Are you wondering if dental implants are covered by your dental or medical insurance? The answer, for the most part, is NO. Dental implants are considered elective procedures and therefore rarely covered by insurance companies. Also, most PPO dental insurance plans have a $1000 to $1500 annual limit for most basic services such as cleanings, extractions, and restorations. Such annual allowances are quickly depleted with routine services, and there are usually inadequate remaining funds to cover dental implants or related crowns. While dental implants are typically not covered, the crowns may be considered as basic services under most dental insurance plans providing the annual limit has not been reached. If you have an HMO dental plan, you have even fewer benefits for most routine dental treatments.
Because dental implants are not covered by most dental insurances, it makes no difference whether you see a participating or non-participating dental implant specialist. So it is best to choose a skilled surgeon, and a great restorative dentist who you trust and feel can provide you with the best service and results.
With the lack of insurance benefits, most patients choose affordable payment plans through third-party companies. This way they can complete their treatment while making payments over time.
Circumstances where dental insurance may cover dental implants:
- Premium dental insurance plans: There are some premium dental plans that offer up to $5000 annual limit and coverage for dental implants. For example, World Bank and IMF offer a premium Aetna plan to their employees with great dental benefits. We have assisted many patients with such insurances for their implant needs.
- Trauma: If you have lost your teeth due to oral trauma, it is possible to get benefits through your medical insurance for bone grafting, dental implants, and crown replacement. A pre-certification may be necessary.
- Pathology: If you have lost your teeth due to jaw cysts or other forms of pathology affecting the jaw bone surrounding teeth, medical insurance may offer benefits for implant replacement of the missing teeth.
Many ask why insurance companies do not cover something as important as dental implants for millions of people who suffer from missing teeth. Their answer is that it is not medically necessary. As far as they are concerned, people can live with uncomfortable partial dentures or simply learn to eat soft foods, because no one has died from NOT smiling!!!