, some plans might not cover the implants. But if the dental implants are considered medically necessary, they may be covered.
Some plans may include an annual allowance that you can use for things like dental implants. If your Aetna Medicare plan has this type of annual allowance, you may be able to apply for reimbursement for your dental implants.
Depending on what type of Medicare Advantage plan you have, it might have a network of participating dentists. You may be able to pay less in out-of-pocket costs by visiting these providers, if network restrictions apply to your dental implants coverage.
Frequently Asked Questions About Paying For Dental Implants
How Much do dental implants cost?
The cost of dental implants is one of the most frequent questions our patients ask. The cost of your dental implant procedure depends on the number of missing teeth, your oral health, and other factors. We always provide two to three treatment plans to choose from and help you pick the best option that fits both your needs and your budget.
We also help you find the payment and financing options that will work best for you.
Does my dental insurance cover dental implants?
Some types of health and dental insurance plans may cover part of the costs of your dental implants. How much is covered depends on several factors, including why you need the implant. If your tooth was lost due to an injury or accident, or if the tooth loss is causing additional medical issues, your insurance may be more likely to cover some of the fees.
The best way to find out if your insurance will cover the cost of your dental implants is to contact our office in Vista and our friendly team will assist you.
Does Medicare cover dental implants?
Medicare covers medically necessary oral surgery related to dental implants. Medicare for dental implants often covers between 30% to 50% of oral surgery procedures for dental implant treatment if its medically necessary.
What if you find that my Medicare plan excludes dental services?
Also Check: Is The Cologuard Test Covered By Medicare
Does Medicare Advantage Cover Dental Implants The Bottom Line
Whether or not your Medicare Advantage plan covers dental implants depends on the plan you selected. To find out which Medicare Advantage companies offer coverage for dental implants, you will need to take a look at some of the plans available to you and compare them on rates and coverage.
To get started looking for a Medicare Advantage plan that covers dental implants today enter your ZIP code below.
Learn More About Your Dental Coverage Options
Its a good idea to continue to explore your options for dental care and coverage, especially when you are in retirement on Medicare. There are a wide variety of dental plans and budget options for most people such as lower cost discount dental plans and full coverage dental insurance plans. You can check out additional articles to learn more about senior dental care. At EasyDentalQuotes, were available to help you find the best dental coverage to meet your needs.
Find Senior dental insurance plans
Don’t Miss: Does Medicare Pay For Mens Diapers
Does Medicare Pay For Implants
While Medicare offers broad coverage for a large portion of your medical care needs, you might be contemplating whether they cover dental procedures such as implants? All things considered, implants include surgery, anesthesia, and other medical things, so shouldnt they be included in your Medicare coverage?
Maybe one might say, however it may not be that simple.
This is what you want to be aware of Medicare dental implants, and what Medicare might cover for you.
Learn about dental implants At the point when a whole tooth is either lost or never grew in the first place, your dentist might replace it with an implant, which is a false tooth that works very much like a real one. It has a root that is set into the jawbone a lot like the original and might be used as an alternative to dentures, or if bridgework is definitely not a practical choice for the maintenance of broken or lost teeth.
How much do dental implants cost?However a ton of factors weigh into the expense of dental implants, you can regularly hope to pay between $3,200 $6,000 per implanted tooth. However, its challenging to give a specific number.
The justification behind such a wide expense range is because of factors like the health and condition of the jawbone and gums, and the degree of prep important to install the implant.
Does Medicare cover dental implants?While Medicare might pay for medical treatments related to implants, it wont pay for the implants themselves.
How Can Seniors Obtain Additional Coverage Fordental Implants
Many seniors who need dental implants can expect to pay significantly for prosthodontic services, in addition to premiums, coinsurance, copays, annual caps and other out-of-pocket costs required by their Medicare Advantage plan. They may want to consider purchasing a stand-alone dental insurance or discount plan if that is financially feasible. Veterans and other populations may be eligible for free or low-cost dental implants through various charities and programs.
Also Check: Is Eliquis Covered Under Medicare
How To Compare Medicare Plans
When deciding which type of Medicare plan is best for you, first consider what exactly it is youre looking for. If you supplement your Medicare with a private plan or insurance through your employer, you may not need additional coverage such as vision and dental. You may be looking just to fill in the financial holes in your Medicare coverage. If this is the case, then a Medicare supplement plan like Meigap is the best route for you.
Medigap pays for:
Remember, original Medicare pays only 80% of your medical costs. If you feel youre going to be using your Medicare extensively, youre going to want to bridge the financial gap.
On the other hand, if its more coverage youre looking for, like dental, then a Medicare Advantage plan is the best way to go. Medicare Advantage plans are sold by private insurers, and you can shop around for the best price and plans. Medicare Advantage offers all the same coverage as original Medicare and then some. Having Medicare Advantage does not mean giving up your original Medicare benefits, it means adding to them.
Medicare Advantage plans include:
- Prescription drugs
Medicare Advantage plans cap annual out-of-pocket expenses at $7,550 for in-network services and $11,300 for out-of-network.
Choosing The Right Option For You
While Original Medicare doesnt usually cover dental implants or other dental treatments, you still have the option of finding coverage. With alternatives like Medicaid, Medicare Advantage, and discount dental cards, its almost impossible to not find dental coverage. Above all, remember to carefully weigh the pros and cons of each alternative to find the most suitable one for you.
You May Like: Can I Switch Medicare Supplement Plans
How Can You Get Coverage Of Dental Implants
There are thousands of Medicare Advantage plans offered across the U.S. by dozens of different insurance companies. And some of these plans may cover dental implants.
