Original Medicare (Part A and Part B) does not cover the cost of dental implants. But, there are certain, Medically necessary procedures that require someone to get dental implants. In those events, Medicare may for some of the cost associated with those services.
Separately, there are insurance plans such as Medicare Advantage Plans (Part C), Medicare Part D and stand-alone dental plans that may offer coverage for dental implants and prescription medications. Please keep reading to learn more…
What are Dental Implants?
Dental implants are a type of prosthetic device that are surgically placed into the jawbone. They are typically made of titanium and form a permanent connection between the jawbone and the artificial tooth. The implant acts as an anchor for the artificial tooth, which can be a crown, bridge, or denture. Dental implants are an increasingly popular option for replacing missing teeth, as they are a more permanent and stable solution than traditional dentures or bridges.
Approximately 13% of individuals who receive dental implants fall within the age range of 65 to 74. Over the next six years, from 2020 to 2026, the overall number of dental implant procedures is expected to rise by 23%.
How long does a Dental Implant procedure take?
The length of the dental implant procedure varies depending on the number of implants being placed, the type of implant, and the amount of bone in the jaw. Generally, a single implant can take between one and two hours to place, while multiple implants may take longer. Your dentist will be able to provide an estimate of the length of the procedure.
Benefits of Dental Implants
Dental implants offer several advantages when compared to more traditional methods of tooth replacement. These include:
- Improved Appearance: Dental implants look and feel just like natural teeth and can be matched to the surrounding teeth in size, shape, and color.
- Improved Comfort: Since dental implants are anchored into the bone, they do not move around like dentures. This makes them more comfortable and easier to use.
- Improved Function: Dental implants are more stable than traditional dentures and bridges, allowing for better chewing, speaking and overall function.
Risks of Dental Implants
- Although dental implants are generally safe and effective, there are some risks associated with the procedure. These include:
- Infection: There is a risk of infection at the site of the implant, which can cause pain and swelling.
- Nerve Damage: There is a risk of damage to the adjacent nerves, which can cause numbness, tingling or pain.
- Sinus Issues: In some cases, the implant may interfere with the sinus cavities, leading to sinus headaches or pressure.
Now let’s explore the Medicare coverage options available for dental implants in greater detail, including Original Medicare, Medicare Advantage Plans, Medicare Supplement Plans, and Medicare Part D.
Original Medicare, which consists of Part A (hospital insurance) and Part B (medical insurance), does not typically cover dental services, including dental implants. This is because Original Medicare considers dental services to be a separate and distinct category of healthcare that is not covered under the program.
However, there is one exception. Original Medicare will cover dental implants if they are considered necessary to treat a medical condition that is covered by Original Medicare, such as jaw cancer or a traumatic injury to the jaw that resulted in the loss of teeth.
Medicare Advantage Plans
Medicare Advantage plans, also known as Medicare Part C, are private insurance plans that are approved by Medicare and provide coverage for the same services as Original Medicare (Part A and Part B). However, these plans can have different rules, benefits, and costs than Original Medicare, so the coverage for dental implant may be different.
Some Medicare Advantage plans do include coverage for routine dental services, including dental implants, as part of their benefits. These plans may also have lower out-of-pocket costs for dental services, such as copays or coinsurance amounts. However, coverage for dental services can vary greatly from plan to plan and even within the same plan based on the specific coverage and benefits offered. So, it is important to check with your Medicare Advantage plan to confirm the level of coverage for dental implants, if any.
Medicare Supplement Plans
Medicare Supplement plans, also known as Medigap plans, are private insurance plans that are designed to fill the gaps in coverage left by Original Medicare. These plans can help to pay for out-of-pocket costs, such as copays, coinsurance, and deductibles, that are not covered by Original Medicare.
However, most Medicare Supplement plans do not cover dental services, including dental implants. This is because Original Medicare itself does not typically cover dental services, and Medicare Supplement plans are designed to fill the gaps in Original Medicare coverage, so they don’t cover services that aren’t covered by Original Medicare.
Medicare Part D
Medicare Part D is a prescription drug plan that will help cover the cost of medications prescribed because of dental procedures, such as painkillers, antibiotics, or any other medication prescribed by your doctor to treat complications related to the dental implant procedure. It is important to check with your plan provider to make sure the medication you need is covered under your Part D plan.
Medicare Dental Plans in my state
Alternatively and/or in addition to Medicare, you should consider a stand-alone Dental plan. There are several types of dental plans and not all dentist accept all insurance. These plans can generally be used in addition toward your Medicare coverage. Some dental plans are indemnity (Cash) plans. Meaning, they reimburse you for services rendered.
In some states, you may be able to purchase a combination plan that includes Dental, Vision and Hearing. Call and speak with a Senior HealthCare Solutions expert today, 866-633-4427.
Original Medicare does not cover the cost of dental implants or any other dental procedures. However, some Medicare Advantage Plans offer additional coverage for dental implants, so be sure to check with your plan provider to see what is covered. Additionally, Medicare Part D will help cover the cost of medications prescribed because of the dental implant procedure. It is important to check with your plan provider to make sure the medication you need is covered under your Part D plan.
Are you looking for more information about Medicare coverage for Dental Implants? Our team of licensed agents at Senior Healthcare Solutions are here to help! Contact us today at 866-MEDIGAP (866-633-4427) to speak with one of our Medicare experts.