Dental coverage and health insurance are confusing, especially when it comes to cosmetic procedures like dental implants. Many patients ask about whether insurance covers dental implants, and our answer is that it depends on your specific insurance and the type of implants you receive. Russell Street Dental Associates in Worcester, MA can help you figure out your insurance benefits and design a treatment plan that fits your needs and budget.
Understanding Dental Insurance Coverage
Many insurance companies do not consider dental implants to be medically necessary. Instead, they are classified as cosmetic procedures and often do not cover the full cost. Anyone who is missing teeth knows how important it is to replace them, so we can work with your insurance to help maximize the coverage.
Covering your implant procedure may require using both dental and medical insurance coverage, depending on the reason you need them. Some medical plans mention dental procedures and explain the coverage in their materials, but always be sure to ask the insurance company questions, such as:
- Does the plan cover implants?
- What percentage of the procedure does the policy cover?
- What is my annual maximum out-of-pocket cost?
- Do I need a referral before receiving dental implants?
Most dental offices have dedicated insurance staff to help you navigate your insurance, so make sure to ask!
Are Implants Covered By My Insurance?
To determine whether your insurance covers implants, it’s important to know the different parts of the treatment and how much mouth preparation is needed. The amount of coverage also depends on whether you are receiving a full arch of restored teeth or just replacing one or two missing teeth.
Tooth Extraction: Depending on whether you are already missing teeth or if the tooth needs to be extracted, this procedure will be part of your dental implant treatment. Most insurance companies cover all or most of a tooth extraction.
Bone Grafting: Some patients need their underlying jawbone strengthened prior to the implant procedure to ensure the implant will stay in place. This part of the procedure may not be covered, despite it being a crucial step in the implant procedure.
Placing the Implant: The implant placement procedure is considered a “major” dental procedure. Don’t be afraid of the word “major,” though — this is a term insurance companies use that does not always reflect the intensity of treatment. Some plans cover up to 50 percent of major procedures.
Placing the Artificial Tooth: The artificial tooth that provides the appearance and functionality of natural teeth is also considered a major procedure. Some plans consider this the same as crowning a natural tooth and may cover more of the cost, so check directly with your insurance company.
Dental Implants in Worcester, MA
We understand that working with insurance and a budget can get confusing. The Russell Street Dental Associates staff will work with you, your dentist, and your insurance company to offer you the best treatment based on your needs and budget — and a long-lasting smile. Schedule a consultation online or call (508) 687-6579 today.