Are Dental Implants Covered by Insurance?

Dental implants are an incredible addition to the options that are available in dentistry for replacing missing teeth. Dental implants become attached to bone providing lifelike replacement of teeth for patients. However, dental implant procedures are complicated and require many steps from planning, to implant placement, to fabrication and placement of life-like tooth replacements. As the number of implants required increases, the planning, the placement, and the delivery of the replacement teeth and becomes more complicated. Patients in need of dental implants typically look for ways to offset the costs. The first place they turn is often to their dental insurance. But does insurance cover dental implants?

It is impossible to answer this question definitively and for everyone, as there are a myriad of different dental insurance plans available. However, for the majority of plans, dental implants are not covered.  These plans are pre-payment plans purchased by your employer as a benefit. What your employer pays for the plan will determine what benefits are provided.

Reasons for Lack of Coverage

If dental implants are not specifically needed for a medical reason, they are often viewed by insurance companies as a type of cosmetic treatment, akin to veneers or teeth whitening treatments. Most dental insurance plans do not cover cosmetic treatments.

In some cases, dental insurance requires patients to visit multiple specialists. This may require them to visit a specialist, such as a surgeon, outside of their insurance network. This may place any procedures conducted by the out-of-network professional outside of the dental insurance benefits provided by the insurance carrier. However, the carrier may still be obliged to cover the procedure.  Predetermination of your benefits can determine what benefits are available for you.

Dental implants are sometimes required to replace teeth that were lost in an accident or trauma, such as an automobile collision. In these cases, while dental implants may fall outside the realm of dental insurance, they will likely be covered by regular medical insurance.

Coverage Maximums

One of the most common limitations on dental insurance coverage for dental implants is the built-in coverage cap. Most dental insurance plans have a maximum coverage amount that resets every year. This maximum is often set at $1,000 or $1,500 dollars, which falls short of the cost of a single dental implant or bridge for that matter. Even if the dental insurance policy in question covers dental implants, that coverage does not extend past the cap.

Alternative and Related Procedures

Dental implants are one of the more expensive dental procedures that can be performed. While dental insurance plans often stop short of covering dental implants, these plans will in some cases cover less costly procedures.

The most common alternative is a tooth-supported fixed bridge. This procedure involves grinding away health tooth structure on adjacent teeth to support a bridge that will span the location of the missing tooth. A resin-bonded bridge, or “Maryland Bridge,” works in a similar fashion, but forgoes grinding away healthy teeth and clips onto them instead. Removable partial dentures are another alternative.

While these alternatives are less expensive upfront, there are drawbacks in terms of comfort, appearance, and longevity and what damage they may do to the teeth that remain .to the teeth that remain.

Some dental insurance plans will cover procedures leading up to the installation of a dental implant, but still stop short of covering the implant. A tooth extraction is one such procedure. A common first step when getting dental implants, a tooth extraction is considered by many dental insurance plans to be a basic procedure, and is therefore covered.

Learn More

To talk through payment options for dental implants, and to learn more about what to expect once you get dental implants, contact Specialty Dental Care P.C. We are experienced implant dentistry professionals, and we do our best to work with patients in the Omaha area to provide comprehensive dental care.