Dental implants are known for being an excellent option to replace missing teeth. However, its price is usually a detriment since it requires a surgical procedure that’s composed of three parts. Each case is different for every patient, and the steps needed to place the implant should be analyzed by an experienced professional. But at the end of the day, everyone asks themselves if their insurance will cover dental implants.
Will My Insurance Cover Dental Implants?
Knowing if your insurance company will cover the procedure or the implant pieces is hard to tell and varies on a case by case basis. There are different aspects to consider, such as the type of medical and dental insurance, the specifics of each (or both), how the tooth issue developed, and much more.
A lot of insurance companies recluse themselves for not covering dental implants attempting to make the argument that this is still an experimental procedure and that it is cosmetic and optional. None of this is true, however, since implants have been a solution to replace teeth for almost 50 years now. And it has been proven that they can save the jawbone, prevent bone loss and future dental problems.
What Will Insurance Companies Cover?
When talking about insurance it is important to understand two concepts, annual maximum coverages and pre-existing conditions. The first one is the maximum your insurance will cover that year, any extra fees will have to come out of your pocket. Sometimes, if a part of the process is done at the end of the year and the next one at the beginning, you can still cover all of the expenses. And pre-existing conditions refer to any condition the patient had prior to the policy, which in some cases is a critical factor in coverage.
Medical procedures are divided into basic procedures, preventative care and major procedures. Preventative care is usually fully covered, however, it will vary for each individual case, so checking with your policy provider would always be wise. Basic services might be covered depending on the policy specifics, but 80% of coverage is typical in the industry.
Unfortunately, most dental implants are considered a major procedure. This means that unless the patient and dentist can demonstrate that the implant is a need and not a merely cosmetic or optional procedure, the patient might have to carry the treatment on their own. If the tooth falls due to an accident or injury it may be covered by the insurance.
Questions You Should Ask Your Insurance
There are a couple of questions that are important you ask your insurance company before starting a dental implant procedure to be better informed about the coverage and policy.
It is really useful to become familiar with the professionals included in your insurance network, this will make the process of finding a doctor much easier. You should also ask about the coverage structure and which parts of the dental implant procedure will your insurance cover. And finally be aware of schedule / appointment availability to make sure it matches your calendar and needs.
As previously mentioned, not all insurance policies will cover the whole implant process, others just provide partial coverage, and in a worst case scenario, the cost will have to be shouldered by the patient. Everything will depend on your insurance company and plan. Take a moment to schedule a consultation with one of our talented and caring professionals to learn more about dental implants and how we can work with you and your insurance company.