Health insurance and dental coverage can be confusing, especially when it comes to how much and what parts of a specialty procedures like dental implants are covered. Patients routinely ask us if their insurance covers dental implants, and the answer is that it depends on your insurance provider and type of implant treatment you receive.
Arlington Heights, IL dentist office AH Smiles 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 to be purely a cosmetic procedure, and therefore not medically necessary. However, anyone living with missing teeth knows that replacing the missing teeth is critical to their oral health as well as their self-confidence and sens of well-being.
It may require using both your medical and dental coverage to cover your implant procedure, depending on the reason that you have been recommended to have implants placed. The materials on dental coverage that you were provided upon enrollment may list whether it is covered at least in part and which part. Before agreeing to have any procedure, it’s important to ask the insurance company questions about coverage to ensure there are no surprise costs:
- Does my plan cover implants?
- What percentage of the procedure does my policy cover?
- What is my annual maximum out-of-pocket cost?
- Do I need a referral before receiving dental implants?
The staff at AH Smiles or your local dentist’s office will be able to work directly with your insurance provider to determine your coverage based on the proposed 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: If you have a damaged tooth that is beyond repair, this procedure will be part of your dental implant treatment. Most insurance providers will cover all or most of a tooth extraction.
Bone Grafting: Some patients may not have sufficient healthy jaw bone tissue to support an implant. These people may require a bone graft surgery to reinforce and strengthen the underlying jawbone tissue prior to the placement to ensure the implant will stay in place. This part of the procedure may not be covered, although it is a necessity for some patients.
Placing the Implant: The implant placement procedure is considered a “major” dental surgery but don’t be afraid of the word “major.” This term is commonly used by insurance companies but does not always reflect the intensity of treatment. Some dental insurance plans cover up to 50 percent of major procedures.
Placing the Artificial Tooth: The placement of the artificial tooth (crown) that provides the look and functionality of a natural tooth is also considered a major procedure. Some plans consider this part of the process to be the same as crowning a natural tooth after tooth decay and a root canal and may cover more of the cost, so it’s always a good idea to check directly with your insurance company.
Dental Implants in Arlington Heights, IL
We understand that navigating the world of insurance while on a budget can get confusing. The AH Smiles staff will work with you, your dentist, and your insurance company to help you get the best treatment based on your needs and your budget and a healthy smile. Schedule a consultation online or call (847) 230-9703 today.