Did you know that the average American adult has over two missing teeth? Yes, that’s true, so if you are missing some of your teeth, you are not the only one. However, if you are looking to replace your lost teeth, implants are a good but expensive solution.
But, if you do not want to bear the burden of paying the full cost of dental implants, you need to ensure that you are under dental insurance that covers implants.
Unfortunately, finding dental insurance that covers implants 100% is a common misconception in some form because of the cosmetic nature of the procedure. Most dental insurance plans will cover about 10% to 50% of dental implants and crown coverage after you have paid your deductible.
>> Learn More: Dental Insurance Levels: A Complete Guide
In this article, we will discuss dental implant insurance coverage, factors that affect the coverage, why you need dental insurance for implants, and how to know if your dental insurance covers implants.
So, let's get right to it.
What Exactly are Dental Implants?
Dental implants are artificial tooth roots typically made of titanium alloy inserted surgically into your jaw to replace a tooth. The complete dental implant system comprises the implant body, the abutment, and the crown. The implant body is the screwlike root that replaces the tooth root; the abutment supports the crown through the gums, while the crown is the attached artificial tooth.
Does Insurance Cover Dental Implants?
Whether or not insurance covers dental implants depends on the type of dental insurance plan that you have. Some dental plans will cover some of the implant expenses or cover the costs of specific steps (like consultations, x-rays, extractions, bone grafts, and implantation) if the procedure is medically necessary.
On the other hand, if it’s for cosmetic purposes, most insurance companies will not cover it
While you must understand what your dental plans cover, highlighted below are a few common coverage rules for different dental insurance plans.
Private Dental Insurance
Most private dental insurance that offers full-coverage policies will pay about 50% of the cost of major dental procedures, and this can sometimes include implants. Some other plans cover implants distinctly, but if your insurance doesn’t cover implants entirely, it may still cover some of the steps, like consultation, x-rays, or crowns.
Public-funded Dental Coverage
Medicaid dental coverage differs from state to state, with some states offering extensive dental care for diagnostic and preventive dental procedures. Although dental implant coverage is less common, there are exceptions when the implants are considered medically necessary.
Why You Need Dental Insurance for Dental Implants
Did you know that without dental insurance, you will need to pay between $3,000 and $7,000 for a single dental implant? Even though this cost depends on how complex your case is or if you will need any extra procedures, the average cost covers the implant device and the surgery. Some additional costs that you can incur include the following.
Preliminary X-rays: $200 to $450
Bone grafting: $500 to $600
Sinus lift: $1500 to $2500
Prefabricated abutment: $700 -$800
Implant-supported crown. $1,500
Anesthesia
Specialist care
Factors that influence the cost of dental implants
Even though the cost of dental implants is expensive across the board, several factors influence how much you will be paying. Some of them are highlighted below:
Location: If you live in a big city with a higher cost of living, the cost of dental implants will be more than if you live in a small town.
Type of Implant: Although titanium is the typical type of implant used, the newer zirconia implants are more expensive.
Number of Implants: If you have multiple missing teeth, the cost of your dental implants will be more than if you had to get a single dental implant.
Implant location: If you need implants in areas of the mouth that are difficult to reach, you might need a sinus lift, which will increase the costs.
Procedure Complexity: Preexisting health conditions like periodontal gum disease and procedures like bone grafting and tooth extraction can affect the cost of the implants. Additionally, if your situation is complicated, you may need to see a specialist, further increasing your costs.
How Much Do Dental Implants Cost Post-insurance?
Now that we have discussed how much you will have to pay if you don’t have insurance and the factors that influence these costs let's look at how much you will pay after insurance.
Firstly, the cost of dental implant post-insurance depends majorly on your dentist’s fee and the percentage that your dental insurance covers. Most dental insurance plans will cover about 10% to 50% of dental implants and crown coverage after you have paid your deductible. This means that if your implant costs about $3000, the amount you will pay post-insurance ranges from $1,500 to $2,700 if you have reached your plan’s deductible.
However, you will also need to pay for the abutment and crown separate from the implant body.
With insurance, the average cost for a crown will be about $750, while the abutment will cost about $350. This means that the average cost of getting an implant, abutment, and crown will be about $2,600—vastly different from the $7,000 cost before insurance.
What to Consider when Choosing a Dental Insurance
If you are looking for a dental insurance plan, here are a few factors to consider.
Full Dental Implant System Coverage: You can check if the insurance plan covers the implant, abutment, and crown. If they do, you should check the implant coverage percentage and crown coverage percentage—this way, you can know how much you’ll pay out of pocket.
Maximum Coverage Limit: You need to consider whether the plan has a maximum coverage limit, especially because implants are expensive. You also need to check if the plan has an annual implant maximum or lifetime implant maximum, which will enable you to know how much the insurance company will cover for implants.
Waiting Period: It is vital to check if there is a waiting time before your insurance plan will cover your implant or crown costs.
If you are not sure dental implants are right for you, you can consider dental bridges, as they do not cost as much as dental implants.
However, if you decide dental implants are the right move, you must discuss it with your dentist to ensure that it is medically necessary. This way, your insurance plan will be able to cover some of the costs.
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