Does Medicare Cover Dental Implants
A versatile, highly customizable tooth replacement technology for edentulous patients of all ages, dental implants can greatly improve quality of life for adults from all walks of life. Indeed, dental implants offer a number of advantages as compared with conventional dentures, making them more and more attractive to those who are reticent about the prospect of having dentures made. However, dental implants also take more time to create and place and are generally more costly than conventional dentures, which can raise some pressing questions about affordability and insurance coverage. Those with Medicare might find themselves asking: Does Medicare cover dental implants? Unfortunately, the short answer is no; Medicare does not cover dental implants. Nevertheless, it is possible to achieve some coverage of certain portions of procedures and prescriptions by both Medicare and alternative insurance coverage, so it is important to understand what Medicare does and does not provide before going ahead with plans to get dental implants.
Dental Implants Overview
Dental implants offer a form of tooth replacement that, in contrast to other existing alternatives, truly replaces the entirety of the tooth. Unlike conventional dentures, which sit upon the gumline and showcase prosthetic crowns that operate only above the surface of the gum, dental implants also provide a stand-in for dental roots, which play an important part in providing strength, stability, and even stimulation that preserves bone mass in the jaw.
As such, the first step in installing dental implants is a surgical procedure in which the prosthetic root – also known as the implant fixture – is embedded into the jawbone. This small post, typically made of titanium, remains hidden below the surface of the gums, which are stitched up and allowed to heal following the procedure.
The next step is perhaps the lengthiest of the entire process and also an invisible one: the implant fixture must be allowed a period of time to fully fuse with the jawbone, becoming one with this foundational oral structure. This can take anywhere from two to four months and cannot be rushed. This process of osseointegration is the most important part of the process of installing dental implants, as the implant fixture is what provides the impressive strength and durability of the implants that they support.
Once the implant fixture has fused with the jawbone, a connecting piece called an abutment is then attached to the top of the fixture, below the gumline. After that has been done, the prosthetic crown or other appliance (i.e. implant-retained bridge or denture) can then be attached to the abutment, thereby finalizing the process.
Cost of Dental Implants
Given the labor-intensive process of creating and installing dental implants, which also includes surgical intervention and all the costs associated with surgery, dental implants are a significant financial investment. While costs for single or multiple dental implants can vary widely based on geographic location, expertise, and material choices, a single dental implant usually costs anywhere from $1500 to $4000, with a full set of implants costing around $30,000. Costs for full replacement can be less with implant-retained dentures, which only require two to six implants per arch.
These estimates assume that there is good quality bone mass already existing in the jaw; if bone mass is not adequate to support dental implants, bone grafting could be required before beginning the process of installing dental implants. This would necessitate extra charges.
Medicare and Dental Implants
Medicare Parts A and B, also referred to as original Medicare, does not cover dental implants on the whole. However, some visits may be covered by Medicare Parts A and B, usually in cases in which these visits are associated with another procedure or comprise a pre-op visit in the hospital. Instances in which coverage is provided are very limited, so it is important to check with your Medicare support team to find out if any of your planned visits might be covered in advance of scheduling them.
Medicare Part D, which is an add-on to Medicare Parts A and B, may cover any prescription drugs that are required before, during, and after the installation of dental implants. Because Part D is not a part of original Medicare, you should first ensure that you have this add-on coverage before then verifying if and what medications may be covered by your plan.
Medicare Part C, also known as Medicare Advantage, tends to vary quite a bit in terms of coverage. This is because it is administered by private insurance companies with different coverage parameters. If you have Medicare Part C, you should have a careful conversation with a plan administrator about what is and isn’t covered when it comes to dental implants.
Similarly, Medigap, or supplemental Medicare plans, can vary widely in terms of coverage. Most plans will not cover the full cost of dental implants, but some plans will cover select visits and procedures. To find out more, contact your plan administrator directly.
Alternative Coverage, Payment Plans, and Other Options
Because many find that the various parts and supplemental plans associated with Medicare do not cover enough of the costs of dental implants to make them financially accessible, it can be worth the cost of purchasing alternative private insurance to cover more of the cost. Because your dentist, oral surgeon, and assistants deal with these policies every day, they can be a wonderful resource in steering you towards an alternative insurance plan that can provide better coverage than Medicare does.
As providers of high-cost health solutions, your dentist also may provide payment plan options via their office, as well. While this is not the same as insurance coverage, the ability to make low monthly payments on such a hefty financial investment can make or break some folks’ decision to pursue a technology like dental implants or not.
Finally, if you can’t make it work with dental implants, it is important to remember that there are good alternatives, most of which are much more affordable as well as quicker to produce and place. You may find that Medicare doesn’t cover the cost of bridges or conventional dentures, either, but the price point on these alternatives is low enough that a monthly payment plan is often enough to make these interventions affordable, even on limited incomes.
For more information on tooth replacement options that could work for you, as well as more information on insurance coverage and payment plans, call our office today.