Does Medicare Cover Dental Implants
Dental implants are becoming an increasingly popular solution for replacing missing teeth. It is common for patients to lose their teeth or have significant issues as they age. A common question related to dental implants is whether Medicare covers the cost of dental implants. In the most simple terms, unfortunately the answer is no. Medicare plans do not cover the cost of dental care, including the cost of dental implants. While Medicare does not cover dental procedures, including dental implants that does not necessarily mean it does not cover other costs associated with the implant procedure. This article will review various options for patients in terms of Medicare and dental implants.
Dental implants are a tooth replacement solution which involves the placement of a screw-like device into the jawbone. An artificial tooth is then placed on top of the metal implant to give it the function and appearance of a natural tooth. Dental implants are incredibly secure and can last for many years when they are well cared for.
The procedure used for dental implants is quite complex compared to traditional dentures. As a result, the entire process for implants can take a few months to a year. In addition, various types of procedures, appointments, and prescription medications may be included in the procedure. While Medicare does not directly cover the cost of the dental implants, it may cover some of the associated costs.
Cost for Dental Implants
Similar to most types of dental and medical procedures, the cost for dental implants can significantly vary. Implants may cost more based on various factors such as the geographical region, additional health conditions which must be considered such as diabetes, in addition to the type, location and number of implants being used.
Dental implants contain two main components which includes the implant and the abutment or crown. The actual implant and surgical procedure will typically cost about $1,000 to $3,000. The abutment or crown will usually cost an additional $500 to $3,000. On average, implants cost about $1,500 to $3,000 or more. When a complete set of implants are required, the cost may be closer to $30,000.
The procedure for dental implant involves a few different steps. The first phase of the process will include a full evaluation or consultation. This appointment will review the patient’s oral health, medical history, medications and desired outcome for the procedure. The next step of the process will involve the dentist or surgeon placing the implant. This is followed by the attachment of an abutment, and lastly, the permanent crown is placed.
In some cases, patients are looking for an alternative solution to dental implants because of the associated cost. In other cases, the patient may not be a candidate for implants based on the amount of bone present or other risk factors. Fortunately, there are other options which can be used to replace missing teeth. Other tooth replacement solutions include removable partial dentures, fixed-tooth bridges, and resin-bonded bridges. While each of these options are typically less expensive than dental implants, Medicare will still not cover the cost. Some of these options, however, may be covered by Medicare Advantage.
Medicare Part A
Medicare Part A covers care which is provided in a hospital setting. While it is not common for dental implants to be completed in the hospital, some portions of the procedure may be done in a hospital. There may also be special circumstances which require the procedure to be completed in a hospital. Medicare Part A covers some dental checkups and dental care such as when it occurs before a kidney transplant or heart valve replacement. However, this does will not apply to dental implant procedures.
When portions of the implant procedure or diagnosis is performed in the hospital, this does not mean that Medicare will cover the cost. Medicare may pay for the admittance to the hospital, without specifically covering the dental care which is performed. It is important to discuss the expected costs, coverages and details with the dentist prior to the procedure.
Part D: Prescription Drug Coverage
Medicare Part D offers prescription drug coverage for patients. Contrary to Medicare, Part D is provided by private insurance companies. It must be purchased separately from Medicare. In addition, it may also be subject to specific coverage areas and other limitations which typically do not apply to Medicare.
When a patient receives dental implants, it will typically include a prescription for a post-procedure pain relief medication. The private Medicare Part D plan almost always covers these types of medications. Be sure to the coverage and expected costs prior to the procedure.
Medigap Plans and Dental Implants
Medigap plans, which are also called Medicare Supplement Plans, are private insurance plans which aid in covering addition fees which are not covered by Medicare. This may include deductibles and coinsurance payments. Medigap plans do not directly cover most type of medical care, and will not cover the direct cost for dental implants. However, if any portion of the dental implant procedure is performed in a hospital, the Medigap plan can aid in covering the Part A deductible.
Medicare Advantage, which is also called Medicare Part C, offers Medicare benefits through a private insurance company. Medicare Advantage plans are required to provide equivalent coverage to Part A and Part B. However, many plans provide patients with additional coverage. Medicare Advantage plans often to cover vision and dental care, which are not covered by Original Medicare.
Medicare Advantage plans are private insurance plans, as a result of this, they are subject to many of the limitations associated with other private insurance plans. These plans are typically either HMO or PPO plans. The coverage area is not unlimited as it is with Original Medicare. In many cases, this is a compromise many patients are willing to make because the Medicare Advantage plans often offer additional coverages.
There is no easy way to determine whether a patient’s Medicare Advantage plan will cover dental implants. Some plans, however, do offer this type of coverage. Many plans also cover the cost for routine dental care, which can cover portions of the dental implant procedure. Medicare Advantage can be slightly more complicated than using Original Medicare. It is important to review your options before making a final decision.