Is there dental insurance that covers implants? And does having dental implant insurance help pay for the cost?
The answer to both questions is yes, sometimes and to some extent.
If you happen to have dental insurance, the odds are that your plan offers no coverage for dental implants, because most plans don’t. Those that do come with higher premiums, usually contain limiting terms and conditions, and probably won’t cover the majority of your procedure, unless you’re only looking to replace a single tooth.
Before we continue, please be aware that I am not a financial advisor and nothing stated in this post is financial advice. Moreover, I am not an insurance broker or an expert on any type of insurance or insurance company. The purpose of this post is simply to help people who are interested in getting dental implants and want to understand how having insurance may affect the cost. I’m merely speaking as a DDS that has placed a lot of implants and has seen a large number of insurance plans over the years.
The information shared here is based on experience and on research performed in April 2022. All content in this post should be taken as opinion. I encourage anyone reading this to do their own research and speak to a licensed insurance broker (and their insurance provider if they have one). Insurance plans and costs change, and there are a wide variety of providers and plans available in Texas alone.
Does Insurance Cover Dental Implants?
Some types of insurance cover dental implants. Specifically, there are a few dental insurance plans that offer limited coverage for dental implants. Many of the major providers offer exactly one plan that includes them. However, many also do not.
Almost every insurance provider considers dental implants a cosmetic procedure. Additionally, those less-common plans with dental implant insurance usually come with relatively higher premiums and only allow for a portion of the yearly maximum to go towards an implant procedure.
Therefore, one shouldn’t expect their dental insurance to cover the bulk of their implant procedure. In fact, it probably won't cover a large amount. The few dental insurance plans that include implant coverage usually only offer an annual maximum of $1-1.5k per year. This is a small amount compared to the total cost of a typical procedure. At best, coverage will almost always be partial.
To be clear, most dental insurance plans do not cover dental implants at all.
And those that do cover implants consistently come with higher premiums and don’t cover any more than $1k-1.5k maximum on average.
To put this amount in perspective, the average cost of a single tooth dental implant in Texas is $4,561. This includes the implant and crown. If the implant and crown are placed by separate providers, that cost rises almost $1,000. Both of these costs assume no extractions or grafting are necessary.
Terms and Conditions - Like Waiting Periods - Often Reduce Your Coverage
Be aware that the terms and conditions of the plan can limit coverage for dental implants. For example, plans often require a waiting period before any coverage for implants is made available. These waiting periods are often 6-12 months, though they can be longer.
The annual maximum is commonly not available until after a waiting period of 12-32 months. In fact, it may never be available for dental implants, even after a waiting period. Often only a percentage of the maximum is available.
For example, at the time of writing this blog (April 2022), UnitedHealthcare offers an insurance plan that includes coverage for dental implants. It's called the Premier Plus Plan. According to the digital flyer outlining the plan, it offers a maximum annual coverage of $2,000. However, only 40% of this maximum is available for dental implants after the first year. Only 50% is available after year 2.
The yearly maximum may also assume multiple procedures. In this scenario, your yearly maximum wouldn't be fully available unless you had multiple procedures within the same year. So if you had one dental implant procedure, only a portion of your yearly maximum would go towards the cost of that treatment.
Another factor to consider is pre-existing conditions. For instance, if a tooth was missing before you purchased your plan and you decide later that you want a dental implant to replace that tooth, that pre-existing condition may negate your coverage for that procedure.
Finally, one must also remember the deductible. In the aforementioned example of UnitedHealthcare’s Premier Plus Plan, the deductible is $50 per person per year, while the Pinnacle Choice plan with Spirit Dental and vision is $100 as of April 2022.
So does insurance cover dental implants? Sometimes. But not often, and usually only a minority portion of a relatively small procedure.
Do Any Dental Insurance Plans Cover Implants 100 Percent?
I have practiced dentistry for over 35 years, and I am unaware of any dental implant insurance plans that promise to cover 100% of any dental implant procedure.
Insurance providers almost always offer an annual maximum in their plans. Because this maximum rarely exceeds $2,000 per year, it’s highly unlikely that your dental insurance would cover 100% of your implant procedure. If it did, it would probably only be a single tooth. Personally, if the price is that low, I would question the quality of the treatment.
We Offer Affordable Rates To Increase Your Value, With or Without Insurance
Given that few dental insurance plans cover implants at all, our office doesn’t process dental insurance for payment. Instead, we offer favorable pricing for dental implants compared to the rest of the market.
One reason these affordable costs are available is because we don't employ extra people to process insurance! By avoiding the costs of processing and collecting insurance claims, we are able to pass those savings on to you. We believe that offering affordable dental implant costs better serves you and better adds value to your procedure.
We also offer one bill with no hidden fees that covers every procedure you will require from start to finish. This is possible because we handle every step of the dental implant process in one location with one team. With this streamlined process, we can lower our own expenses and eliminate unnecessary charges from your bill.
We Help You File Your Insurance If You Have It
If you have dental insurance, our office staff will happily help you file it. We’ll fill out all of the forms and help you send them off. Historically, we’ve seen some of our patients receive partial reimbursement for their procedure this way.
Financing as an Alternative to Dental Implant Insurance
You can always apply for dental financing if you want to lower the cost of your procedure. Our office offers financing plans with terms as long as 5 years and with rates as low as 0% for up to 2 years for qualifying credit scores! Having affordable monthly payments can greatly increase the affordability of your procedure.
Want More Help?
We recommend scheduling a free consultation with me and my staff at The Dental Implant Place in Fort Worth, TX if you're interested in dental implants. You can learn about dental implant costs and procedures from a highly experienced team that has focused exclusively on dental implant dentistry since 2007.
If you choose to get a CT scan, you can also get a detailed treatment plan with an itemized quote. An itemized quote includes every single procedure involved in giving you beautiful teeth with minimally invasive care. Fill out the form at the bottom of this page if you're interested. My team will promptly follow up with you.
Sources
- https://www.consumersadvocate.org/dental-insurance
- https://www.ehealthinsurance.com/ehealthinsurance/benefits/dt/GoldenRule/2018/45586-G201812.pdf
- https://spiritdental.com/docs/default-source/planbrochures/sd-allplans-tx
- https://www.dentaly.org/us/dental-insurance-usa/dental-implant-insurance/
- https://www.uhone.com/api/supplysystem/?FileName=45586B-G202108.pdf
