Will My Insurance Cover Dental Implants?

Many people who seek to restore their smiles turn to dental implants, a reliable and permanent option that closely mimics the look and function of natural teeth. While the benefits of dental implants are clear, many people face the question: Will my insurance cover dental implants?

If getting dental implants is important, it is equally important to understand the insurance coverage, as dental implants are a huge investment.

In this blog, we’ll explore whether insurance covers dental implants, the factors that affect coverage, and what you can do if your policy falls short.

To find out if your insurance covers dental implants, you need to know what parts of the treatment are involved and what kind of preparation your mouth might need.

Tooth Extraction

If you’re missing teeth already, you may not need extractions, but if a damaged tooth is still in place, it will need to be removed before the implant is placed. Tooth extractions are often covered by most insurance companies, either fully or partially, as it is considered necessary for the implant procedure.

Bone Grafting

Some patients need bone grafting to strengthen the jawbone before the implant is placed. Unfortunately, bone grafting may not be covered by insurance, even though it is an essential step in ensuring the success of the implant. It’s important to check with your insurance provider to see if they cover this crucial procedure.

Placing the Implant

The actual implant placement is considered a “major” dental procedure. Some dental insurance plans cover up to 50% of major procedures, but it’s essential to confirm the specifics with your provider.

Placing the Artificial Tooth (Crown)

The artificial tooth, or crown, is put on top of the implant to make it look like a natural tooth. Some insurance plans cover a portion of this procedure, especially if it is considered similar to a crown used for tooth decay. Coverage for the crown can vary widely, so it’s important to check directly with your insurance company to understand what’s included.

Generally, most dental insurance plans do not fully cover the cost of your dental implants. They may cover certain parts of the procedure, such as the initial consultation, X-rays, or even extractions, but the actual implant and surgery are often considered elective or cosmetic procedures, making full coverage less likely.

The difference between medical and dental insurance also plays a key role in implant coverage. While dental insurance may only cover a small portion of the implant process, medical insurance could cover more if the procedure is deemed medically necessary—for example, if tooth loss is caused by an injury or certain medical conditions. In such cases, your medical plan might pay for the surgery, while your dental plan covers the restoration (like the crown placed on the implant).

Check Your Insurance Policy

Start by reviewing your insurance policy’s coverage details, either through your policy documents or online portal. Look specifically for sections related to dental implants or major restorative dental procedures. Some policies will outline what is covered, what is excluded, and whether implants fall under medical or dental insurance.

Contact Your Insurance Provider

For a clear and direct answer, call your insurance provider’s customer service line to ask about your specific plan’s coverage for dental implants. Be sure to ask about any restrictions, such as pre-existing conditions or waiting periods, and inquire about coverage for different parts of the procedure (consultation, surgery, restoration).

Consult with Your Dentist’s Office

Most dental offices have insurance specialists who can help verify your coverage. They contact your insurance provider on your behalf and provide an estimate of what costs will be covered versus what you will need to pay out of pocket.

If your insurance doesn’t cover dental implants, there are still several ways to make the procedure more affordable:

Alternative Payment Options

Many dental offices offer flexible payment plans which allows you to pay for your implants in monthly installments instead of covering the entire cost upfront. It eases the financial burden and makes the procedure more manageable. 

Dental financing options, such as credit programs like CareCredit, also allow you to finance the cost of your implants with low or no interest, depending on the terms.

Discount Dental Plans and Savings Options

If your insurance doesn’t cover implants, consider enrolling in a discount dental plan. These plans aren’t insurance, but they offer discounted rates for dental services, including implants, when you visit participating providers. Some dentists may also offer in-house savings plans for patients without insurance, which can reduce the overall cost of the procedure.

While many insurance plans offer partial coverage for certain aspects of the procedure, others may require alternative payment solutions. It’s essential to understand your plan, ask the right questions, and explore all available options.

At 5th and Olive Dental, Seattle WA we’re here to help you understand the insurance coverage and explore the best options for your dental implants. Book an appointment today or call us at (206) 340-2500 to start your journey toward a confident, restored smile!

Most dental insurance plans do not cover the full cost of dental implants. However, depending on the plan, they may cover parts of the procedure, like the consultation, X-rays, or crown.

Medical insurance might help if the implants are considered a medical necessity, such as after an injury or due to certain medical conditions that impact your ability to eat or speak.

Some dental plans may cover up to 50% of the cost for major procedures like implant placement. However, this varies by plan, so it’s important to review your policy carefully.