Patients frequently wonder if their insurance will cover the expenses associated with dental implants. Finding your way through the intricacies of health insurance and dental coverage, especially when it comes to specialized procedures like dental implants, can often be confusing.
In general, the extent of coverage depends on the patient’s specific insurance plan and the nature of the chosen implant treatment.
Understanding the Complexities of Dental Insurance Coverage
Numerous insurance companies categorize dental implants as primarily a cosmetic procedure rather than medically necessary. Consequently, these insurers usually don’t extend coverage for such treatments. However, individuals living every day with missing teeth understand that replacing them can help maintain their overall health and well-being.
You can avoid any unexpected surprises about treatment costs and insurance by:
- Reviewing your dental insurance policies
- Focusing on the information furnished to you when you initiated the policy
- Engaging in proactive communication with your insurance and dental providers
You will want to ask your insurance company the following questions:
- To what extent does the policy cover the implant procedure?
- What is the maximum annual out-of-pocket expense?
- Are there deductibles or copays?
- Is a referral mandatory before undergoing dental implant placement?
Our dental office is well-equipped to communicate with your insurance provider, ensuring you have a comprehensive understanding of your coverage based on your proposed treatment plan.
Implant Coverage Under Your Insurance
Whether or not your insurance covers dental implants may come down to your specific treatment plan and how much preparation your mouth requires for successful implantation. It’s also contingent upon whether you require a complete restorative arch or exclusively replace one or two missing teeth.
For example, you might need:
- A Tooth Extraction: The necessity of tooth extraction depends on whether you are already struggling with missing teeth or if a tooth is damaged and needs to be removed before the implant process. If the tooth is damaged, this procedure will be an integral aspect of your dental implant treatment and is typically covered either fully or partially by most insurance plans.
- Bone Grafting: Certain patients necessitate strengthening of their underlying jawbone before proceeding with the implant procedure to ensure stability. Despite its critical role in implant success, insurance coverage for this stage may be limited, if not excluded entirely.
- Implant Placement: The implant placement procedure falls under the “major” dental procedure category. It’s worth noting that the term “major” is used by insurance companies to denote cost rather than intensity. Only some dental insurance plans may cover up to 50 percent of expenses associated with major procedures.
- Artificial Tooth Placement: Installing an artificial tooth, commonly referred to as a crown, simulating the appearance and functionality of a natural tooth, is similarly categorized as a major procedure.
However, select insurance plans might consider this as addressing tooth decay with a crown and may consequently provide more substantial coverage. It’s advisable to directly consult your insurance provider for clarity.
Explore Your Insurance Coverage Options for Dental Implants at JM Dental of Westbury
Comprehending dental insurance coverage and the intricacies surrounding dental implant procedures requires diligence and effective communication. Collaborating with experienced dental professionals like JM Dental of Westbury and actively engaging with your insurance provider will facilitate a smoother path toward achieving a healthy and vibrant smile that you will be happy to show off.
JM Dental of Westbury, a reputable dental provider, is committed to collaborating with you and your insurance provider to develop a tailored treatment plan that aligns with both your oral health needs and financial considerations.
Contact our office today to learn more about your dental implant treatment options and insurance coverage. Call 516-334-3444 or contact us online today.