Dental insurance plans provide different levels of service for all kinds of patients and treatments. Because of this, determining the extent of your health insurance coverage for dental procedures may require some clarification.
In this article, you will understand the cost of specialty dental procedures like dental implants and how to get dental implants covered by insurance.
Understanding Dental Insurance Coverage
A dental implant is an artificial tooth root, usually made from titanium alloy. It is placed in your jawbone to bond with your natural bone, and it will give you back your bright smile. However, because of their benefits, many insurance companies do not cover implants and classify them as cosmetic procedures.
Despite this classification, many individuals know that a dental implant procedure is critical to their general well-being and overall health.
With these limitations in mind, you may consider getting your dental implant through a combination of both medical and dental insurance. Review your current insurance policy or discuss it with a representative of your insurance company to see if they can help you cover your expenses.
If you are still processing your insurance plan, consider if they offer dental implants and the amount you can access for this procedure before you choose a final policy.
Dental Insurance Covering Implants
Like other dental treatment options, the coverage for dental implants depends on your insurance plan and its limitations. As dental insurance policies vary from one insurance carrier to the next, here are some dental implant insurance providers you may consider:
Delta Dental Insurance aims to provide dental benefits to more than 41 million people across 15 states, the District of Columbia, Puerto Rico, and the Virgin Islands.
For dental implants, you may access them via their DeltaCare® USA, Delta Dental PPO™, and Delta Dental Premier® plans. However, before you start the treatment, it is essential to have a pre-treatment estimate with your dentist and identify upfront how much you will have to shoulder and how much the insurance provider covers.
Denali Dental offers two main plans: the Denali Summit and the Denali Ridge plan. Aside from that, they have plans specific for families, individuals, children, and seniors. All of these plans offer preventive and primary dental procedures like tooth extractions and major services like dental implant treatment.
The main difference between these plans is the specific coverage details. You may request a quote from their insurance agent to identify the best choice for your dental care.
At Spirit Dental and Vision, you can get an insurance plan covering dental implants whether you need one or more. Aside from the implants, this insurance provider also helps patients afford appointments and treatments they might need before and after the procedure.
Spirit Dental's Choice and Network plans provide affordable, high-quality dental care while also ensuring guaranteed acceptance and no waiting period for your dental care needs. Their plans have a one-time $100 deductible and annual maximum limits of up to $5,000.
Ameritas offers dental and vision benefits compiled into one to give care suitable for an individual or their family. Their plan offers an annual benefit of $1,750 for each person included, and it is up to the holder how they will spend it. For dental implants, they fit the company's Type 3 category, and the plan only extends 50% coverage for the procedure.
Cigna Dental Care offers dental implant surgery coverage to help people access this treatment at a wallet-friendly price. With Cigna Dental, you get a discount of 50 to 75% of what you would pay if you don't have dental coverage for the placement, repair, removal, or restoration of a dental implant.
Medical Insurance Covering Implants
If you can't find dental insurance coverage for your implants, alternative options are available. Some medical insurance providers may cover part or all of the cost of dental implants. Here are some of them.
- Medicaid: Medicaid is a federal program that provides health care coverage to low-income individuals and families. Depending on your state, Medicaid may cover all or part of the cost of a dental implant. To find out if Medicaid will cover your implant, you will need to contact your local Medicaid office.
- Medicare: Medicare is the federal health insurance program for individuals 65 and older, and for certain individuals with disabilities. Original Medicare does not cover the cost of dental implants. However, if you have Medicare Part B, you may be eligible for coverage for certain dental services, including dentures, bridges, or crowns. Also, if you have Medicare Advantage, you may have implants built into your plan.
- Blue Cross: Blue Cross is a private medical insurance company that provides coverage for individuals, families, and businesses. Its plans may provide coverage for dental implants, depending on the type of plan you have. To find out if your Blue Cross plan covers dental implants, contact your local Blue Cross insurance agent.
Paying For Dental Implants Using FSA Or HSA Funds
Paying for dental implants using a Flexible Spending Account (FSA) or Health Savings Account (HSA) can be a great way to save some money. Here is what you need to know about using FSA and HSA funds to pay for dental implants.
First, it is important to understand the difference between FSA and HSA funds. An FSA is a pre-tax account that allows you to set aside money to pay for medical, dental, and vision expenses. An HSA is a tax-advantaged savings account for medical bills. Both accounts are designed to help you save money on health-related costs.
When it comes to using FSA or HSA funds to pay for dental implants, there are a few things to consider. First, you will need to check with your employer to see if they offer either of these accounts. If they do, you will need to make sure that your employer allows you to use the funds to pay for dental implants.
Upon confirmation, you will need to make sure that you are following all of the rules and regulations associated with the account. This includes making sure you submit all of the necessary paperwork and use the funds for the approved expenses.
In addition, you will need to make sure that your dentist accepts FSA or HSA funds. Many dentists will accept these forms of payment, but it is important to double-check before making an appointment.
Finally, you will need to keep all of your receipts and records for your dental implants. This is important for both FSA and HSA funds, as they will be needed to be reimbursed for the expenses.
Dental implants are essential procedures that can help people improve their health and well-being. The methods mentioned above are some of the best ways on how to get dental implants covered by insurance. You can get started by exploring these options to see which one is the most viable for your needs and situation.
Frequently Asked Questions:
Coverage for dental implants varies among dental insurance plans. While some plans may cover a portion of the cost, others may not cover dental implants at all. It's essential to review your dental insurance policy and discuss the coverage options with your provider to determine the extent of coverage for dental implant procedures.
To maximize dental insurance coverage for dental implants, start by reviewing your dental insurance policy to understand the extent of coverage and any applicable limitations or exclusions. Choose a dentist who is in-network with your insurance plan, as this may result in lower out-of-pocket costs. Discuss with your dentist any alternative treatments that may be covered by your insurance, such as dental bridges or dentures, and weigh the pros and cons of each option. If your insurance plan has an annual maximum, plan your dental implant procedure in a way that utilizes your benefits strategically over multiple benefit years.
If your dental insurance doesn't cover dental implants, you can explore alternative options such as researching discount dental plans, which may offer reduced fees for dental implant procedures. Look into dental schools, which may provide dental implants at a lower cost through supervised student or faculty clinics. Inquire about financing plans, payment options, or discounts for paying upfront or in cash with your dentist. You might also consider dental tourism, but be aware of the potential risks, such as lower standards of care, communication barriers, and travel expenses.
Some dental insurance plans may partially cover dental implants, but it's not typical as they are often considered a cosmetic procedure.
To potentially increase your chances, consult with your insurance company beforehand, provide necessary documentation proving the medical necessity of the implants, and consider supplemental or specific dental implant insurance.
If you're looking for other ways to get dental implants, check out these free government grants for dental implants!