Contact a licensed insurance agent to find a Medicare Advantage plan available where you live that includes coverage of dental implants. It can be especially helpful to work with an agent who is licensed to sell plans on behalf of multiple different carriers, as that may allow you to cast the widest net in your search for dental implant coverage.
If you are outside of your Initial Enrollment Period , you may have to wait until the Annual Enrollment Period that takes place from Oct. 15 to Dec. 7 each year. This is the time when many Medicare beneficiaries may enroll in, drop or switch Medicare Advantage plans and would be your opportunity to enroll in a plan with dental implant coverage.
How To Get Medicare To Cover Dental Implantsour Best Tips
Discover Medicare Dental Coverage
Medicare Advantage plans plus dental coverage.
Stand-alone Medicare dental plans.
If the eyes are the gateway to your soul, the mouth is the gateway to your health.
Dental care is vital to a healthy body and healthy aging. But dental services are expensive, making it hard to get Medicare coverage for dental care. Insurance plans across the spectrum have complicated rules about dental work coverage. Thats whether you have Medicare, Obamacare, or independent health care.
In this article, we will discuss how Medicare treats dental implants. Plus will show you the best way to get your dental implants covered. Lets get started!
Looking for better Medicare? Compare plans with the Insurify Medicare comparison tool! Medicare Advantage plans as low as $0/month! Free and confidential search tool. Try now!
Also Check: Is Medicare A Social Security Benefit
Seniors Can Get Coverage For Dental Implants With Private Dental Plans
If youre a maturing adult in need of dental implants or other major dental work, there are a variety of coverage options available. You can get coverage for the dental services you need with a dental insurance plan in the private market.
Dental insurance plans for individuals, families, and seniors are available with a wide variety of top carriers including Delta Dental, Renaissance Dental, and Nationwide Insurance. Many plan options can provide dental benefits up to $3000 each year per member, and some plans have no waiting periods for major services.
At EasyDentalQuotes, we offer a wide variety of senior dental plans with no age limits that are great for seniors on Medicare. The Max Choice plans with Renaissance Dental provide access to coverage for dental implants with no waiting periods for major services. Plans with Delta Dental insurance can provide benefits for other major dental services like dentures, root canals, or bridges. Its easy to view plans and rates just by providing your zip code.
Does Medicare Cover Oral Exams
No, Medicare wont cover an oral exam. But, some companies sell Medicare dental plans either alone or bundled with Advantage.
Each company is different, and some only carry benefits. Even the most basic plans should cover preventive services like dental exams and x-rays. Sometimes youll have a copay.
Your insurance may pay the full cost of an exam, or you may have to pay part of the bill. Your plan may also require you to choose a primary dentist or use the dentists in the network.
If you need a dental exam because youre having a kidney transplant or heart valve replacement, Part B may cover your exam, but it wont cover any dental work you need.
Read Also: When Does One Qualify For Medicare
Procedures Not Covered By Medicaid
Dental implants fall into the category of treatments not generally covered by Medicaid. Other excluded dental procedures include:
- Dental appliances, which include dentures and dental retainers
- Routine examinations
These treatment options are available only if they are medically necessary to protect your health and well-being.
What Is Considered Medically Necessary
It is well documented in the medical field that oral disease worsens many other organ diseases. Including heart disease where some mouth infections can lead to heart attacks, blood clots leading to stroke, valvular, and vascular infection. Oral disease adds to the risk of pulmonary infection and can contribute to pneumonia. Patients with COPD are at high risk of pulmonary infections from mouth disease. Patients who have diabetes are at considerable risk of infections in other parts of their bodies as a result of bacteria from gum disease . The mouth is a primary target of diabetic infection and poor healing. Patients with GERD and other GI issues have many of these problems due to poor diet and not being able to choose healthy food groups for proper nutrition. A recent study by the cancer society links colon cancer to periodontal disease and chronic infections in the mouth.
If you experience any of these conditions and you have significant dental disease, you may qualify for medical necessity. You may be eligible to have a portion of primary dental services covered.
Why Doesnt Medicaid Routinely Pay For Dental Implants
Does Medicaid Cover Dental Implants
Dental implants are a great treatment alternative, so why does Medicaid refuse to cover them?
Medicaid considers dental implants procedure to be cosmetic which is a bit inaccurate considering they help prevent movement of your teeth to remain healthy.
The real reason is that the cost of dental implants is typically higher when compared to other kinds of dental correction procedures.
Its estimated that one dental implant could cost between 4000 to 6000 USD, and thats why dental implant procedures fall outside the scope of Medicaids coverage.
Its a bit confusing, considering Medicaid is designed to help low-income individuals afford medical costs.
How Much Do Aetna Medicare Plans With Dental Coverage Cost
The cost of an Aetna Medicare Advantage plan with dental benefits varies depending on the type of plan you have and where you live.
In parts of Los Angeles, for example, there are five Aetna Medicare Advantage plans available in 2022, and all five plans include dental coverage. Monthly premiums range from $0 to $90, and annual deductibles are between $0 and $750. There are likely other plan options with higher or lower costs in many other parts of the country.
Plan selection differs everywhere, so connect with a licensed Medicare insurance agent to learn about Aetna Medicare Advantage plans with dental coverage that may be available where you live. The agent should be able to discuss each plans coverage of dental implants with you.
Read Also: Can You Sign Up For Medicare Part A Only
What Dental Services Are Covered By Medicare
If youre a Medicare beneficiary, you might wonder if dental services are covered. Unfortunately, Original Medicare doesnt cover routine dental. But, you can buy a dental plan alongside Medicare to pay for cleanings, exams, and dental care. Another option is an Advantage plan with dental benefits. Were here to help you make the right decision for your dental care needs and explain when Medicare covers dental services.