When looking for a tooth replacement, the first option that comes to mind is dental implants. Many patients search for dental implants near you, but often wonder what the cost would be. Knowing what is and isn’t covered can help you plan better. If you need help, a dentist near Cranston can take you through your coverage and create the most affordable treatment plan for you.
Does Insurance Cover Dental Implants?
Dental implants are something that you do not need to change for years. However, insurance coverage can vary widely. Some plans now consider implants as a standard of care, while other plans consider them elective.
Many dental insurance companies will cover part of the implant procedure, but not all. Review the benefits carefully as policy differs. Many patients will also investigate their supplemental or optional benefits, like dental insurance for missing teeth and implants that are limited by their primary plan.
What Parts of the Dental Implant Are Typically Covered?
Insurance may cover certain aspects of a comprehensive implant procedure, while excluding others. Here’s what you can generally expect.
- Diagnostic and Preliminary Procedures.
Insurance often covers.
- Initial exam.
- X-rays.
- CT scans.
- Treatment consultations.
The standard actions summarised below are those that are likely to be in a basic or preventative plan.
- Tooth Extractions.
Many insurance plans may cover a portion of the extraction cost if a tooth needs to be removed prior to an implant. This typically falls under basic dental services.
- Bone Grafting (Sometimes Covered).
Bone grafting for loss of bone may or may not be covered. Some of the plans will consider bone grafting medically necessary, while others will not. Read the policies on reconstructive devices carefully.
What Parts Are Not Covered by Insurance?
Insurance coverage limits often come into play when it concerns prosthetics or surgical implantation. Common exclusions include.
- Implant Fixture.
Some insurance companies don’t pay for the titanium implant post because they consider it an elective treatment. This is typically the costliest component.
- Abutment and Crown.
Some policies may pay for some of the abutment or crown, even when the implant post is excluded. But coverage typically relies on the price of a regular denture or bridge. This means insurance will only pay the lesser of the invoice or the market value.
- Additional Surgical Procedures.
You may not get coverage for advanced surgeries like sinus lifts, ridge augmentations, etc., unless the insurer deems them necessary.
Waiting Periods and Missing Tooth Clauses.
The missing tooth clause, an insurance restriction common to many plans, takes some patients by surprise. Put simply, if you lost a tooth before the beginning of your policy, the plan may deny you coverage for implants to replace that tooth.
Additionally, many plans include.
- Major procedures require a 12-month wait.
- Annual maximums that limit total coverage.
- Restrictions on pre-existing conditions.
Specialized dental insurance for missing teeth and implants can be helpful here, as this comes with plans that help reduce one’s out-of-pocket expenses for such restorative treatments.
How to Maximize Your Insurance Benefits.
Here are some effective ways to reduce your overall cost.
- Ask for a pre-treatment estimate – they can give you an idea of what they will pay.
- Flexible spending accounts (FSA) or health savings accounts (HSA) can use pre-tax dollars to pay for implants.
- Be aware of annual maximums. When scheduling your treatment, know when to start or finish to maximize your benefits each year.
- Pick a clinic that helps you navigate your insurance – professionals can avoid surprise bills.
- To summarise, obtain guidance on implant coverage.
Conclusion: Get Personalized Guidance on Implant Coverage
Figuring out insurance coverage for implants might be difficult, but it doesn’t have to be. At Sorensen Dental Group, the experienced team helps patients evaluate their plans, see what’s covered, and create affordable treatment plans. If you’re thinking about getting dental implants or have questions about the added benefits of getting the treatment, our dentist in SE Calgary can walk you through everything.
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