Does Medicare Cover Dental Implants
In short, no, medicare plans do not cover dental care which does include dental implants. Medicare may cover some of the costs associated with having a dental implant placed which we will review here.
What is a dental implant?
A dental implant is a dental prosthesis made up of three parts that is used to replace one or more missing teeth. The implant is a titanium post that is surgically placed directly into the jaw bone to support an implant crown or other implant restoration. Dental implants are a stable and natural-looking way to replace one or more missing teeth. Implants also support bone health and keep the surrounding teeth healthy. Depending on the number of teeth you need replaced, implants can cost up to $30,000 for one full arch of implant-supported dentures.
Having an implant placed is a complex procedure that can take quite some time so multiple procedures, diagnoses, and drug prescriptions could be involved in which Medicare may help cover some of the cost.
Medicare Part A
Medicare Part A covers care in a hospital setting. Implants are not usually placed in a hospital, usually in an oral surgeon’s office, but some areas of your care may need to take place in a hospital. Prior to a medical procedure such as a transplant or heart valve replacement, Medicare Part A will cover dental checkups and dental care but this will not apply to actual dental procedures. If part of your dental diagnosis or procedure is done in a hospital, Medicare will not necessarily pay for it but they may pay for hospital admittance. The hospital where you will be having any procedure will be able to inform you of your Medicare Part A benefits before admission.
Medicare Advantage (Part C)
Medicare Advantage plans are provided through private insurance companies and offer at least the same coverage as Medicare Parts A and B but may also provide additional coverage which may include dental and vision. Medicare Advantage plans will be either HMO or PPO plans, just like other private insurance plans, and are subject to a lot of the same limitations. Your overall coverage will not be unlimited as it is with Original Medicare.
Using Medicare Advantage can be more complex than Original Medicare so it is important that you understand your options before you make a decision and choose the plan that is best for you. Not all Medicare Advantage plans will cover dental implants but many plans do provide routine dental care which may also help cover some of the cost of the implant process.
Medicare Part D
Medicare Part D is also provided through private insurance companies and is for your prescription drug coverage. Part D is purchased separately from the rest of Medicare and may be subject to coverage areas and other limitations like Medicare Advantage. Medicare Part D will cover any pain medications and antibiotics that you require after dental implant placement.
Medigap Plans
Medigap plans, or Medicare Supplement Plans, help cover the fees that Original Medicare does not, like deductible and coinsurance payments. Supplemental plans are also provided through private insurance companies but unfortunately, will not cover the cost of medical care or dental implants. If Medicare Part A is going to cover some of your hospital fees, a Medigap plan will help cover the deductible that would otherwise be a fully out-of-pocket expense.
Private Insurance Options
Since dental implant coverage through Medicaid is limited, many patients choose to go with a private dental insurance plan that they purchase on their own. It is important to research private insurance options to make sure that you select a plan that will cover dental implants.
How much do dental implants cost?
There are a few factors that can affect the cost of dental implant treatment. For one, the physical location of your dental provider: patients in rural areas usually pay less than those receiving treatment in a metropolitan area. The number of implants you need and the materials used will also play a role in the overall cost of treatment. If you have any pre-existing health conditions that require additional care, you may also pay a little more. The cost of each implant can run between $1,000 and $3,000 for the actual implant placement. The restoration, the implant crown or denture, can tack on an additional $500 to $3,000 per tooth. Patients looking to get a full set of implant supported dentures can expect to pay up to $30,000 per arch, up to $60,000 total.
How are dental implants placed?
Implant placement restoration requires the care of two dental professionals, an oral surgeon or a periodontist, who will surgically place the actual implant and your general dentist who will restore the implant with a dental prosthesis. The prosthesis will be either a crown, bridge, or denture. Before treatment is initiated, you will have a consultation and examination with the specialist to make sure that you are a candidate for a dental implant. Once it has been determined that an implant is the best treatment for you, the specialist will schedule your implants placement surgery.
A local anesthetic is administered via an injection into the area being treated. The doctor will then make a small incision in the gum tissue and drill a small hole into the jaw bone to place your implant. The implant will be covered with a temporary abutment (healing cap) to protect it while you heal and the implant integrates with your jaw bone. After the implant is healed and fully integrated, your dentist will place your restoration.
Alternatives to Dental Implants
If a dental implant is not the best treatment for you, there are other options available to restore your smile. A dental bridge uses crowns placed on neighboring, healthy teeth to hold a fake tooth or teeth in place. A bridge is permanently cemented in place. A removable partial denture works like a bridge but is not fixed in place and can be taken out by the patient for cleaning and maintenance. Unfortunately, Medicare will not cover these options either but Medicare Advantage may help defer some of the cost of your dental restorations.