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Will Insurance Cover Dental Implants?

will insurance cover implants

Dental implants are an increasingly popular choice when we need to replace a lost tooth or teeth. The reasons for choosing an implant are clear: implants look just like our natural teeth, are firmly anchored in the jaw just like our natural teeth, and are easy to clean and care for just like our natural teeth.

Not as clear? Whether your insurance will cover your implant procedure. Because implants are often more expensive than other replacement options, it’s important to learn just what your insurance plan provides, and what your out-of-pocket expenses will be. What do you need to know?

Know your policy

Dental and medical plans vary widely, from individual to individual, company to company, and state to state. Depending on your specific policy, you might be covered for part or most of the cost of a procedure, or your plan may provide no coverage at all. It pays to find out ahead of time!

Know the reason for your procedure

Your coverage may be affected by the reason for your procedure and whether it’s seen as medical or dental.

  • If your dental insurance policy considers an implant to be a cosmetic or an elective treatment, implant surgery may not be covered. However, the cost of the crown restoration could be, at least in part.
  • If implants are used to anchor a bridge or a denture, your dental policy might provide partial coverage, at least to the monetary extent that the insurance company would cover standard bridges or dentures.
  • If you are suffering medical complications because of tooth loss due to illness, accident, or injury, your medical health insurance could cover some of your expenses.

 Know your plan’s annual and lifetime limits

If you do have dental coverage, there might be limits imposed on the kind and number of procedures allowed during a calendar year. You could also have yearly maximum benefits or lifetime maximum benefits, after which your expenses will be out-of-pocket.

Find out which steps of the implant procedure are covered

The implant process can require different steps, some of which may be covered by insurance while others are not. Depending on your needs, these steps can include:

  • Extraction
  • Bone grafting
  • Implant surgery
  • Crown restoration
  • Anesthesia

Your policy may or may not cover any of these individual procedures, so it’s always best to discover exactly what’s involved in your implant treatment before you begin.

Know how to find out what you need to know!

  • Talk to our Union City, NJ office before you schedule surgery. Oral and maxillofacial surgeons are experts in implant procedures, and can provide you with an explanation of just what services will be involved at every stage of your implant treatment, as well as a pre-treatment estimate.
  • Talk to your dental insurer to see exactly what coverage they provide for the procedure or procedures you might need.
  • And don’t forget to touch base with your medical insurer if you need implants as the result of a medical condition, accident, or injury.

Finally, talk to Dr. Herbst again! We want to make sure that you receive all of the coverage that you are entitled to, and that your implant procedure is as affordable as it can be for this lifetime investment in your oral health. Whether it’s working with you to make the most of your insurance coverage, or working with you to discuss a financing plan that fits your budget, we will do their best to provide the clear answers you need.