Does Medicare Cover Dental Implants
Dental implants are one of the most beneficial ways to replace missing teeth. A dental implant can support an individual implant crown all the way up to a full arch of dentures! Dental implants have a success rate of about 95% and with proper care and maintenance, can easily last a lifetime. Dental implants are a stable and natural-looking way to replace missing teeth. Implants also support bone health and keep the surrounding teeth healthy. Depending on the number of teeth you need replaced, implants can cost up to $30,000 for one full arch (upper or lower) of implant-supported dentures.
A dental implant is a dental prosthesis made up of three parts: the implant, an abutment, and the prosthesis. The actual implant is a titanium post that is surgically placed directly into the jaw bone to support; the abutment works as the bridge between the implant and the prosthesis; the prosthesis can be in individual crown, a partial denture, or a full denture.
Having an implant placed is a complex procedure that can take quite some time so multiple procedures, diagnoses, and drug prescriptions could be involved in which Medicare may help cover some of the cost. Medicare plans do not cover dental care which does include dental implants but it may cover some of the costs associated with having a dental implant placed.
Medicare Part A
Medicare Part A covers care in a hospital setting. Implant surgery does not typically take place in a hospital but in an Oral Surgeon’s office, however, some areas of your care may need to take place in a hospital depending on your overall health. Prior to a medical procedure such as a transplant or heart valve replacement, Medicare Part A will cover dental checkups and dental care but this will not apply to actual dental procedures.
If part of your dental diagnosis or procedure is done in a hospital, Medicare may not necessarily pay for your visit but may pay for your hospital admittance. The hospital where you will be having any procedure will be able to inform you of your Medicare Part A benefits before admission.
Medicare Advantage (Part C)
Medicare Part C plans are provided through private insurance companies and offer 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 and are subject to a lot of the same limitations as other private insurance plans. Your overall coverage will not be unlimited, as it is with Original Medicare.
Using Medicare Advantage can be more complex than Original Medicare so it is important to 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 help cover some of the cost of the implant process. If you anticipate needing a dental implant, make sure to choose the coverage that will serve you best.
Medicare Part D
Medicare Part D is also provided through private insurance companies like Part C is. Part D is used for your prescription drug coverage. Part D is also purchased separately from Medicare and may be subject to coverage areas and limitations like Medicare Advantage. Medicare Part D will cover any pain medications and antibiotics that you may require after dental implant placement surgery.
Medigap Plans
Medigap, or Medicare Supplement plans, help cover the fees that Original Medicare does not, such as your deductibles and coinsurance payments. Supplemental plans are also provided through private insurance companies but unfortunately, 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 that would otherwise be an out-of-pocket expense.
Private Insurance
Since dental implant coverage through Medicaid is limited, many patients elect to purchase a private dental insurance plan on their own. It is important to research private insurance options to make sure that you select a plan that will cover dental implants and any other work you may need.
What is the cost of dental implants?
A number of factors can affect the overall cost of dental implant treatment. For one, the geographical location of your dental provider: patients in rural areas usually pay less than those receiving treatment in a metropolitan area. The number of implants you need and the materials used will also play a major role in the overall cost of treatment.
Any pre-existing health conditions that require additional care may cause you to pay a little more. The cost of each implant can run between $1,000 and $3,000 for the actual implant placement and surgery and the restoration can tack on an additional $500 to $3,000 per tooth. Patients looking to get a full set of implant-supported dentures can expect to pay up to $30,000 per arch.
How are dental implants placed?
Implant placement requires the care of two dental professionals, an Oral Surgeon or a Periodontist, who will perform the implant placement surgery and your general Dentist who will restore the implant with a dental prosthesis. The prosthesis will be either an individual implant crown, a multiple tooth bridge, or a denture. Before treatment is initiated, you will have a consultation and examination with the implant specialist to make sure not only that you are a candidate for a dental implant but also that you have sufficient bone structure and gum health to support an implant. Once it has been determined that an implant is the best treatment for you, the doctor will schedule implant placement surgery.
A local anesthetic is administered via an injection into the area being treated. The doctor will then make a small incision in the gum tissue and drill a small hole into the jaw bone to place your implant. The implant is then covered with a temporary abutment (healing cap) to protect it as your gum tissue heals and the implant integrates with your jaw bone. After the implant is healed and fully integrated, your Dentist will take over treatment to place your implant restoration.
What are some alternatives to dental implants?
If it is determined that a dental implant is not the best treatment for you, there are other options available to restore your smile! A dental bridge uses crowns placed on neighboring, healthy teeth to support a fake tooth and is permanently cemented 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 but Medicare Advantage may help defer some of your out-of-pocket cost.