Are Dental Implants Covered By Insurance? - Texas Center For Oral Surgery Blog

Dental coverage for dental implants can be confusing. Make sure you understand your plan.

One question we hear at least ten times a day in our practice is “Are dental implants covered by dental insurance?“.  The answer is a resounding “sometimes”.  Dental implant coverage can be complicated. It is important that you are well educated about your dental plan allowances and limitations. Here are some tips to help you make sense of it all.

Read Your Dental Plan Documents

The first step in determining whether or not your dental insurance will assist you with the cost of dental implants is to read your plan documents.  If there is coverage for the treatment, it will be specified within the terms of coverage.  These documents are sometimes a little difficult to decipher, so if you need help, give us a call.

Beware The Missing Tooth Clause

Some insurance policies cover dental implants, but only if the missing tooth was removed while you were covered by the plan.  Make sure you understand if a limitation like this applies to you. If your dental insurance covers dental implants, read carefully. Be careful not to assume that a dental implant will be covered for a tooth that was extracted 10 years ago while you were covered under a different policy.

Maximize Your Dental Benefits

If your dental insurance provides coverage for dental implants, plan your treatment to maximize your insurance plan’s contribution.  Most dental plans allow payments up to a specified annual maximum (usually $1500 or so).  In the best case scenario, you can use your benefits to pay for the implant placement toward the end of the year.  If you reach your annual maximum, there is a good chance that your benefits will renew again on January 1st.  Because most dental implants need a few months to heal and osseointegrate (get solid in the bone), you won’t be having the crown completed right away. You can utilize your new annual insurance benefits for the completion of the implant at a later date.  On January 1, you will have a brand new maximum to help cover the cost of the dental crown.

Use Your HSA or Flex Medical Account

Even if dental insurance does not cover the cost of a dental implant, you can still utilize your HSA or Medical Flex Account to cover the cost.  Make sure to use those funds before December 31 this year, or they are lost forever.  ** BONUS** Using your HSA funds to cover the cost of a dental implant is extra sweet because those funds are often pre-tax. It is like getting a discount.

Dental Implants Not Covered? The Dental Implant Crown Probably IS

Don’t get discouraged if your dental insurance does not cover dental implants.  In most cases, if the plan covers a traditional dental crown, they must also cover a dental implant crown.  This means that you may be entitled to at least partial coverage, even if dental implants are excluded under your plan

Still Confused About Dental Implants and Dental Insurance?

If you still need help determining if your dental plan covers implants, we are here to help.  Give us a call or send us an email any time, and we will be happy to help you figure it out.  Even with no dental insurance coverage, dental implants are now more affordable than ever.  We can even help you fit the needed treatment into your budget using a monthly payment either through Care Credit or other financing resources-with no interest.

 

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