Are Implants Covered By Insurance?
Dental implants are a great way to fill in missing teeth. Sometimes we lose teeth, either through blunt-force trauma or to an infection. Rather than have unsightly gaps in your teeth, many Americans opt for a dental implant. Implants are surgically inserted into the gum and are more permanent than dentures. A titanium post is fused into the jawbone, and when it is completely fused, a dental prosthetic—the replacement tooth–is placed on top of the post. This acts as the tooth’s surface while the post anchors it. Implants can be customized to take on the hue of your natural teeth, which means that it is very hard for someone to distinguish implants from your teeth.
If you think an implant might just be what you need, the next thing is to find out if your insurance covers implants and how much dental implants are with insurance. Here are some things that you need to know about this.
Are Implants Covered by Insurance?
Most basic dental policies do not cover implants. Instead, a dental policy that includes cosmetic dental procedures may cover certain costs related to implants. In many cases, this policy will cover about 50% of the cost of the procedure, with the client paying the rest. Your general medical insurance may also cover the cost of a dental implant, but this varies from policy to policy. Typically, if your employer provides your medical insurance cover, they are the ones who decide if to include dental implant coverage or not. Reading through your policy contract will give you an idea of what is covered and what is not.
Coverage May be Conditional
If you have looked at your medical insurance policy and realized that it does cover dental procedures, it is a good idea to double-check the following.
What Is Your Annual Maximum?
This refers to insurance companies’ cap on how much they will pay within one calendar year. What this means is that even if your insurance policy covers dental implants, it is possible for the insurance company to refuse to pay. This is because if you have spent most of your annual cap, there will be nothing left to cover the procedure. Most covers have an annual maximum of between $1,000 and $2,000.
Is It a Pre-Existing Condition?
Medical insurance companies do not generally cover pre-existing conditions. If you lost the tooth before taking the cover, the insurance company might rule that as a pre-existing condition.
Partial Coverage
When your insurance does cover dental implants, you should also check to see what is covered. Many insurance policies do not cover the entire procedure but only components of it. A dental implant consists of the post, the abutment, and the prosthetic, or replacement tooth, which usually is called the crown. Most insurance companies will cover the abutment and crown costs, but not the post. Given that dental implant costs will typically range between $4000 and $7,000, you may find yourself paying a significant amount out of pocket.
Other Factors to Consider
When looking at dental implant coverage by your insurance provider, it will also be helpful to get information on whether you can choose the dentist to perform the procedure. Insurance companies sometimes have dental specialists that they prefer to work with. If you get to select your specialist, you may have some leeway when it comes to finding a reasonably priced dentist. You should also check if your cover has a Least Expensive Alternative Treatment. Insurance companies typically use this clause to get policyholders to seek the least expensive option if different treatment options exist.
Get a Smile Makeover From Concierge Group
When you come to Concierge Dental Group, you are assured of top-notch dental care. We take pride in the lasting relationships we have built with our clients over the years through excellent dental services. For dental implants and other dental services, please call us today and schedule an appointment.