Does Medicare Cover Dental Implants
Dental implants are an excellent alternative to the conventional dentures of years past. Not only are they more functional and long-lasting, but they are also attractive and comfortable. Because they are designed to look and act just like natural teeth, they’re difficult to spot. They also offer more flexibility with food choices, increased bone health, a rejuvenated facial appearance, and even increased quality of life and better mental health as compared to the use of conventional dentures. In short, dental implants are today’s preferred method of tooth replacement technology by dentists, surgeons, and patients alike.
These prosthetics don’t come cheap, however, and many people have questions and concerns about what their insurance or Medicare plan will cover. While some insurance companies will cover partial costs associated with dental implants, Medicare generally does not (though some visits and prescriptions may be covered).
Dental Implants Steps and Procedures
Dental implants are created and placed over time. As such, they require a good deal of planning and numerous visits to one’s dentist and/or oral surgeon.
First, a thorough examination of your mouth and health history will be undertaken. Your dentist or oral surgeon will examine your mouth visually and they may also choose to do X-rays to help them better visualize the structures of your mouth and jaw. At this time, she or he will ask about any underlying health conditions or concerns you may have. All of this together will help them determine if you are a good candidate for dental implants.
If you are indeed a good candidate for implants, the first step is having the main structural component – a small post made of titanium or zirconia – surgically installed below the gumline into the bony structure of the jaw. Once the fixture is placed, the gums are stitched up and two to six months are allowed for the affected tissues to heal and the implant fixture to fuse with the jawbone in a process called osseointegration.
Once this has taken place, your dentist or oral surgeon will then attach the abutment to the implant fixture below the gumline. This is a small connecting piece that connects to the implant fixture below the gums and also protrudes above the gums for the prosthetic crown, bridge, or implant to be attached to.
After the soft tissues of the gums have been given a couple weeks to heal, the implant crown or other implant-retained appliance can then be attached. Depending on one’s individual preferences, this connection might be permanent (cemented on) or removable (snap-in).
Medicare Coverage of Dental Implants Steps and Procedures
Dental implants, like all dental care, is not covered by Medicare Parts A and B (original Medicare). In limited cases, Medicare A and B may cover some visits, particularly if they are associated with another procedure or are a requirement prior to a surgical intervention in a hospital, but these instances are quite limited and should be verified in advance of any dental work including dental implants that is done for this reason.
Medications such as prescription painkillers associated with dental implants may be covered by Medicare Part D, which covers prescription drugs. This is an add-on to Original Medicare that is not automatically included; to determine if your prescription drugs associated with dental implants might be covered in this way, first verify that you have Medicare Part D and then check with your plan provider to find out if your medications can be covered.
Medicare Part C, also referred to as Medicare Advantage, is the Medicare coverage that most widely varies, as it is administered by private insurance companies that offer different levels of coverage. If you have Medicare Part C, you should check with your plan administrator to determine if some parts of your dental implants may be covered by that policy.
Supplemental Medicare plans such as “Medigap,” which are private policies designed to supplement the coverage that you get through Medicare, might also provide some options in terms of coverage. This varies quite a bit from policy to policy and most will not cover any direct costs of dental implants, but they may help with some expenses and/or deductibles incurred while using a Medicare Plan C policy.
Cost of Dental Implants
Especially because dental implants are typically not covered by Medicare, it is important to have an idea of the overall cost of dental implants before making plans. The cost of dental implants, however, is highly dependent upon a number of factors, including the number of implants needed, the materials chosen (titanium vs. zirconia), the availability of quality bone mass in the jaw, and any underlying health or other conditions that may require accommodation before, during, or after surgery.
For this reason, only your dentist or oral surgeon can give you an accurate estimate for what dental implants might cost in your particular situation. As a general reference, one dental implant and crown usually costs around $3,000; a full set of implants may cost as much as $30,000.
Alternative Insurance or Payment Plans for Dental Implants
Given the high cost of dental implants, it may be worth the cost of purchasing alternative private insurance to cover some of the cost. Your dentist or oral surgeon might be able to recommend a plan that they know covers at least some of the costs of the procedure.
Whether you opt to purchase a private insurance plan or not, payment plans via your dentist or oral surgeon’s office can also help lessen the burden of the cost of dental implants. In many cases these plans offer the ability to make low monthly payments over time, oftentimes with reasonable interest rates and associated costs.
Alternatives to Dental Implants
If these options are not feasible for you, don’t fret. While dental implants are in some ways the Cadillac of tooth replacement options today, there are lots of dependable options out there, most of which have a lower price point. While Medicare won’t likely cover those appliances, either, such as conventional dentures or partial bridges, they are typically more affordable.
For more information on what kinds of tooth replacement options might work for you and your budget, schedule a consultation with your dentist today.