Does Insurance Cover Dental Implants? (Dental Care Budget Guide)

imed22/ May 19, 2021/ Dental/ 0 comments

Are you suffering from lost or missing teeth? If you happen to do so, your dentist might recommend having a dental implant. But since it involves a complex process, dental implant surgery may come at a higher price. If you are on a budget, it is completely normal to look for ways to reduce your expenses. This includes turning to your dental plan. However, does insurance cover dental implants? Let’s find out.

Whether you already have coverage or are considering adding dental benefits as a part of your health insurance, it’s essential to learn the fundamentals of an insurance policy.

What Is A Dental Insurance?

Dental insurance is a specializing branch of health coverage. It aims to provide patients with much-needed peace of mind, especially given the high cost of some dental treatments. Like other healthcare policies, dental insurance allows you to get coverage for your dental needs. Depending on your plan, you can enjoy benefits from regular tests and cleanings to more advanced treatments like root canals and extractions.

With an excellent dental insurance package, you will indeed find financial freedom. Of course, all dental plans are different, so policyholders must review their coverage limits. It allows you to identify which is and isn’t available in a specific situation.

Typically, an insurance company may offer dental policies in three different ways:

• As a part of your employee benefits, or most popularly known as an employer-sponsored dental plan.
• Inclusion to your existing health plan, which you can purchase through a licensed broker.
• A personalized and stand-alone dental plan.

What Are Dental Implants?

Over the years, dental implants have been the most popular tooth replacement option. It involves the placement of an artificial tooth root, which serves as a protection for crowns, dentures, and bridges.

Many dental specialists and patients recommend dental implants because of their life-like results. It is known to provide the same feel, look, and function as a natural tooth. Moreover, they’re the only cosmetic treatment that offers complete restoration.

What Is the Cost for Dental Implants?

According to some studies, an average cost of a single implant could be between three thousand to five thousand dollars. This cost may vary depending on several factors. If you need multiple implants, it is safe to assume that the prices will be much higher.

If you wish to repair your missing teeth with dental implants, but the cost seems to be out of your reach, you can consider getting dental insurance. Some dental insurance policies may cover a part of the cost of your dental implants.

What Factors Influence Dental Implant Cost?

Dental implant surgery involves a complicated process. From planning, fitting, fabrication, and placement require more time and effort than other procedures. The following factors are what make the treatment option cost more than the rest.

Consultation

Before beginning any operation, your dentist will evaluate the status of your oral health. It includes checking your jawbones, teeth, and gums. Your dentist will also ask you to have x-rays and 3d scans to assess your dental structure and identify the best places to put the implants. This first consultation should include a discussion of costs and health coverage.

Sometimes, you may need to take two trips to the dentist’s office. The first one is to do the necessary tests, imaging, and other data for the dentist’s assessment, and the second is for your recommended treatment plans and estimated costs. You can visit SLDC Pyrmont’s website today and book a consultation.

Procedure

If you are a suitable candidate for implants, you and your dentist must determine which type is best to fit your needs. Afterward, your surgery will take place. The dentist will use local anesthesia or other sedatives to ensure your comfort. If necessary, they will also prescribe you some over-the-counter pain medications to help ease the recovery process.

Abutment and Crown Placement

After securing the implant root, your dentist will place an abutment and a crown. These are necessary to protect the implant against infection and decay. These accessories are often personalized and may take a few weeks to manufacture. Once ready, your dentist will permanently attach the crowns along with custom-designed bridges and dentures for a more natural look.

Does Insurance Cover Dental Implants?

While it is almost impossible to get free dental implants, there are many dental care plans available. For some people, whether or not their dental insurance would cover the cost of their implant surgery is a determining factor before considering the treatment option. However, knowing if your insurance can protect your dental implants still depends on several conditions. It will vary based on your needs, policies, and other information.

Everyone’s dental plan and coverage differ, so it is essential to hear more about the different insurance company policies.

How Do I Check My Insurance?

An insurance company may offer different payment options and coverages for your dental care. Depending on why you need an implant surgery, your medical, dental insurance, or both could provide you with the necessary financing solutions. Here are few things to remember when it comes to funding for implants:

Coverage

If the procedure is not necessary for medical purposes, most insurance policies will not cover your dental implants. Insurance providers often consider dental implants a form of aesthetic practice, similar to veneers or teeth whitening procedures.

On the other hand, there are several companies that offer plans for cosmetic dental procedures. This dental plan allows coverage for a portion of your expenses. In most cases, the insurance company could cover half of the cost, which is already a great deal. However, you must first ensure that you will reach the minimum service cost required before your insurance could provide their share. This condition applies depending on how much you must pay for other dental services for the whole year.

Pre-existing Conditions

You’ll need to review your insurance policy to determine if they will allow coverage for your pre-existing conditions. If you already have missing teeth before the effective date of your insurance, the coverage might not be available. Since you already had it before your policy, the insurance company deems it a pre-existing disorder.

