🦷 How Much Do Dental Implants Cost with Insurance?
When it comes to remedying missing teeth, dental implants emerge as the most popular choice because of their toughness, functionality, and natural appearance. However, the patient’s decision concerning the cost of dental implants is one of the major factors to consider. Many individuals may be reluctant to proceed with the treatment only due to the financial aspect of it but the good news is that with dental insurance, their worries can be lessened. This post will break down in detail what dental implants cost with insurance are, on which price factors it is based, and the steps to process the coverage of insurance for your implants.
Does Dental Insurance Cover Implants?
The definition of implant dental insurance coverage relies heavily on your insurance scheme. While some schemes cover nothing or only in part, some parts of the treatment at all others can still offer partial coverage for a single step, like the crown or abutment.
Please, check the policy clause for the information on what is specifically part of the insurance company’s coverage and if the implants are a part of it from the perspective of medical necessity under which you can claim them being covered.
How Much Is a Dental Implant Without Insurance?
There are many elements that contribute to the total expense to be incurred in the dental implant process, such as the location where it is done, the expertise of the dentist, and the type of dental implant specifically used. The usual price range for a single dental implant is from $2,000 and can go up to $4,500, while the cost for a full-mouth restorative implementation (All-on-4 or All-on-6 implants) is from $8,000 to $30,000.
As a rule, these costs include the implant post, the abutment (the connecting part), and the crown. More complex procedures, such as bone grafting, sinus lifts, or extractions, might increase the budget. Albeit a long-term option, dental implants create good function and are cost-effective, which is why they have become a very popular choice for many patients.
What Does Insurance Typically Cover?
Dental implants are generally not fully covered by insurance, but most dental plans will reduce the amount you have to pay. Nevertheless, coverage is highly dependent on the type of plan and the insurer. Below is what is accessible to you as a consumer:
- Medically Necessary Implants: In some cases, dental implants are allowed for coverage when their condition is proven to be medically necessary. Such a situation is most common when the cause of the patient’s tooth sings is a car accident, trauma, or other medical conditions. In such cases, the insurance company could pay even up to 100% of the charges in case of the latter being an operation.
- Cosmetic Implants: Various insurances won’t cover such implants because they are considered unnecessary procedures since they do not restore oral health for the patient. If in some states they still can be considered medically necessary, the insurance might cover this service partially or completely. But being generally elective, dental implants are normally excluded from insurance services.
- Partial Coverage: Many dental insurance policies offer partial coverage for dental implants. With a grant like this, the insurance company does not cover the full cost of the implants but instead, they exempt the fees for services such as the abutment or the crown. Be sure to go through your policy for the purpose of finding out the specifics of the procedure covered.
- Orthodontic Plans: In some instances, where dental implants are a secondary or complementary treatment to other orthodontic procedures, or when the patient has purchased a top-of-the-line dental plan, the costs can be partially covered. The majority of services, including implants, may be covered to some extent by dental plans or orthodontic plans.
Factors That Affect Implant Costs with Insurance
- Type of Implant: There are several dental implant types, ranging from traditional titanium to the more recently developed ceramic ones. The implant type is a key element in the total cost of the procedure. The cost of ceramic implants is usually higher than the cost of titanium implants, and certain insurance plans might cover the former but not the latter.
- Location of the Clinic: Dental implant prices typically vary widely by geographical area. Dental clinics in capital cities or other high-income areas can be more expensive than those in the suburbs. The absence of standard pricing in the same urban area also results in price discrepancies across different clinics that offer the same treatment. Therefore, it’s important to reach out to multiple clinics and obtain price quotes to have a clear idea of the situation.
- Additional Procedures: The presence of additional procedures, like bone grafting or a sinus lift, in the treatment will lead to an increase in the cost of the implants. These treatments are often necessary for patients with a lack of bone mass. Though insurance may provide some cover for these additional costs, the probability is less that the insurer will cover it entirely, depending on the policy.
- Dental Networks: Some insurance plans limit the choice of dentists and, as a result, only cover dental services provided within their own networks. Should you pick a dentist outside this network, your insurance plan could pay less, and as a result, you may have to pay more money out of your own pocket.
