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.
What Is A Dental Implant
A dental implant replaces a missing tooth. There are at least three parts to every implant: the actual implant , the implant crown, and the abutment . A dental implant can replace one tooth, several, or an entire arch of teeth. They can even be used to help hold dentures in place.
Your dentist or oral surgeon will be able to give you an estimate for treatment based on your individual case. Theyll also be able to look at your insurance coverage to find out if it covers implants and, if so, how much it will help.
Medicare Advantage Coverage For Dental Implants
The most coverage for dental implants you will find with Medicare comes from Medicare Advantage plans. Some Medicare Advantage plans provide dental benefits for policyholders which can include coverage for dental implants.
To receive this extra benefit, you may pay a higher monthly premium. However, you will need to keep in mind the maximum dental benefit. Medicare Advantage plans almost always require copayments and deductibles for dental services. On most plans, you will be responsible for 100% of the cost after you meet the plans maximum benefit.
When choosing a Medicare Advantage plan to cover dental implants, you want to first be sure your plan offers dental coverage. Secondly, ensure the plan covers dental implants as well. Some Medicare Advantage plans with dental coverage explicitly exclude dental implant coverage. To verify coverage eligibility, you will need to review the plans Evidence of Coverage.
Find Medicare Plans in 3 Easy Steps
We can help find the right Medicare plans for you today
Also Check: Which Insulin Pumps Are Covered By Medicare
Are You Looking For Free Insurance Quotes
Secured with SHA-256 Encryption
D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsburys 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve…
Written byD. Gilson, PhDProfessor & Published Author
Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc…
Farmers CSR for 4 Years
Medicare And Dental Implants
Medicare and dental implant coverage is tricky. Remember that Medicare was not designed to cover routine care were used to pre-Medicare. Even so, there are many ways to work around coverage issues.
Youll need to be enrolled in your plan for several months before you get dental implant coverage. Typically, this takes one year.
Expecting your dentist to prescribe painkillers? Youll need good prescription drug coverage to help cover the cost of medications.
Don’t Miss: What Is The Medicare G Plan
Medicare Options That Do Not Cover Dental Services
Original Medicare does not cover dental procedures like dental implants. Medicare Part B coverage is notorious for not offering much in the form of dental care, except in very rare circumstances.
Likewise, Medicare Supplements do not cover dental implants, as their coverage is the same as Original Medicare.
For dental services and dental implant coverage, youâre going to have to look at Medicare Advantage options.
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.
Recommended Reading: Can Medicare Take Your House
Medicare Advantage And Dental Implants
Dental care is a pretty routine benefit of Medicare Advantage plans. However, whether or not youll have coverage for dental implants depends on the policy. Not all plans that include dental coverage extend that coverage to all dental services.
If you know you need a dental implant and are searching for a Medicare Advantage plan that includes them, youll need to check the plans summary of benefits. Look for information about implants specifically, as plans typically put implants in their own category. Sometimes, the plan will offer coverage for the implant crown but not the implant itself.
If you already have a treatment plan, you should also look to see how other parts of your treatment are covered. For example, if youre getting an implant denture, check the denture coverage as well.
What Else Should I Know About Medicare And Dental Implants
Its not always easy to determine your benefits when it comes to dental implants. As we mentioned earlier, many plans have fine print that you should consult before purchasing. In addition, there are other services that youll likely need when getting an implant. Your dental professional may discuss bone grafting, 3D x-rays, sinus lifts, etc.
Whether you purchase a stand-alone dental plan or have it included in your Medicare Advantage plan, there are always annual limits on coverage. For instance, you may have an annual maximum of $1,000. That means that even if you have coverage for all dental procedures, your insurance plan will only pay $1,000 that year.
Dental implants are certainly an investment, even with the best insurance. Fortunately, they are done over a series of months, which will help spread the cost out. There are several third-party financing options available for those who want more affordable monthly payments. You can use these in addition to any Medicare dental benefits you might have.
If youd like to learn more about dental insurance plans, speak with one of our licensed insurance agents. We work with several kinds of policies, so well be able to find one that has the coverage you need. Call us today to schedule your consultation.
You May Like: Who Is Eligible For Medicare Advantage Plans
What Does Medicare Cover For Dental Care
Some Medicare Advantage plans may offer additional benefits for dental care, including services related to dental implants. Medicare Advantage plans are offered by private Medicare-approved insurance companies, so they are able to include supplemental benefits not available under Original Medicare. For example, many Medicare Advantage plans include coverage for routine dental care such as annual exams and cleanings.
Some Medicare Advantage plans even offer supplement dental insurance with coverage for more complex dental procedures such as extractions, fillings, and other types of tooth replacement or restoration, which may include dental implants. You may have to get your dental care from a network provider, and your plan may only pay a set amount for these additional services, regardless of the actual charge. There may be a separate monthly premium for supplemental dental insurance with your Medicare Advantage plan.
Does Medicaid Cover Dental Implants
Medicaid in some states does offer some dental coverage not provided by Original Medicare, but no Medicaid program explicitly covers dental implants. In the cases where Medicaid does provide some dental coverage, the help typically is for more affordable solutions like dentures.
Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age. The Center for Health Care Strategies has compiled how each state addresses dental care with Medicaid beneficiaries.
Don’t Miss: How To Choose A Medicare Supplement Plan
Why Doesnt Original Medicare Cover Dental
Medicares key coverage points have changed very little since the program was established in 1965. Why dental coverage wasnt included in the original package is a matter of debate, but introducing it now would require an enormous political effort and financial investment.
