Does Insurance Cover Dental Implants?

Health insurance and dental coverage can be confusing, especially when it comes to specialty procedures like dental implants. Many patients ask us whether insurance covers dental implants, and the answer is that it depends on your insurance and type of implant treatment you receive. Reston, VA dentist office Ridgetop Dental will work with you and your insurance company to create a treatment plan that fits your needs and budget.

Understanding Dental Insurance Coverage

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?

The staff at your dentist’s office will be able to work directly with the insurance company to determine your coverage based on the treatment plan.

Are Implants Covered By My Insurance?

To determine whether your insurance covers implants, it’s important to know the different parts of the treatment and how much mouth preparation is needed. The amount of coverage also depends on whether you are receiving a full arch of restored teeth or just replacing one or two missing teeth.

Tooth Extraction: Depending on whether you are already missing teeth or if the tooth needs to be extracted, this procedure will be part of your dental implant treatment. Most insurance companies cover all or most of a tooth extraction.

Bone Grafting: Some patients need their underlying jawbone strengthened prior to the implant procedure to ensure the implant will stay in place. This part of the procedure may not be covered, despite it being a crucial step in the implant procedure.

Placing the Implant: The implant placement procedure is considered a “major” dental procedure. Don’t be afraid of the word “major,” though — this is a term insurance companies use that does not always reflect the intensity of treatment. Some plans cover up to 50 percent of major procedures.

Placing the Artificial Tooth: The artificial tooth that provides the appearance and functionality of natural teeth is also considered a major procedure. Some plans consider this the same as crowning a natural tooth and may cover more of the cost, so check directly with your insurance company.

Dental Implants in Northern Virginia

We understand that working with insurance and a budget can get confusing. The Ridgetop Dental staff will work with you, your dentist, and your insurance company to offer you the best treatment based on your needs and budget — and a long-lasting smile. Schedule a consultation online or call (571) 313-7010 today.