It is very rare for Original Medicare to cover any dental procedure, including dental implants. Original Medicare might cover dental procedures in cases of traumatic injury to the face that require hospitalization, but Medicare patients who desire comprehensive dental insurance need to sign up for Medicare Advantage plans or work with a private dental insurance provider. Even though Medicare can’t be expected to cover dental implants, it may cover certain costs that can be associated with dental implant treatment, and some Medicare Advantage plans and private insurers do, in fact, cover dental implants. With so many different things to consider, make sure you’re carefully researching your options if you’re thinking about getting dental implants to replace your missing teeth. It can be helpful to understand the dental implant procedure, too, as you’re learning about which types of treatments and procedures might be covered in each of your prospective insurance plans.
Dental implants are tiny cylindrical posts that are surgically implanted into the jawbone, underneath the gums. As the bone heals around the implant posts, it fuses to the implant, creating an impregnable bond. Once the bone has fully healed to the implant post, the top of the implant is exposed and an attachment abutment is affixed; then, a prosthetic tooth called a dental crown is attached to the abutment, creating a structure that looks, feels, and acts like a natural, healthy tooth. The dental implant procedure takes a relatively long time and may include multiple ancillary procedures, like bone grafts or treatment of periodontal disease, and it may also require multiple different procedures and prescriptions, some of which may be covered by Medicare.
Medicare Part A provides coverage for patients in a hospital setting, and Medicare Part B provides coverage for outpatient procedures and general medical care. It’s unusual to get dental implants placed while in a hospital, though it’s not impossible, but it’s not uncommon for dental procedures to be prerequisites for other procedures, like heart valve replacement or certain organ transplants; these prerequisite dental procedures may be covered by Medicare Part A. Additionally, some parts of the overall treatment plan for dental implants could occur in a hospital and may therefore be covered, though this isn’t something anyone should rely on, as it’s an uncommon situation. It’s very important to research the nuances of your specific coverage with individual hospitals before committing to any treatment, however, as sometimes Medicare pays only for hospital admittance and not for the care provided in the hospital once the patient is admitted.
Medicare Advantage, which is also called Medicare Part C, allows patients to receive their Medicare benefits from private insurers. Medicare Advantage plans are required by law to be at least as comprehensive as Medicare Part A and Medicare Part B, andmany Medicare Advantage plans also provide additional coverage like dental or vision insurance. Because these plans are provided by private insurers, they face a number of limitations, including reduced coverage areas; for many patients, this is an acceptable trade-off for the additional benefits these plans provide. Using Medicare Advantage can be more complicated than Original Medicare, and there isn’t an easy way to know in advance whether a Medicare Advantage plan will cover dental implants, so thorough research is important.
Because the Medicare Advantage coverage options for dental implants are limited, you may want to think about a private dental insurance plan. If you decide to choose a private dental insurance provider, check with them to learn about the extent and specifics of their coverage and ask if this coverage includes dental implants, as many private providers do. Many dental practices also work with third-party financing organizations to help patients pay for dental implants in reasonable installments. The cost of dental implants can vary widely and depends on the geographical location of the doctor and patient, the number and location of implants needed and the materials used, and the overall health and oral health of the patient, among other things. Because dental implants are made up of a few different pieces, including the implant post and the prosthetic tooth itself, the cost of each piece should be factored into the total cost of the procedure. Implant posts, which are made of titanium or other medical-grade, biocompatible material, tend to range in price from about $1,000 to $3,000 or more, per implant. The attachment abutment and dental crown are priced separately and can range from as little as $500 to more than $3,000. While this is a significant range, it is generally safe to say that a single dental implant will rarely cost less than $3,000, all told, and can end up costing significantly more, especially when additional medical procedures are necessary to ensure the success of dental implants. In cases where patients are replacing an entire row, or even both rows, of missing teeth, the total cost can easily exceed $30,000.
There are several alternatives to dental implants for people who can’t afford the cost, with or without dental insurance, or for people who aren’t good candidates for dental implants. Removable partial dentures, resin-bonded bridges, and fixed-tooth bridges are just a few of the effective dental restoration options available as an alternative to dental implants. While these less-invasive dental prosthetics are also less expensive, their cost is still not covered by Original Medicare, though some may be included in Medicare Advantage insurance plans. These temporary solutions can help patients eat more comfortably and can restore the appearance of the smile, though their brackets may be visible and they may interfere with biting or chewing; removable dental prosthetics should be removed for eating and sleeping. While these alternate types of dental restorations don’t provide the long-term health benefits that dental implants can bestow, they can help prevent problems with the bite and other issues that could arise when a missing tooth is left entirely unaddressed, so make sure to gather all the information you can as you select your Medicare benefits package and plan for a contented, healthful future.