Medical Emergencies

Dental implants are necessary to repair teeth that got damaged due to an injury or trauma, such as a car accident. Although dental implants may be beyond the scope of dental insurance in these situations, they are likely to be protected by standard medical insurance.

If you currently don’t have dental insurance or your existing policy, you should opt into a health policy that does. You can also look at some dental plan memberships that offer discounts.

Annual Maximums

Most dental and medical insurance companies offer an annual maximum coverage. This part of the policy represents how much your insurance company can pay for your dental care needs in a calendar year. Technically, this policy means that the insurance provider is bound to cover only that specific amount of coverage. Once you’ve reached your annual maximum, you’ll be liable for the remaining cost of your treatment.

Premiums

If you want to maximize your savings, you can opt for policy premiums. While this type of plan can cost higher than your standard dental policy, your insurance coverage will also be a lot wider. As the maximum limit is more, this policy is advisable for individuals who require many dental works throughout the year.

With a premium policy, you do not have to schedule your procedures to fit the calendar. Most importantly, you won’t have to pay out of your pocket because your limits are relatively higher.

Should I Get A Dental Insurance?

If you don’t have dental insurance right now, you might be asking if it’s worth it to have your own. Since everyone’s financial condition and oral health needs are different, there is no universal solution.

To help you decide, you can compare the costs of a dental package to your average annual dental coverage costs. By breaking down the yearly charges for your routine dental care procedures, you can compare these prices to the premiums under various dental plans. These procedures include fillings, cleanings, X-rays. It is best to keep in mind that you will be entitled to subtract the premium costs after filing your taxes.

When considering whether or not to purchase your dental plan, you must also consider your overall dental wellbeing. If you have a history of dental complications, it would almost certainly be worth the money to have the extra financial protection that comes with your coverage. You can visit DDSS Sydney CBD’s website if you have questions about dental insurance.

Tips for Buying A Dental Policy

Are you looking for an insurance package for your dental care needs? If so, here are some essential tips that you should consider before making your decision.

Confirm your dentist’s accreditation

Unless you’re fine with switching to a new dental provider, you must first make sure that your current dentist accepts the policy you’re considering. If you’re lucky enough, some licensed insurance agents can make arrangements to look for plans that belong to the network of your existing dentist.

Check the fine print

Before you sign up for any dental policy, it is essential to read the fine print and make sure you know your responsibility. This contract shows details on how much you’ll have to spend out of pocket. It also identifies explicitly what’s covered and what isn’t and how much your deductible would be.

Customize your coverage

Today, insurance companies offer stand-alone plans which you can tailor to fit your specific preferences and budget. By simply purchasing what you only need, you can save a lot more money. Depending on your current oral health status, you opt for coverage limited to routine dental checkups and minor treatments.

Purchase early

As experts usually say, putting off a dental insurance policy is not advisable. Many insurance providers have a waiting period for up to a couple of months before the effectiveness of the coverage will kick in. Therefore, the sooner you prepare your dental plan, the sooner you can start taking advantage of its benefits.

Are there any Alternatives and Related Procedures?

Dental implants are one of the most expensive dental treatments available. Although most dental insurance policies do not cover this treatment option, they can cover less costly procedures in some circumstances.

A tooth-supported fixed bridge is the most popular alternative. This treatment involves scraping the tooth structure from a healthy neighboring tooth to support a bridge that will cover the gap left by the missing tooth.

However, if you do not like to undergo the grinding portion, a specialized type of bridge known as the “Maryland Bridge” is best for you. The process is similar, but it skips the scraping method off a part of the adjacent teeth. Instead, it uses the resin bonds technique that comes in several colors, resembling a natural tooth.

Another choice is through removable partial dentures. However, dentures cannot prevent gum and jawbone deterioration. Therefore, this technique might not be the best choice for multiple missing teeth.

While these options are less costly upfront, they may have disadvantages in terms of convenience, aesthetics, and durability, as well as the potential for damaging the remaining teeth. Click here if you want to learn more about the prices of dental services.

Wrapping It Up

Any dental insurance policies allow coverage for treatments that lead to the placement of a dental implant, but not the implant procedure itself. For example, one such treatment is tooth extraction. Tooth extraction is a common first step before getting dental implants. An extraction procedure is considered a standard treatment by many dental insurance plans. Therefore, it is covered.

Getting a quality dental service must not be a pain to your wallets. Call your medical and dental insurance company to discuss reimbursement options for your dental implants. You can also ask questions to know more about what to expect before considering the treatment option. Since every insurance provider is different, you must collaborate with your providers. It is up to your best effort to maximize your current dental plan. You can also go to Dental Excellence Woden’s website to learn more about dental plans.

References:

http://integrativemedalliance.org/free-dental-implants-disabled/

https://www.healthcare.gov/coverage/dental-coverage/

https://www.nbcnews.com/better/health/reason-your-dental-work-isn-t-covered-medical-insurance-ncna813666