Does Medicare Cover Dental Implants
A dental implant is a tooth replacement option that uses a titanium or zirconia post placed into the jaw bone that secures a crown or bridge.
The simple answer is no; Medicare plans do not cover dental care in general. Dental implants are included in that dental care. Despite this broad policy towards dental procedure, Medicare may cover different costs associated with getting dental implants.
The first thing to keep in mind about Medicare and dental services, is that Medicare usually does not cover any dental service. The exception comes in when the dental care is related to an illness or injury. One of the reasons Medicare may cover a dental appointment is when you need to be cleared by a dentist for organ transplant surgery or heart valve surgery. If you suffer from oral cancer or have had a face or jaw injury, Medicare will usually cover the dental procedures you need to address those instances. Medicare almost always pays for inpatient hospital care. If your dental procedure is complex enough to need to be completed in the hospital, Medicare should pay for the hospital stay. You will still be responsible for the dental procedure.
Knowing that Medicare does not pay for dental implants themselves means that you could still expect Medicare to cover some associated costs. Depending on your dentist and you oral and medical health, the dentist may choose to do your implant procedure in the hospital. Medicare may cover the costs associated with your hospital stay. If you struggle with health complications as a result of your dental implant surgery, then Medicare will typically cover the medically necessary care to address those complications. An example of this would be problems as a result of an infection from your dental implant surgery.
What Does Medicare Cover For Dental Care?
There are some Medicare Advantage plans that do offer benefits for dental care; these benefits can include any services related to dental implants. Private Medicare-approved insurance companies offer Medicare Advantage plans. These private insurance companies are able to offer supplemental benefits in these Medicare Advantage plans that are not available with Original Medicare. In fact, many of the Medicare Advantage plans include annual dental exams and routine cleanings. Moreover, some Medicare Advantage plans even offer supplement dental insurance. These policies will cover more complex dental procedures like tooth replacement and restoration, extractions, and fillings. These types of policies may include dental implants. It is important to be sure that your dental care provider is in your network; the policy may only cover a percentage of the additional services. Take the time to talk to the dentist about the type of procedures you need and then take time to review your policy to note their coverage type. When the bill comes, you will be more prepared and be able to make a more informed decision. Depending on your Medicare Advantage plan, you may have a separate monthly premium to have the supplemental dental insurance.
Does Medicare Cover Dental Medications Before or After Implant Surgery?
Depending on the location where you have your dental implant surgery, Medicare may cover medications. If you have your dental implant surgery in the hospital, Medicare Part A will cover any medications you need to take when you are in the hospital. In nearly all other instances for Original Medicare, there is not typically any prescription medication coverage for dental services.
In the case of Medicare Part D Prescription Drug Plan, your plan will most likely cover antibiotics, pain medication, and the other prescription medications the doctor prescribes for your procedure either prior to it or afterwards. Even Medicare Advantage plans with prescription drug coverage offer similar opportunities to pay for medications related to your dental implant. Before you have the dental implant procedure, be sure to talk to the dentist about the types of medications they may prescribe for you. Additionally, be sure to review the plan formulary to ensure the prescribed medications suggested by the dentist prior to your dental implant surgery will be covered.
In the case of routine dental care and more specifically dental implant, Original Medicare, Part A and Part B, do not provide coverage. Some Medicare Advantage plans can include routine dental services in their coverage. Medicare Part C is one way to secure your Medicare coverage through a private health insurance company that is approved by Medicare. Before Medicare Advantage plans can offer additional coverage, they first must provide the same benefits as Medicare Part A and Medicare Part B. Their additional coverage often extends into prescription medication coverage and routine dental care. When you are looking at Medicare Advantage plans, take the time to ask specifically about dental implant coverage or other dental services you think you may need going forward. If you choose a Medicare Advantage plan, you may still need to pay your monthly premium for your Medicare Part A or Medicare Part B plan in addition to the premiums from your Medicare Advantage plan.
How Much Do Dental Implants Cost?
While there is no way to determine the specific cost of your dental implant without first talking to the dentist performing the procedure, it can cost you between $1,000 to $3,000 for the implant alone. Dental implants may also need an abutment to attach to the crown and a crown itself. Those additional components may cost an additional $500 to $3,000 each. In the event you are looking to replace all your teeth with a full set of implants, you may end up paying about $30,000.
If the impact of dental implants on your budget without the assistance of Medicare, you can talk to the dentist about the alternative tooth replacement options including removable partial dentures, fixed-tooth bridges, and even resin bonded bridges. The cost of these procedures will not be as high as dental implants but these are not covered by Medicare either.
If you want to move forward with dental implants, you may want to consider obtaining dental insurance from a private insurance company. Not all insurance companies cover dental implants so ask about coverage when looking into different policies.