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How to Get Dental Implants Covered by Insurance

How to Get Dental Implants Covered by Insurance

Investopedia / Mira Norian

Dental implants offer a lasting solution for missing teeth, but they can be expensive. While some dental insurance planꦰs help cover the cost, others offer limited or no coverag🃏e for implants. 

By understanding how 澳洲幸运5开奖号码历史查询:dental insurance works for implants—and what to look for in a policy—you🦄 can make a more informed decision about your oral health and potentially save money in the prꦺocess.

Key Takeaways

  • Dental implants are often considered a major dental procedure, and your coverage could vary widely depending on your insurance plan.
  • Most plans that cover implants only pay a percentage of the cost (typically 10% to 50%) after you meet your deductible.
  • Factors like waiting periods, annual maximums, and coverage limits can significantly impact how much you’ll pay out of pocket.
  • To save money on dental implants, consider reduced-cost dental care from a dentistry school, savings plan options, or using pre-tax funds from an HSA or FSA.

Does Your Dental I🙈🐼nsurance Cover Dental Implants?

Coverage for dental implants varies widely among dental insurance plans. Some plans offer coverage, while others may exclude implants completely or have 澳洲幸运5开奖号码历史查询:strict limitations. In some cases, coverage might only apply if the implants are considered medically necessary. To determine if your plan covers implants, you’ll need to revie🃏w your policy details and discuss your specific needs with your insurance provider. 

If your dental implants are covered, your insurer may pay up to 50% of the cost of the procedure. Some plans may only cover certಌain aspects of the implant, like abutments or crowns, 𓂃while you must cover the rest out of your pocket. 

What Are Dental Implants?

Dental implants are medical devices designed to replace missing teeth. The process involves three main pieces:

  • The implant: A titanium post surgically placed into the jawbone to act as a tooth root
  • The abutment: A connector that attaches the implant to the crown
  • The crown: A custom-made artificial tooth that sits on top of the abutment

Implants are 𓃲appealing alternatives to bridges or dentures because they resemble and function like natural teeth. However, their high cost can be a barrier for many people. 

What Affects Dental Implant Coverage?

How your insurer covers dental implants will depend on how the procedure is classified under your plan, its medical necessity, and your insurer’s pre-authorization requirements. By understanding these factors and how they🥂 impact your coverage, you’ll be 🌜better able to calculate your out-of-pocket costs and maximize your insurance benefits.

Note

Many dental insurers require pre-authorization for implants. This means your 🌠dentist needs to submit a treatment plan, cost estimate, and supporting medical documentation to the insurance company before the procedure. Getting pre-authorization can help you understand the costs involved before you commit to surgery.

How to Know if Dental Implants Are Covered

To find out whether you’re covered, review your policy carefully and commun🦄icate any questions or concerns you might have to your insurance provider. Follow these steps to verify if, and how, your dental insurance covers implants.

Step 1: Review Your Plan’s Classification of Implants

Most dental insurance plans categorize procedures into thr🌱ee tiers:

  1. Preventive: Cleanings, X-rays
  2. Basic: Fillings, extractions
  3. Major: Implants, crowns, bridges

Of the insurers that cover implants, many classify it as a major procedure and only provide partial coverage (like up to 50% of the total cost) or limit the number of implant pro🌟cedures you can have per yeaꦬr. Meanwhile, plans often cover the entire cost of preventive procedures.

Step 2: Check Your Policy’s Coverage Details

Wh꧑en reviewing your policy, pay close attention to the following details about implant coverage:

  • Cost sharing: While this can vary greatly depending on your plan’s specifics, most insurers will pay only a percentage cost of the implants if they’re covered.
  • 澳洲幸运5开奖号码历史查询:Waiting periods: Identify waiting periods, which can range from six months to 12 months for major dental procedures. If an insurer has a 12-month waiting period for implants, you must wait that long to be eligible for coverage.
  • Annual or lifetime maximums: Determine if your plan has annual or lifetime maximums on how much it will pay for implants. 
  • Frequency limitations: Some insurance companies may offer coverage for certain major procedures but limit how often they are covered.

Step 3: Talk with Your Provider and Insurance Company

  • Confirm with your dentist: Discuss your dental implant needs with your dentist. They can provide a treatment plan and cost estimate, which you can use to discuss coverage with your insurer.
  • Contact your insurance company: Call your dental insurance provider to confirm coverage details. Ask specific questions about your plan’s dental implant coverage, including limitations, waiting periods, and out-of-pocket costs. If possible, get confirmation in writing.

