Health insurance and dental coverage can be perplexing, especially when it comes to how much and what parts of a specialty procedure like dental implants will be covered. Patients often ask us if their insurance will cover dental implant placement, but the answer depends on your insurance company, coverage and type of implant treatment you receive. Chesapeake, VA dentist Dr. John C. Cranham will work with you and your insurance company to create a treatment plan to meet your needs while maximizing your available insurance coverage.
Understanding Dental Insurance Coverage
Most insurance companies view the placement of dental implants as a purely cosmetic treatment, and therefore not medically necessary. However, as anyone that lives with missing teeth can tell you, a full, healthy set of teeth is essential to one’s oral health as well as their self-confidence and sense of well-being.
It may require using both your medical and dental coverage to cover as much of your implant procedure as possible. Which will pay and how much, depends on the reason that you are being offered dental implants. The informational materials on your dental coverage that you were provided upon enrollment may discuss whether it will be at least covered in part. Before scheduling any procedure, it’s important to contact your insurance company to inquire about coverage to be certain there will be no surprise costs. Questions to ask include:
- Does your plan cover implants?
- What percentage of the procedure does the policy cover?
- What is your annual maximum out-of-pocket cost?
- Will I need a referral before receiving dental implants?
The staff at Dr. Cranham’s office will be able to work directly with your insurance company to determine your coverage based on the treatment plan Dr. Cranham creates for you.
Are Implants Covered By My Insurance?
To determine whether your insurance covers implants, it’s important to understand the different parts of the dental implant procedure and what kind of preparation is needed for your mouth to receive them. The amount that your insurance covers will also be dependent on whether you will be getting a full arch of teeth restored or just one or two missing teeth.
Tooth Extraction: If you have a tooth that is damaged beyond repair, you will need to have it extracted prior to your dental implant treatment. Most insurance companies will cover all or most of a tooth extraction regardless of whether it is part of an implant treatment plan or not.
Bone Grafting: Some patients may not have enough healthy jaw bone tissue to support an implant. If this is the case, a bone graft surgery may be necessary to reinforce and strengthen the underlying jawbone tissue to help the implant stay securely in place. Unfortunately, this part of the treatment may not be covered, although it is a necessity for some patients to benefit from dental implants.
Placing the Implant: The implant placement procedure is defined as a “major” dental procedure by insurance companies. However, don’t let that word scare you. “Major” is frequently used by insurance companies to describe the cost of the procedure and does not always reflect the intensity of the treatment. Some dental plans may cover up to 50 percent of major procedures.
Placing the Artificial Tooth: The placement of the artificial tooth (crown) that restores the look and functionality of a natural tooth is also considered a major procedure by insurance providers. Some plans consider this part of the procedure to be the same as crowning a natural tooth after tooth decay and a root canal. Therefore, more of the cost may be covered for this aspect of the treatment so it’s always a good idea to check directly with your insurance company.
Dental Implants in Chesapeake, VA
We understand that working within a budget with your insurance coverage can get confusing. Dr. Cranham’s dedicated staff will work with you, and your insurance company to offer you the best treatment based on your needs and budget — and a long-lasting smile. Call 757.656.4109 or contact us online to schedule a consultation today.