Oral and dental health are an important part of our overall health—both physical and mental. Poor oral health can lead to tooth loss, but so can age. As we grow older, losing teeth is a larger concern, and dental implants are one available solution. Dental implants replace any missing teeth to restore your smile and your ability to chew.
Because they’re often considered cosmetic, dental implants aren’t always covered by health insurance plans. Even when they are, they may still come with a high price tag. Original Medicare generally doesn’t cover dental care. While most Medicare Advantage plans do, prior authorizations and cost structures often cause you to be on the hook for most or all of the costs of dental implants.
We’ll explain the details of how dental implants work, who should consider getting them, and how coverage works with Medicare below. But, 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 implants are artificial teeth that are attached to your jaw using screws. The screws (attached to the artificial teeth via an abutment) act as the roots, and all that’s visible is the tooth itself. Dental implants help restore a person’s ability to chew, and can also restore someone’s confidence in their physical appearance. Getting dental implants often takes several months, and you may need to set aside time for recovery.
People of all ages may consider dental implants if they:
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:
Like with any medical procedure, placing dental implants has potential risks to consider. You should talk to your doctor about these risks before deciding to move forward with the implants:
The cost of dental implants varies, but the cost of one implant to replace one tooth is between $3,000-$4,500. For a full mouth of implants, you could be looking at paying $40,000-90,000. The cost of the procedure is high because it’s a lifetime investment and the procedure is pretty complex. In some cases, you may need a CT scan before starting. You may also require structural work like a sinus lift, which can increase the final cost.
Some of the other factors that can lead to higher costs include:
Dental coverage is lacking in Medicare. Generally speaking, Original Medicare and Medicare Supplement plans do not help cover the costs of dental care (although there are a few exceptions). While most Medicare Advantage plans offer dental coverage, 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.
While Medicare Part A might cover some dental services that are required during a hospital stay, Original Medicare does not generally include dental coverage. Dental implants are considered a cosmetic or elective procedure, so they are not covered under Original Medicare. This means that you’ll be responsible for the cost of dental implants, including consultations and related services.
Medicare Advantage 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. Because dental implants are often considered a cosmetic or elective procedure, they're often not covered. Medicare Advantage plans also have copayments, deductibles, and coverage limits that may make even covered services expensive. Many Medicare Advantage plans also require prior authorizations for covered services, so keep this in mind when considering your Medicare coverage options.
If you’re on Original Medicare, you may also have a Medicare Supplement (Medigap) policy. While Medigap policies do not directly cover dental implants (or any other dental care), some plans may offer supplemental dental coverage for services related to dental procedures or emergencies. Like with Medicare Advantage plans, check the details of your coverage to understand what is and is not covered.
Medicare may cover some post-surgery services that are deemed medically necessary. Medicare Part D covers any antibiotics or other medications you need after getting dental implants. Unfortunately, Original Medicare will not cover any additional dental procedures that you may need after dental implant surgery.
If you are still having trouble affording dental implants, there may be resources available to help. 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.