Does Medicare Cover Dental Implants

Medicare plans do not cover dental care which includes dental implants. Medicare may cover some of the costs associated with getting a dental implant which we will review here but first, let's take a look at what a dental implant is!

What is a dental implant?

A dental implant is a dental prosthesis that is used to replace one or more missing teeth. A dental implant is a titanium post that is screwed directly into the jaw bone and supports an implant crown or other restoration. Dental implants are a secure and aesthetically pleasing way to replace missing teeth. Implants support bone health and keep the surrounding teeth healthy, Having an implant placed is a complex procedure that can take quite some time so multiple procedures, diagnoses, and drug prescriptions could be involved which Medicare might cover.

Medicare Part A

Medicare Part A covers your care in a hospital setting. Having an implant placed in a hospital is rare but some areas of your care may need to take place in a hospital. Medicare Part A will cover dental checkups and dental care when done prior to a medical procedure such as a transplant or heart valve replacement but this will not apply to any dental procedure. If part of your dental diagnosis or procedure is done in a hospital, Medicare it not necessarily pay for it but they may pay for hospital admittance. The hospital where you will be having any procedure will be able to inform you of your Medicare Part A benefits.

Medicare Advantage (Part C)

Medicare Advantage plans are private insurance plans that provide at least the same coverage as Medicare Parts A and B but may also provide additional coverage which may include dental and vision. Medicare Advantage plans will be either HMO or PPO plans just like other private insurance plans and are subject to a lot of the same limitations, so your overall coverage will not be unlimited as it is with Original Medicare.

Using Medicare Advantage can be more complex than Original Medicare so make sure you understand your options before you make a decision and choose the plan that is best for you. Not all Medicare advantage plans will cover dental implants but many plans do provide routine dental care which may also cover some portion of the implant process.

Medicare Part D

Medicare Part D is also provided through private insurance companies and provides you with prescription drug coverage. Part D has to be bought separately from the rest of Medicare and may be subject to coverage areas and other limitations like Medicare Advantage. Medicare Part D will cover any pain medications and antibiotics that you require after a dental implant.

Medigap Plans

Medigap plans, or Medicare Supplement Plans, are another private insurance plan that help deter the cost of fees that Original Medicare leaves to you, such as deductible and coinsurance payments. Unfortunately, Medigap plans will not cover the cost of medical care or dental implants. If Medicare Part A is going to cover some of your hospital fees, a Medigap plan will help cover the deductible.

Private Insurance Options

Since dental implant coverage through Medicaid is limited, many patients choose to go with a private dental insurance plan. It is important to research private insurance options to make sure that you select a plan that will cover dental implants as not all do.

How much do dental implants cost?

There are a few factors that can affect the cost of dental implant treatment. For one, the geographical location of your dental provider: patients in rural areas can expect to pay less than those in a metropolitan area. The number of implants you need and the materials used will also play a role in determining the overall cost of treatment. If you have pre-existing health conditions that require you to need additional care, you may also pay a little more. The cost of each implant can run between $1000 and $3000 for the actual implant placement and the restoration, the fake tooth, can tack on an additional $500 to $3000 per tooth. Patients looking to get a full set of implant supported dentures can expect to pay up to $30,000 per arch.

What is the procedure for dental implants?

Having an implant placed requires the care of two dental professionals. An oral surgeon or a periodontist will surgically place the actual implant and your general dentist will restore the implant with a dental prosthesis, either a crown, bridge, or denture. Before any treatment is started, you will have a consultation and exam with the specialist to make sure that you are a candidate for a dental implant. Once it has been determined that an implant is the best treatment for you, the specialist will schedule surgery.

A local anesthetic is administered to the area being treated and the doctor will then make a small incision in the gum tissue and drill a small hole into the jaw bone and place the implant. The implant is then covered with a temporary abutment to protect it as you heal. After the implant is healed and fully integrated with the jaw bone, your dentist will place your restoration.

Dental Implant Alternatives

If a dental implant is not for you, there are other options available to restore your smile. A bridge uses the support of neighboring healthy teeth to hold fake teeth in place. A removable partial denture works like a bridge but is not fixed in place and can be taken out by the patient for cleaning and maintenance. Unfortunately, Medicare will not cover these options either. Medicare Advantage may help defer some of the cost of dental restorations.

If you rely on original Medicare for medical necessities, it may be beneficial to find an alternative for dental treatment. Dental implants are one of the best ways to restore missing teeth and Medicare Advantage or a private dental plan can help ease the burden of cost.

Minimum Age and Dental Implants