Does Medicare Cover Dental Implants?
Modern dentistry offers several options when you lose teeth, including dental implants. These implants can restore both your smile, your confidence, and your ability to eat comfortably. While dentists try to save your natural teeth when possible, sometimes implants are the best choice for replacing missing or decayed teeth.
However, dental implants are expensive, and Original Medicare doesn't cover them. This means you'll need to find other ways to pay for this procedure.
Like with any healthcare service, check the details of your specific health insurance coverage to determine if it covers dental implants. If you’re unsure, give us a call or speak with your doctor to get help understanding what’s covered and how much you will owe out of pocket.
Dental coverage on Medicare
Dental coverage is lacking in Medicare. Generally speaking, Original Medicare and Medicare Supplement plans do not help cover the costs of dental care or dental implants (although there are a few exceptions).
While most Medicare Advantage plans offer some dental benefits, you should be sure to understand the specifics of your Medicare Advantage plan to know what you’ll owe for routine care and other dental services.
Here's what you need to know:
Original Medicare
Original Medicare does not generally include dental coverage. When it provides coverage, it won’t pay for implants even if they are considered necessary.
If you need a hospital stay in connection with your dental implant procedure, Medicare Part A might cover some hospital costs. The dental implants themselves are not covered for two reasons:
Medicare offers no dental coverage
Implants are considered a cosmetic, elective procedure, and Medicare won’t pay for these types of services
This means that you’ll be responsible for the cost of dental implants, including consultations and related services like routine exams, X-rays, and cleanings.
Medicare will pay for some dental services under Medicare Part B if the service is related to certain medical conditions. This coverage never extends to implants.
If you need a heart valve replacement or a bone marrow, organ, or kidney transplant, Medicare will pay for an oral exam and dental treatment.
If you are getting chemotherapy treatments for cancer, Medicare will pay for tooth extractions to treat mouth infections.
If you are getting treatment for head and neck issues, Medicare will pay for treatment tied to complications.
If you have an accident that requires jaw reconstruction, Medicare will pay for that but not any cosmetic work, such as crowns, dentures, or implants.
Medicare Advantage
Medicare Advantage plans, also known as Medicare Part C plans, often include additional benefits, such as dental, vision, and hearing coverage. If you are considering a Medicare Advantage plan to help cover the cost of dental implants, carefully review all of the plan details. Benefits vary widely, and only some plans will cover cosmetic or elective procedure.
These plans are typically set up as HMOs or PPOs, which means that full coverage only applies for in-network dentists. Even if you have dental implant coverage, you must use an in-network dentist to get full coverage.
Medicare Advantage plans also have copayments, deductibles, and coverage limits for dental care that may make even covered services expensive. Many Medicare Advantage plans also require prior authorization for covered services. Keep this in mind when considering your Medicare coverage options.
Medicare Supplement
If you’re on Original Medicare, you may also have a Medicare Supplement (also called Medigap) policy. Medicare Supplement plans don't cover dental implants or any other dental care directly.
However, some offer dental coverage for services related to routine dental checkups or emergencies. Several of these dental insurance plans are add-ons to your Medicare Supplement. In this case, you'd pay an extra monthly premium for dental coverage. Even with this coverage, you’ll likely still have out-of-pocket costs like copayments, coinsurance and deductibles.
Medicare coverage after dental implants
Medicare may cover some post-surgery services that are deemed medically necessary. Medicare Part D covers any antibiotics or other prescription drugs you need after getting dental implants. Unfortunately, Original Medicare will not cover any additional dental procedures that you may need after dental implant surgery, even if they are considered medically necessary.
Dental implants 101: Everything you need to know
What are dental implants?
Dental implants are artificial teeth that replace any missing teeth. They're secured to your jaw with small screws, similar to how natural tooth roots work. The artificial tooth attaches to the screw using a connector piece called an abutment. Unlike dentures, which you can remove daily, dental implants stay permanently in place.
You might consider dental implants if you:
Have missing teeth
Want a long-lasting alternative to dentures
Have trouble speaking clearly due to missing teeth
Want to eat and smile with confidence
Getting dental implants put in place usually takes several months to complete, with time needed for healing between steps.
Benefits of dental implants
Most obviously, dental implants restore your smile and your ability to chew. As a result, they generally increase confidence as well. Some of the other benefits of dental implants are that they:
Help your jawbone maintain the correct size and structure
Keep gums and adjacent teeth healthy
Support the stability of adjacent teeth
Improve your quality of life
Potential risks of dental implants
Like with any medical procedure, placing dental implants comes with potential risks you should consider. You should talk to your doctor about these risks before deciding to move forward with the implants. Risks include:
Damage to surrounding teeth during the procedure
Injury during surgery to either your jaw or surrounding tissue
Infection to your bones and gums
Poor implant function due to a loose abutment screw or shape of the implant
Are there different types of dental implants?
There are several types of dental implants, each designed for different needs. Here are six of the most common dental implants:
Endosteal implants: These are the most common type of dental implants. Titanium screws are placed directly into your jawbone to support replacement teeth. They offer a stable, long-lasting solution.
Subperiosteal implants: These sit on top of the jawbone, under your gums. They're a good option if you don't have enough jawbone for traditional implants and want to avoid bone grafting surgery.
Implant-supported bridges: When you're missing several teeth, implants can support a bridge. This prevents nearby teeth from shifting and helps maintain normal chewing and speaking.
Zygomatic implants: For those with significant upper jaw bone loss, these implants attach to the cheekbone instead. While more expensive, they eliminate the need for bone grafting.
All-on-4 implants: These support a full arch of teeth using just four implants. They're often less expensive than traditional dentures and provide a more stable fit.
All-on-6 implants: Similar to All-on-4, but using six implants for extra stability. These work well for people with more bone loss who need additional support.
Talk to your dentist about which option best fits your needs, budget, and oral health.
What’s the cost of dental implants?
Dental implants are a significant investment, but they can last a lifetime. The total cost of dental implants varies based on where you live and your specific needs.
A single tooth implant typically costs between $3,000-$4,500. An implant-supported bridge ranges from $5,000 to $16,000. Full-mouth implants can cost between $40,000-90,000.
Your total cost depends on:
How many implants you need
Your location and choice of dentist
The type of implant used
Whether you need additional procedures
Additional procedures that affect the final cost include CT scans, x-rays, bone grafting, sinus lifts, and anesthesia. Some cases require an oral surgeon, which can increase costs further.
Ways to reduce the costs of dental implants (outside of insurance coverage)
Even with dental insurance, the out-of-pocket costs for dental implants can be high. But you may have access to resources that help lower the costs.
Most dental offices have financing plans for costly services like implants. Community-based health providers, dental schools, and charitable organizations often provide dental services at reduced costs or on a sliding scale based on income.
If you have any questions about what your Medicare insurance covers or how you can get coverage that better fits your health and financial needs, we’re here to help! Speak with one of our licensed Medicare Advisors or caring Advocates to get help understanding your healthcare options.