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Dental Insurance that Covers Implants: Are You Covered?

When life knocks you down, you stand up, still in one piece like the resilient person that you are. Sometimes, however, life gives you a blow that will leave you a couple of teeth short. When such a thing occurs, you will be wishing that you have a dental insurance that covers implants.

dental implant insurance

Dental implant insurance is your last line of defense against debt because it will reduce the costs of replacing missing teeth with dental implants. If you have dental insurance for implants, you can be sure that the expenses involved with the surgery and restoration of dental implants will be partially covered. In this article, you will know the benefits and costs of dental implants, terms to look out for, and the possible situations where your insurance will cover dental implants.

Benefits

Missing a tooth can definitely affect the way you interact with other people, personally and professionally. In this case, getting a dental implant is a must because other than improving your appearance, it offers many advantages:

  • Speech – Dentures that are poorly constructed might slip, which may cause you to slur or mumble as you speak. With dental implants, nothing can stop you from confidently enunciating every word.
  • Comfort – Dental implants fuse with bone, eliminating the need for separate removal and cleaning that come with regular dentures.
  • Chewing – With dental implants, you will have to worry about the pain and the misalignment that are sometimes caused by dentures.
  • Confidence – You can smile and grin like a young child because you know that you have a complete set of teeth.
  • Oral health – Dental implants do not require teeth reduction like other dental procedures. Moreover, implants improve oral hygiene by allowing greater access between teeth.
  • Long-lasting – With adequate care, an individual implant can last for many years. It is not rare to read about cases where the implant has lasted a lifetime.

Costs

Looking at the benefits, it is an overwhelming yes to go for dental implants against dentures until costs are taken into consideration. Enjoying the benefits of individual implants might mean paying a bill worth $1000 – $3000. Upon seeing these astronomical figures, people are looking at dental implants insurance for help.

Terms

Reviewing your insurance policy can be a struggle sometimes because even if you understand what the words mean, you still do not have any clue how you will be covered. Finding a dental insurance that covers implants is a rarity and if you have struck gold, it is typically stated in your policy. Nonetheless, you need to be on a lookout for these terms to determine whether your policy covers dental implants or not:

  • Existing conditions – If you have a missing tooth prior to the signing of your policy, then you are not covered.
  • Cosmetic Procedures Exclusion– Insurance companies consider dental implants as a cosmetic procedure even if the benefits go beyond appearances. When your policy states that cosmetic treatments are excluded, then you can be certain you will not be covered.
  • Least Expensive Alternative Treatment – Having a LEAT clause in your policy simply means that the insurance company will not cover the total costs of implants due to applicable alternative treatments like a removable denture.
  • Waiting Time – If you come across these words, it means that you have to wait for a year before your policy covers rigorous dental procedures like dental implants.

Taking time to check and re-check your policy is important so that you can determine whether your policy will shoulder any fraction of the costs.

Coverage

In some cases, people do not bother reading the fine print because they assume that their primary and secondary dental insurance plans will not cover anything. The assumption can be erroneous because there are situations where your insurance provider is obligated to write a check under your name.

Even if your dental insurance policy does not cover implants, it is possible to be reimbursed partially for expenses incurred involving dental implants. Most insurance policies will not pay for the surgical phase of the implant. However, once your implant needs restorative work, it should be under prosthetic coverage.

If such is the case, your insurance policy is supposed to cover at least a part of the expenses involved with the restorative phase of the treatment. You will be reimbursed for restoring the implant with a crown, the same way you will be covered if your natural teeth need to be restored.

In very specific cases, your dental insurance provider will be amenable to cover the cost of going under the knife for an individual implant if it is the more cost effective procedure. If you are suggested to go through a three-teeth bridge, your provider will not hesitate to suggest that you instead opt for a dental implant. In this case, the provider will be able to save more because the cost of going for a three-unit bridge is much more expensive in the long term.

If your dental insurance policy covers dental implants, it is better to check the maximum allowable benefit before giving your dentist a go-signal. Most plans are only intended to cover basic care, emergencies, and maintenance, and for that reason, providers set an allowable benefit of $1000 – $5000 per year.

If you have gone through a medical procedure within the year that you also need a dental implant, verify your annual maximum benefit so that you can determine whether your policy can still cover the cost. Keep in mind, an individual implant may come with a $3000 price tag so even if your policy states that you are covered, inquire about the bill of your last procedure.

Although it is safe to assume that medical insurance does not cover dental implants, there are a few cases where your medical insurance is obligated to pay for the procedure. Depending on the type of coverage of your policy, you can make a claim for dental implants if you are missing all of your teeth and medical complications are not out of the question. You insurance provider will also cover the cost if your injury is work-related.

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