The Straight Facts About Dental Implants and Insurance Coverage

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Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

November 7, 2022

Dental implant surgery presents a preferred option for those who have lost teeth due to gum disease, trauma, or other dental problems. Implants involve the surgical insertion of a metal frame in the jaw. The metal frame is intended to hold prosthetic teeth in place and do so permanently. While many would like to undergo this procedure, they worry about cost. More specifically, would-be patients worry about whether their dental insurance plan covers an implant procedure.

Concerns About Dental Insurance

Dental insurance generally does not cover dental implants. Dental implants fall under the category of a cosmetic procedure. Dental insurance rarely, if ever, covers cosmetic procedures. Also, a dental insurance policy may stipulate it covers the least-costly and most-acceptable treatment option. So, if removable dentures address the problem of missing teeth, partial costs related to procuring dentures might be paid for by the insurance provider.

Recent reports reveal financial facts about dental coverage. With major approved procedures, dental insurance usually only covers 50% of the costs. All this may be subject to a $1,500 annual cap under standard dental insurance plans.

Reviewing Your Own Policy

Policyholders concerned about insurance coverage for dental implants must review their policies. A proper review can reveal covered procedures and ineligible procedures. General statistics about insurance coverage may be helpful to someone seeking basic information. In reality, only the actual wording in the insurance contract carries weight. National data estimating that the average dental insurance plan caps out at $1,500 won’t impact someone with a policy cap of $2,500.

Unique Policy Options

The standard dental insurance policy most people carry won’t likely cover cosmetic procedures. The terms of standard policies don’t mean other insurance plans capable of covering implants don’t exist. An “indemnity insurance plan” could very well act as a dental implant insurance policy. Indemnity plans, not surprisingly, cost more than standard dental insurance, but they come with added benefits. An indemnity plan could include no waiting periods or limitations on the dentist you choose to visit. Of course, anyone with an indemnity plan must pay accordingly.

The annual premium will be much more than a standard plan. A trade-off exists here, though. The annual cap on dental coverage would be higher.

As with all other insurance policies, coverage in a dental indemnity policy varies. Look closely at any insurance quotes to determine if implants receive coverage in whole or in part.

Pre-Existing Conditions and New Policies

Switching to a new dental policy to acquire additional coverage may prove futile for those with pre-existing conditions. A person who is missing teeth might find any coverage for dental implants excluded from a new policy. A policy may also impose a waiting period on implants or other procedures. Planning in advance makes sense here. If you are seriously worried about losing your teeth in the years ahead, then it may be wise to consider looking for a comprehensive policy long before a procedure becomes necessary.

Explore Alternative Financing

Financing implant surgery could be an option. Look into dental loans or credit card options. If insurance doesn’t cover the procedure, at least paying for implants can be made more financially manageable.

Andrew Slavin, DMD, FACS

Andrew Slavin, DMD, FACS

Hello there, great choice moving towards the personal dental health care you desire!

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