The American Dental Association has also consistently opposed the idea of bundling dental coverage into Original Medicare, citing the threat of lower pay.
Runner Up Best Overall: Denali Dental
Denali Dental plans can be tailored to cover your needs, are available in many states, and the coverage amounts increase each year.
Secure a higher level of coverage the longer you wait
Major services like implants covered in both plans
Tailor your dental insurance coverage
$6,000 maximum for individual and family plans
Prices varied around the country
Not available in 16 states
Recommended Reading: What Is The Best Medicare Advantage Plans In South Carolina
Let Us Help You Find Dental Plans That Cover Dental Implants
Even though Medicare does not cover dental implants, the right Medicare Advantage plan or commercial dental insurance plan can help pay for the treatments your dentist recommends. Call 833-438-3676 or contact us here to arrange an appointment with a licensed agent.
This post was originally published on June 12, 2019, and updated on January 7, 2020.
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
Read Also: How To Qualify For Medicare Part B
Does Unitedhealthcare Medicare Cover Dental Implants
- Some UnitedHealthcare Medicare Advantage plans may cover dental implants, though not all plans cover them. Learn how to find out what plans cover dental implants and how to enroll if any are available where you live.
Dental implants can be expensive, costing somewhere between $3,000 and $5,000 on average per tooth. Given that investment, its natural to wonder if UnitedHealthcare, one of the largest insurance companies in the U.S., covers the cost of dental implants.
UnitedHealthcare Medicare Advantage plans may not always cover the cost of dental implants, though some UHC Medicare plans do cover them. Thats because dental implants are sometimes considered cosmetic, and some insurance plans may not cover cosmetic procedures.
However, some UnitedHealthcare Medicare Advantage plans that include dental coverage may cover the cost of the crown, bridge or denture that is supported by the implant.
Dental benefits vary by plan, so be sure to check with your UHC Medicare plan carrier directly if you already have a plan, or carefully review the coverage information of a prospective plan youre considering. You can compare Medicare Advantage plans online or get help by calling to speak with a licensed insurance agent.
How To Enroll In Medicare Plans That Include Dental Insurance
You can enroll in a Medicare Advantage plan when you first become eligible for Medicare or during the open enrollment period, which runs from Oct. 15 to Dec. 7 this year, says Worstell. He suggests visiting Medicares plan comparison website and entering your ZIP code to see each plan youre eligible for and whether they include dental benefits. You can click into each plan summary to learn more about what that dental coverage includes.
You can also enroll in a Medigap plan at any time throughout the year, says Worstell. However, he suggests doing so when you first become eligible for Medicare, since thats when youre likely to get the best rate.
Also Check: How Old To Use Medicare
Original Medicare And Medicare Advantage Dental Coverage
Original Medicare does not cover dental implants or routine dental care. However, private insurance policies called Medicare Advantage plans can offer coverage for additional services Original Medicare does not, including dental services.
If you need dental insurance, an agent with Medicare Plan Finder can work with you to find a MA plan in your area that offers dental coverage. Some plans also offer coverage for vision, hearing and even fitness classes along with all of the services that Original Medicare covers.
Some people may find that their Medicare Advantage plan does not cover all of their dental needs. Those people may need additional dental coverage from private policies called commercial dental insurance plans to cover major procedures such as dental implants.
Choosing Dental Insurance For Implants
There are several important consideration points to keep in mind when choosing dental insurance for implants. Consider how easy it is to apply, get a quote online, how you can manage your account, and if the company offers any extra perks or discounts.
Keep the following in mind when choosing dental insurance for implants:
- Coverage options: You want to research what type of coverage options are available, how many plans there are, what each plan offers, and their respective costs.
- Sign-up process: How easy it is to sign up is important. Can you sign up online or do you need to sign up with an agent over the phone?
- Geographic availability: Find out where the company offers coverage and then check out the providers in your area that accept this type of insurance.
- Customization: Find out if plans can be customized and how you would do that. You want to pay for the coverage that you need and not things you wont use.
Also Check: Where To Get Medicare Information
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.
Also Check: Can A Person Qualify For Medicare And Medicaid
How To Get Medicare To Pay For Dental Implants Medicare And Dental Implants
Despite numerous improvements in dental care, millions of Americans still suffer tooth loss. The cause could be tooth decay, injury, or periodontal disease.
For many years, the only options of treatment available for missing teeth were dentures and bridges. However, today, dental implants are available.
Are There Dental Insurance Options Outside Of Medicare
If you choose to remain covered by Original Medicare or cant find a Medicare Advantage plan in your area that offers dental benefits, you may have dental coverage options outside of the Medicare program. For example, you can get private dental insurance either through a licensed insurance broker like eHealth or an employer. Compare the different types of dental plans in your area and weigh your needs against them. The costs of a dental plan can vary by plan and provider.
Some dental insurance plans have network restrictions, similar to the way that Medicare has you visit doctors and health-care providers who accept Medicare assignment. With a network-type dental plan, you must see professionals who reside in the dental plans network.
There are other options as well. If you have limited income and qualify for state assistance, some Medicaid programs include dental coverage. Medicaid programs are run at the state level, and dental coverage is an optional benefit under federal guidelines, meaning that states may choose whether or not to include this coverage. If youre eligible for Medicaid, contact your states Medicaid department for more information on whether help with dental costs is available.
To learn about Medicare plans you may be eligible for, you can:
- Contact the Medicare plan directly.
- Contact a licensed insurance agency such as Medicare Consumer Guides parent company, eHealth.
- Or enter your zip code where requested on this page to see quote.
You May Like: Do I Need Medicare If My Spouse Has Insurance