Getting clear answers about what’s covered by health insurance and dental coverage can be confusing, especially for specialty procedures like dental implants. Patients often ask whether their insurance will cover the cost of dental implants, but it all depends on what insurance you have and what type of implant treatment you receive.
East Lancaster, CA dental provider Smile Dental Group will work with you and your insurance to create a treatment plan that will compliment your needs and your budget.
Understanding Dental Insurance Coverage
Many insurance companies consider dental implants purely a cosmetic, and therefore not medically necessary procedure and will not cover them. But anyone who is missing teeth knows that replacing the missing teeth is critical to their health and general wellbeing.
Covering your dental implant procedure may require using both medical and dental insurance coverage, depending on the reason you need them. It is a good idea to take some time and review your insurance policy to see whether it is listed in the insurance information you were given when you started the policy. Before beginning treatment, it’s important to ask the insurance company questions to ensure there are no unpleasant surprises:
- Does your 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?
The staff at your dentist’s office will be able to work directly with your insurance company to determine your coverage based on the treatment plan.
Are Implants Covered By My Insurance?
To determine whether your insurance covers implants, it’s important to understand the different parts of the treatment and how much mouth preparation is needed for the implant. The amount of coverage also depends on whether you are receiving a full restorative arch or just replacing one or two lost teeth.
Tooth Extraction: The need for this is dependant on whether you are already missing teeth or if the tooth is damaged and needs to be extracted before it is replaced. If the damaged tooth is still present, this procedure will be part of your dental implant treatment and it is covered by most insurance companies in full or at least in part.
Bone Grafting: Some patients need their underlying jawbone reinforced prior to the implant procedure to ensure the implant will be stable and secure. 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 deemed a “major” dental procedure. Don’t be afraid of the word “major,” though — this is a term insurance companies use that relects cost more than the intensity of treatment. Some dental insurance plans cover up to 50 percent of major procedures.
Placing the Artificial Tooth: The artificial tooth — called a crown in dental parlance — that provides the appearance and functionality of a natural tooth is also considered a major procedure. However, some insurance plans consider this the same as crowning a to halt tooth decay and may cover more of the cost, so check directly with your insurance company.
Dental Implants in East Lancaster, CA
We understand that working with insurance and a budget can be challenging. The Smile Dental Group staff will work with you, your dentist, and your insurance company to offer you the best treatment based on your needs and budget. Schedule a consultation online or call (661) 302-4416 today.