Does Dental Insurance Cover Dental Implants?

When considering an investment in your smile like dental implants, you might wonder if dental insurance covers dental implants. Westborough Dental Associates can help you figure out if your Westborough, MA dental implants are covered by insurance and what to expect every step of the way. As the end of the year approaches, you may find out that you have unused insurance dollars or coverage that you can use towards your cosmetic goals.

How Dental Insurance Works

Many insurance companies consider dental implants a cosmetic, and therefore not medically necessary, procedure. Most insurance plans do not cover cosmetic procedures because they are not considered medically necessary, but anyone who is missing teeth knows that replacing the missing teeth is critical to their mouth health.

Covering your dental implant procedure may require using both medical and dental coverage, depending on the reason you need them. Review your insurance policy to see whether it is listed in the materials you were given when you started the policy. Before getting any procedure, it’s important to ask the insurance company questions to ensure there are no surprises:

  • Does the plan cover implants?
  • What percentage of the procedure does the policy cover?
  • What is my annual maximum out-of-pocket cost?
  • Do I need a referral before receiving dental implants?

Westborough Dental Associates staff will be able to work directly with the insurance company to determine your coverage based on the treatment plan.

Does My Dental Insurance Cover Dental Implants?

Your dental insurance may cover parts of the implant process, so we’ll explain each possible step below. Not all patients need each step, so if you are already missing teeth and have a healthy jawbone, you won’t need a tooth extraction or bone grafting, for example. Your coverage may also depend on whether you’re getting a full restoration (dentures) or one or two individual implants.

  • Tooth extraction: Most insurance companies cover tooth extraction, so if you need an extraction as part of your implant treatment, you are likely covered.
  • Bone grafting: Depending on how long it has been since you lost teeth, you may need to strengthen the underlying jawbone so the implant has somewhere to go. This part may not be covered, but you also may not need this part of the implant procedure if you have only recently lost teeth or have strong jaw tissue.
  • Implant surgery: The procedure to place the implant in the jaw is considered by insurance companies to be a “major” procedure, which refers to the cost rather than the intensity of the treatment. Some plans cover up to 50 percent of major procedures. You may also be able to have it covered after you meet your out of pocket deductible if that is part of your insurance plan.
  • Attaching the crown: The crown is also considered a major procedure, which may be covered in part by insurance. Some insurance companies classify this the same as crowning a natural tooth, so it may be at least partially covered.

Dental Insurance and Dental Implants in Westborough, MA

The last thing you want to think about when dealing with missing teeth is how you will pay for treatment. Our dedicated staff will work with you and your insurance company to maximize your insurance benefits and design a treatment plan that works for your needs and budget. Schedule an appointment with us online or call (508) 342-1519 today.