Dental implants are a popular treatment for missing teeth and jaw issues, particularly among seniors aged 65-74 years old.
When properly placed, dental implants can provide long-lasting support for artificial teeth that can improve a person’s appearance, chewing ability, and overall quality of life.
Though Medicaid covers dental services for all enrollees under the age of 21, states determine whether or not to provide dental benefits, such as free dental implants, for adults.
Unfortunately, less than half of the states provide comprehensive dental care to adults with Medicaid. When paid out-of-pocket, dental implants can cost up to $6,000 per implant, creating a significant financial barrier for many people.
In this article, we’ll cover where Medicaid may offer full or partial financial support for dental implants, whether or not Medicare covers dental implants, and alternative programs available to help lower the cost of this surgical treatment.
Key takeaways
Less than half of the states in the U.S. provide comprehensive dental care for Medicare-enrolled adults.
States that may help cover the cost of dental implants for adult Medicaid enrollees include California, Ohio and West Virginia, but the state may require that the implants are deemed medically necessary and there may be a cap for benefits received in a single year.
Alternative options for finding affordable dental implants include dental schools, clinical trials, and nonprofit dental clinics.
Does Medicaid cover dental implants?
Unfortunately, most states’ Medicaid programs do not cover dental implants for adults, and less than half of the states provide comprehensive dental care for adult Medicaid beneficiaries.
In many states, dental implants are considered an elective or cosmetic treatment, making them ineligible for Medicaid coverage.
However, some states may cover the cost of dental implants if they’re deemed medically necessary, restorative, or required for the treatment of a medical condition, like trauma or cancer. States that may cover dental implants for adult beneficiaries include:
California
Ohio
West Virginia
It’s important to keep in mind that even when Medicaid helps cover the cost of dental implants, there may be a financial cap on the cost of services you’re eligible to receive every year or two years.
Does Medicare cover dental implants for seniors?
Original Medicare (Parts A & B) does not typically cover dental care unless that dental care is administered during an in-hospital stay and connected with the medical care required during hospitalization.
According to the Centers for Medicare & Medicaid Services, the “replacement of teeth or structures directly supporting the teeth” is considered a non-covered dental service.
Alternative programs for affordable dental implants
The cost of a dental implant will vary depending on a number of factors, including the type of implant used, the procedure, and where the procedure is performed.
According to the American Academy of Implant Dentistry, the average cost range of a dental implant or similar procedure is $3,100-$5,800.
Given the high cost of dental implants, many seniors may look for low-cost alternatives for dental care.
Dental schools
Dental care performed by students in dental school will cost significantly less than that performed by a regular dental practice. Though the procedure may take longer, all visits are supervised by experienced faculty.
Though the exact cost of a dental implant will vary depending on where you live and which dental school you visit, according to the Dental Center at UCSF, care performed by student dentists costs between 40%-60% less than what you would receive at a traditional dental practice.
If you decide to pursue a dental implant at a dental school, be sure to find an accredited school with implant programs and experienced supervisors.
Clinical trials
Participating in a clinical trial can be an effective way to receive free or low-cost medical care. However, finding the right study that offers the exact type of treatment you need, in this case a dental implant, may be difficult or take a long time.
There are also eligibility requirements for participating in a clinical trial. If selected, there may also be risks and considerations you'll have to weigh against the benefit of the care received.
To look for appropriate trials, you can browse studies currently recruiting participants at ClinicalTrials.gov.
Nonprofit dental clinics
Nonprofit dental clinics are volunteer-driven organizations that provide reduced fee, sliding scale, low-cost, or free dental care to underserved individuals.
Examples of nonprofit dental clinics that may provide dental implants include:
Mission of Mercy
Remote Area Medical
Community Dental Clinics
However, many of these organizations have limited availability and eligibility requirements. What’s more, not all nonprofit dental clinics provide dental implants, so it’s important to reach out to a nonprofit clinic near you to learn about what services they provide.
Dental tourism
Some people may choose to travel to countries with significantly lower costs of dental care, like Mexico, Costa Rica, or Thailand.
However, it’s important to consider how much it will cost you to travel to said location and compare that with how much it would cost you to receive care in your state. In addition to weighing travel expenses, getting dental care in another country may limit your opportunity for follow-up care and quality control.
Bottom line
Medicaid coverage for dental implants is extremely rare and usually limited to medically necessary cases in select states.
Seniors interested in getting dental implants can explore low-cost alternatives, including dental schools, clinical trials, nonprofit dental clinics, and dental tourism.
Frequently asked questions
Does Medicaid pay for dental implants?
In most cases, no, Medicaid will not pay for dental implants because they are considered cosmetic or elective procedures. However, some states may cover the procedure when deemed medically necessary.
What states cover dental implants for Medicaid recipients?
California, Ohio, and West Virginia may cover dental implants for Medicaid recipients if the procedure is medically necessary or connected with the care of a medical condition. However, some states have a cap on how much they’ll pay per year for this procedure.
Does Medicare cover dental implants for seniors?
No, Original Medicare will not cover the cost of dental implants unless the procedure is performed as part of a hospitalization stay and in connection with medically necessary care performed in the hospital.
Sources
Elani, H., Starr, J., Da Silva, J., & Gallucci, G. (2018). Trends in dental implant use in the U.S., 1999–2016, and projections to 2026. Journal of Dental Research, 97(13), 1424–1430. https://doi.org/10.1177/0022034518792567
Does Medicaid cover dental care? (n.d.). U.S. Department of Health And Human Services. https://www.hhs.gov/answers/medicare-and-medicaid/does-medicaid-cover-dental-care/index.html
Medicare Dental Coverage | CMS. (n.d.). https://www.cms.gov/medicare/coverage/dental
How much do dental implants cost? (n.d.). American Academy of Implant Dentistry. https://connect.aaid-implant.org/blog/how-much-do-dental-implants-cost
FAQ | UCSF Dental Center. (n.d.). UCSF Dental Center. https://www.ucsfdentalcenter.org/about/faq
