Medicare Cover Dental Implants – Dental implants are becoming much more common than they were just a few years ago. They are the best way to replace a missing tooth, though they’re also the most expensive. That leaves many Medicare beneficiaries wondering if Medicare covers dental implants.
The answer? Maybe. It depends on what kind of Medicare plans you have.
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 part that screws into your jawbone), the implant crown, and the abutment (the part that connects the implant to the crown). 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. They’ll also be able to look at your insurance coverage to find out if it covers implants and, if so, how much it will help.
Original Medicare and Dental Implants
If you have Original Medicare (Part A and Part B), dental implants are not covered. The same is true even if you enrolled in a Medicare supplement (Medigap) plan. In fact, no routine or restorative dental services are included in Original Medicare. The only time you may have coverage for dental services is if it is part of a hospitalization due to trauma. For instance, if you end up in the hospital due to an abscessed (infected) tooth, Medicare may help cover some of those costs.
So, how can you get implant coverage if you just have Original Medicare? Many beneficiaries purchase a separate policy for dental insurance. There are many private insurance companies who offer dental plans, and coverage varies among plans. If you’re searching for one that covers implants, be sure to read the fine print. Some have a “missing tooth clause” that states they will not pay for an implant if the tooth was missing prior to the policy’s effective date.
Medicare Advantage and Dental Implants
Dental care is a pretty routine benefit of Medicare Advantage plans. However, whether or not you’ll 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, you’ll need to check the plan’s 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 you’re getting an implant denture, check the denture coverage as well.
What else should I know about Medicare and dental implants?
It’s 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 you’ll 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 you’d like to learn more about dental insurance plans, speak with one of our licensed insurance agents. We work with several kinds of policies, so we’ll be able to find one that has the coverage you need. Call us today to schedule your consultation.