Remember that if your insurer determines you’re getting the procedure for purely cosmetic reasons,ꦅ it could deny you coverage.

Important

If your insurer denies your claim, closely review the denial letter. You can file an appeal if you believe the denial is incorrect or no reason is provided. Include any supporting evidence, such as second opinions or medical records, to strengthen your case. There is usually a time limit for filing appeals, often within six months of the original denial.

How Mu🌊ch Do Dental Implants Cost♉ Without Insurance?

Dental implants can be a significant expense. If you’re not covered by insurance, a single implant could cost anywhere from $3,000 to $6,000 on average. Factors like the complexity of the procedure and where you live can influence the final price. Here’s a breakdown of the average costs, according to data from the American Dental Association:

  • Extraction: $135
  • Bone graft at the time of implant placement: $552
  • Dental implant: $2,013
  • Prefabricated abutment: $718
  • Implant-supported crown: $1,511
  • Total for one tooth: $4,929

If you’re missing multiple teeth, the cost can be significantly higher. For example, an implant-supported bridge, which replaces several teeth, costs $4,199, on average, according to Aspen Dental. Meanwhile, implant-supported dentures cost $7,289, on average.

How Much Do Dental Implants Cost With Insu🐓rance?

The portion of dental implant costs covered by your insurance, and your out-of-pocket e꧑xpenses, depends on various aspects of your plan🌟, including: 

  • Coverage percentage: The portion of the cost your insurer will pay
  • Deductible: How much you’ll need to pay before your coverage kicks in
  • Annual maximum: The most your plan will pay in a year

For example, let’s say your plan covers 50% of the implant cost after you meet your $100 deductible. Here’𓃲s how the math might work:

  • Total cost of the implant: $2,013
  • Your plan’s deductible: $100
  • Insurance pays 50% of the remaining $1,913: $956.50
  • You pay 50% plus your deductible: $1,056.50 ($100 + $956.50)

Remember that the above cost breakdown is only for the implant itself. If abutments and crowns aren’t covered under your plan, those would likely add another $1,000 to $2,000 to your bill.

Best Dental Insurance Companies

Not all dental insurance plans are created equal. Here’s a comparison of the best dental insurance companies and their implant coverage.

% of Dental Implant Care Covered Average Monthly Premium Dental Implant Waiting Period
50% after deductible $64.92 6 months
25% after deductible $30.50 12 months
50% after deductible $43.89 12 months
50% after deductible $39.75 6 months
50% after deductible $42.11 18 months

What Are Other Ways to Save on Implants?

If your insurance doesn’t cover implants—or if the out-of-pocket costs ar♏e too high—consider these alternatives.

Low-Cost Dental Care

Some nonprofit organizations and dental schools offer free or low-cost dental care, including implants. For example, the University of Pennsylvania’s School of Dental Medicine says it offers implant procedures at a fraction of the cost compared to private practices.

Dental Savings Plans

Some companies offer dental savings plans as an alternative to traditional plans. For an annual fee, 𓆉you can access dental procedures at ꦡdiscounted rates, including for implants. 

Health ཧSavings Accounts and Flexible Spendingꦅ Accounts

If you have a health savings account or 澳洲幸运5开奖号码历史查询:flexible spending account, you may be able to use the funds to pay for dental implants, but not if they’re for cosmetic reasons. These a💧ccounts allow you to set aside money before taxes, which can be used for qualified medical expenses, including dental procedures.

The Bottom Line

If you’re missing one or more teeth, dental im🐼plants can be an effective solution. But they can be expensive, and insurance coverage varies. To maximize your savings, review your policy carefully, ask your insurer about coverage specifics, and consider shopping around for a plan that meets your dental and budgetary needs. 

Article Sources
Investopedia requires writers to use primary sources to support their work. These include white papers, government data, original reporting, and interviews with industry experts. We also reference original research from other reputable publishers where appropriate. You can learn more about the standards we follow in producing accurate, unbiased content in our editorial policy.
  1. U.S. Food & Drug Administration. “.”

  2. American Dental Association. “.”

  3. American Dental Association. “.”

  4. Aspen Dental. “.”

  5. Aspen Dental. “”

  6. Keating Dental Lab. “.”

  7. Penn Dental Medicine. “.”

  8. HSA Store. “.”

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