Dental and Medical Insurance for Dental Implant Surgery

Dental and Medical Insurance for Dental Implant Surgery

People can replace their previous teeth with the help of dental implants, which are “[made] of durable titanium” and act as “substitute tooth roots that serve in place of natural tooth roots” (“FAQs”). Implants last longer than bridges, partials, and dentures, “which may require replacement several times throughout [the patient’s] life…” (“FAQs”). Surgical specialists and general dentists with training and experience perform dental implant surgery for their patients (“Answering Your Questions About Dental Implants”). However, the price of a dental implant can range “between $1,600 and $8,200 without any dental insurance. And of course, the amount will vary depending on how involved the surgery is, where the implant is being placed, and the number of implants needed” (Murphy 2019). People also have to pay for services related to surgery, such as anesthesia, crowns, etc. (“Answering Your Questions About Dental Implants”). People can offset the costs of implant surgery with dental and medical insurance.

Dental insurance policies can cover dental implants, but the policies’ conditions may affect coverage. People may not receive benefits for their implants because their policies may “categorize them as a ‘cosmetic procedure’” (Murphy 2019). People with policies that include benefits for implants may have “portions of the implant treatment” covered (“Answering Your Questions About Dental Implants”). People can utilize benefits for “[the] crown attached to the abutment of a dental implant…” (“Does Insurance Cover Dental Implants?”). The policies’ annual maximums could limit the amount of coverage for this treatment (“Does Insurance Cover Dental Implants?”). Also, some people need a bone graft before undergoing implant surgery because “the jawbone beneath the gums may have begun to deteriorate” due to a tooth being “missing for quite some time” (“Is Dental Implant Surgery Covered by Insurance?”). These people may not receive coverage for the bone graft and implant because these procedures “may be viewed as a cosmetic improvement rather than a medical necessity” (“Is Dental Implant Surgery Covered by Insurance?”). Other policies provide coverage for implants based on “an amount equal to the lowest cost alternative treatment (dentures/partials)…” (“FAQs”).

People can also use medical insurance for dental implants. Medical insurance could cover different parts of dental implant surgery in order to “[restore] the jaw for eating and speaking” for people experiencing different types of medical conditions due to tooth loss, people with oral diseases “[complicating] or [causing] other medical problems,” etc. (“Does Insurance Cover Dental Implants”; Murphy 2019; Nierman 1997). Dental providers must justify the medical necessity of the implant in their narrative in order to get coverage for the patient (Nierman 1997). Depending on the medical insurance company, people may also utilize their benefits for implants “when provided for conditions such as reconstruction following trauma or cancer surgery” (Philhower and Blair 2016). Some companies may cover implants addressing injuries derived from work “or other accidents” (“FAQs”).

Some people may find implants expensive, but they can utilize their dental or medical insurance. While both types of policies restrict coverage for implants, the policies can help people pay for them.

Works Cited

“Answering Your Questions About Dental Implants.” Dental Implant Guide. Accessed February
21, 2019. http://thedentalimplantguide.org/answering-your-questions-about-dental-implants/.
“Does Insurance Cover Dental Implants?” AAOMS. Accessed February 21, 2019.
https://myoms.org/procedures/does-insurance-cover-dental-implants.
“FAQs.” Lytle, Tate & Stamper. Accessed February 21, 2019.
https://foothilldentalimplants.com/dental-implants/faqs/.
“Is Dental Implant Surgery Covered by Insurance?” Northeast Oral & Maxillofacial Surgery.
Accessed February 21, 2019. http://www.neomsindy.com/is-dental-implant-surgery-covered-by-insurance/.
Murphy, Caleb. “How to get dental implants covered by insurance?” Authority Dental, January
25, 2019. https://www.authoritydental.org/dental-implant-insurance.
Nierman, Rose. “HOW TO PROFIT FROM… implants.” Dental Economics, November 1, 1997.
https://www.dentaleconomics.com/articles/print/volume-87/issue-11/features/how-to-profit-from-implants.html.
Philhower, Jim and Charles Blair. “Submitting dental procedures to medical insurance has been
voodoo—until now.” Dental Economics, September 22, 2016. https://www.dentaleconomics.com/articles/print/volume-106/issue-9/practice/submitting-dental-procedures-to-medical-insurance-has-been-voodoo-until-now.html.  
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