Does Dental Insurance Cover Implants?

Your first question might be, “Does my insurance even cover dental implants?” To find out, let us take a closer look at the different steps involved in getting implants and how insurance plays a role.

Step 1: Tooth extraction 

If a tooth needs to be removed before getting an implant, that’s called tooth extraction. The good news? Most insurance companies have your back on this one. They often cover the cost, whether it’s replacing a missing tooth or pulling a damaged one.

Step 2: Building a Strong Foundation 

Sometimes, your jawbone needs a little boost to support the implant. This is called bone grafting. Here’s the catch – insurance might not cover this essential step fully. 

Step 3: Placing the Implant 

This is a big deal, and insurance labels it as a “major” dental procedure. Don’t let the word “major” scare you; it’s more about cost than intensity. Most insurance plans can cover up to 50 percent of these major procedures, making the financial burden a bit lighter.

Step 4: Placing the Crown 

The final touch is adding the artificial tooth, also known as a crown. Insurance sees this as another major procedure, but some plans might be more generous with this step. They might treat it like fixing a natural tooth and cover more of the cost. Checking with your insurance company directly is the best option here.

Well, it’s like putting together a puzzle. Some pieces fit perfectly, like tooth extraction being covered, while others might need a bit of maneuvering, like bone grafting. It’s essential to understand your insurance’s puzzle to plan your implant journey.

Residing in Florida provides access to a range of dental insurance options, each with its unique set of rules. It’s akin to being a detective—delving into the details, deciphering the fine print, and engaging in open discussions with insurance providers. Understanding the insurance landscape is paramount for a smooth journey into the world of dental implants.

• Cosmetic Nature: Dental implants, often considered cosmetic, may not be covered as they are not typically deemed medically necessary, similar to veneers or teeth whitening treatments.
• Insurance Plan Exclusions: Many dental insurance plans exclude coverage for cosmetic treatments, limiting the scope for dental implants.
• Specialist Visits: Some cases may require visits to specialists, potentially outside the insurance network. Procedures by out-of-network professionals might not align with standard dental insurance benefits.
• Obligation for Coverage: Despite being out of the network, insurance carriers may still have an obligation to cover certain procedures. Determining benefits in advance can clarify coverage.
• Accidents or Trauma: Dental implants necessitated by accidents or trauma, such as car collisions, may fall outside traditional dental insurance but could be covered by regular medical insurance. Coverage in such cases extends beyond typical dental insurance limitations.

Let’s face it – insurance might not cover every inch of your implant adventure. But don’t worry, there are other ways to make it work. Many dental clinics offer flexible payment plans, making implants more accessible even if insurance doesn’t cover everything.

A flexible spending account (FSA) or a health savings account (HSA) are both tax-advantaged savings accounts that are used to cover the costs of dental implant procedures. However, one must ensure they understand the rules for dental implant procedures.

FSAs

If you have an FSA through your employer, it can be used to pay for a wide range of out-of-pocket healthcare costs and dental expenses.

But remember that you may have to provide a receipt for your implant and a letter of medical necessity duly signed by a doctor.

HSAs

An HSA can be used to pay for dental procedures like dental implants — but only if the implant is done for purely cosmetic reasons. A medical diagnosis is required in this case.

A health savings account (HSA) is very similar to an FSA, except that you can get it through your employer or on your own if you buy your own insurance. You must have a high-deductible health plan to be able to contribute to an HSA.

While dental insurance may not cover every aspect of your implant journey, alternative solutions, such as flexible payment plans and utilizing FSA or HSA funds, can make the process more manageable. Vital Dental Center in Margate, Florida, can help you cover some cost of your dental implants with their financial options.

To know more about Dental Implant procedures or “Does dental insurance cover implants,” contact us now or call (954) 406-7561 for new patients, while all other callers can connect at (954) 975-9779.