- How to Get Dental Implants Covered by Medical Insurance
- Type of Implant: There are several dental implant types, ranging from traditional titanium to the more recently developed ceramic ones. The implant type is a key element in the total cost of the procedure. The cost of ceramic implants is usually higher than the cost of titanium implants, and certain insurance plans might cover the former but not the latter.
- Location of the Clinic: Dental implant prices typically vary widely by geographical area. Dental clinics in capital cities or other high-income areas can be more expensive than those in the suburbs. The absence of standard pricing in the same urban area also results in price discrepancies across different clinics that offer the same treatment. Therefore, it’s important to reach out to multiple clinics and obtain price quotes to have a clear idea of the situation.
- Additional Procedures: The presence of additional procedures, like bone grafting or a sinus lift, in the treatment will lead to an increase in the cost of the implants. These treatments are often necessary for patients with a lack of bone mass. Though insurance may provide some cover for these additional costs, the probability is less that the insurer will cover it entirely, depending on the policy.
- Dental Networks: Some insurance plans limit the choice of dentists and, as a result, only cover dental services provided within their own networks. Should you pick a dentist outside this network, your insurance plan could pay less, and as a result, you may have to pay more money out of your own pocket.
How to Get Dental Implants Covered by Medical Insurance
As dental insurance makes a clear distinction and renders dental implants as a cosmetic procedure, getting medical insurance to cover dental implants can be very difficult. Despite this notion, there are still situations when dental implants are recognized as medically necessary (e.g., trauma or disease) by health insurance, and, consequently, the patients will have some coverage. The process of proving the medical necessity to an insurance company by providing a dentist’s help in this matter will involve the submission of the needed documentation and the right justification.
How Much Are Dental Implants With Insurance?
The cost of dental implants with insurance is typically shared by the insured and the insurer. Depending on the nature of the plan, the insurance could cover between 10% to 50% of the total costs of the implants. Nevertheless, the limitations of the coverage need to be checked, and even with this assistance, one would still be required to pay most of the bill, particularly if the insurance considers the implants a cosmetic procedure.
Will Dental Insurance Cover Implants?
Dental insurance companies usually do not bear the entire costs of dental implants, as number one, dental implants are not a necessity, and number two, they are mostly regarded as a cosmetic surgery procedure. Yet, the patient should not lose all hope as it is still possible that some parts of dental implantation, namely, extractions and the crown, could be covered by the provider. To be financially safe, it is quite significant to confirm with your payer the point of the insurance status towards implants and, consequently, sign up for additional financial resources in the case of the absence of coverage.
Frequently Asked Questions About Dental Implants and Insurance
The coverage for dental implants in dental insurance significantly varies and depends on the plan. While it is true that most of the already existing dental plans do not cover the whole implant expense, some still give a part of the money back, especially for use of medical necessity.
Not every dental insurance scheme includes implants. There are, however, some insurance plans, namely PPO (Preferred Provider Organization) and indemnity, that may partially cover the cost of the implants. For instance, Delta Dental, Cigna, and Aetna are the types of insurance companies likely to cover some of the expenses related to the implant procedure, which will ultimately depend on the plan you have. Always read the small print of your policy.
The majority of dental insurance policies provide for dental implants, but these are typically not fully covered and are often even excluded as they are considered a cosmetic aspect. However, if the implants are recognized as a medical necessity (for example, after an accident or for chewing) some insurance companies may cover them at least partially.
The price of a dental implant with insurance will be determined by the scale of the coverage you have obtained. Typically, dental insurance can cover a range of 10 to 50%, i.e. totally your option. The prices of one implant fall within the scope of $2,000 and $4,500, then even with insurance, you will still be expected to pay from $1,000 to $2,250 or more, which will depend on the percentage of coverage of your plan.
Usually, dental insurance only partially covers dental implants because it is not possible to provide full coverage in most cases. While some plans will reimburse you for a portion of the expenses, the fact is that the coverage is only partial.
