What are dental implants, and are they covered by your insurance?

The procedure is often partly covered, but several factors may affect your out-of-pocket costs. Here’s what to know.

Losing a tooth during childhood is an exciting milestone. But as an adult, it’s a bit more complicated. You don’t have another tooth growing in to take its place.

The good news is that losing a tooth doesn’t mean you have to deal with pain and a gap every time you smile. A dentist can address your missing tooth with a fixture that looks and feels like the real thing.

Dental implants are a popular solution that can help you chew and speak normally. They also hide any visible signs that you have lost a tooth. And depending on your dental plan, they may be at least partially covered by insurance. Below, learn all the basics about dental implants and whether they may be a good choice for you.

Did you know that some dental insurance plans may partially cover dental implants? Call a licensed insurance agent at (800) 827-9990 to find out which ones, or browse your options online today.

What are dental implants?

Dental implants are small fixtures that can be used to replace a missing tooth. The earliest forms of dental implants date back centuries, but dental implant technology continues to evolve to this day.

Implants are typically made of titanium. But ceramic implants have become a workable choice too. Researchers are also exploring 3D printing for dental implants. This is to customize them and make them more precise.

Typically, dental implants are made up of 3 parts:

1. The “implant itself, which is inserted directly into” the jawbone
2. A denture (removable) or crown (not removable) that resembles a natural tooth
3. An abutment that connects the 2 pieces

Dental implants can be placed during a single-stage or 2-stage procedure. If your provider opts for a single-stage procedure, they’ll attach a temporary abutment to the implant and potentially a temporary crown. Those will then be replaced with permanent fixtures after a few weeks of healing.

During part 1 of a 2-stage procedure, your dentist may cover the implant with gum tissue. Once it heals, they may perform a second surgery to place the abutment, then place the crown.

Whether you’ve lost a tooth due to injury or disease, dental implants may be a good option for the following reasons:

• They may help prevent further tooth-related complications.
• They may help keep your other teeth stable.
• They may help with your ability to chew.
• They may make your smile look fuller.

What are the pros and cons of dental implants?

Dental implants have some advantages over other solutions for tooth loss. Some of the pros include:

• Compared to partial dentures, which are removable, dental implants carry a lower risk of cavities or sensitivity in the surrounding teeth.
• Dental implants are also considered to be longer lasting than partial dentures — lasting at least 10 years in an estimated 97% of cases.

Like any dental procedure, dental implants come with potential complications too. Some of the cons include:

• The incision may reopen, exposing the implant.
• In rare cases, the implant may move around during the healing process or cause bone loss.

Thinking about getting dental insurance? Call a licensed insurance agent at (800) 827-9990 to learn more about available plans, or browse your options online today.

Are dental implants covered by insurance?

If you’re in need of dental implants and have dental insurance, you may be covered for part of the procedure.

“Dental implants are typically partially covered by dental insurance rather than fully covered,” says Salah Abuhammoud, D.D.S., an assistant professor of prosthodontics at the University of Iowa College of Dentistry and Dental Clinics. “The extent of coverage can vary depending on the insurance plan and provider.”

Factors such as waiting periods, annual maximums and lifetime limits can all impact how much you’ll have to pay out of pocket, according to Dr. Abuhammoud. (A waiting period is the time in which you wait between signing up for a plan and using it. An annual maximum is a limit on how much your provider will pay per year. And a lifetime limit is an overall cap on how much an insurance plan will pay for services.)

With so many variables, the most efficient way to find out if and how dental implants may be covered is to contact your insurance provider. Generally speaking, though, “most plans cover a percentage of the cost, often ranging from 25% to 50%,” says Dr. Abuhammoud.

The specifics of your coverage may hinge on whether your case is considered medically necessary or cosmetic by your plan’s standards, says Dr. Abuhammoud. “Dental implants are often considered medically necessary because they play a crucial role in restoring oral function and aesthetics,” he says. “However, the classification of ‘medically necessary’ can vary between insurance providers, which is why it’s important to check the specifics of your plan. Some insurers might still categorize certain implant procedures as cosmetic, depending on the circumstances.”

Before the procedure, you may also have to get preauthorization, an indication that your insurance company views your case as a medically necessary treatment. “Preauthorization is not always required but is often a good idea before services are rendered,” says Dr. Abuhammoud. The approval can take up to 30 days to be returned by insurance companies, he adds.

Bottom line: Dental implants may be a good option if you’re missing a tooth or teeth. And depending on your insurance, you may be partially covered for the procedure. That’s something to smile about, right?

Need a dental implant? Dental insurance may help. Call a licensed insurance agent at (800) 827-9990 to find out about available plans, or browse your options online today.

Disclaimer:
For informational purposes only. This information is compiled by HealthMarkets Insurance Agency and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.