Does Dental Insurance Cover Implants?

Mar 2, 2023

For people who are missing a tooth or several teeth, dental implants offer a durable and efficient solution to restore their smile. They differ from dentures in that they are anchored directly into your jawbone, giving them a natural-looking appearance and feel.

If you are a good candidate for dental implants, you might be wondering: Does dental insurance cover implants? The answer is that it depends. Generally speaking, if the implants are medically necessary then dental insurance might cover some of the cost. If they are for purely cosmetic reasons, then you can expect that dental insurance will not cover the cost.

Keep reading to learn more about dental implants, how they work, and more answers to does dental insurance cover implants. Remember that members of the Affiliated Workers Association have access to insured dental benefits as one of the many benefit options.

How Do Dental Implants Work?

Dental implants are a great tooth replacement option for people with loose or missing teeth. Unlike a crown that is attached to a tooth root, dental implants serve as a substitute both for the missing tooth and its root.

The first step is to have dental implant posts surgically inserted into the jaw. There is then a waiting period while a healing process called osseointegration occurs. It involves the bone merging with the implant. This can take anywhere from two months to six months, depending on a number of factors. When healing is completed, the implant is attached to the post.

When Would One Require Dental Implants?

A dental implant might be an excellent option for someone who has lost a permanent tooth. Of course, the goal is generally to preserve natural teeth while possible. However, tooth extraction or tooth loss on occasion may be inevitable. When that occurs, dental implants can be necessary.

Common causes of loose or missing teeth that would require dental implants include:

Infection
Injury
Chronic gum disease
Dental decay
Trauma

Despite the fact that some teeth can be salvaged, receiving dental implants is occasionally required for medical reasons.

Who is a Good Candidate for Dental Implants?

If you want to get dental implants, you need to:

Have a loose or missing tooth or teeth
Have a jawbone that is strong enough to tolerate the healing process
Be in overall good health
Not have any significant dental health issues

Are Dental Implants Required Medically?

The key to answer the burning question, “Does dental insurance cover implants?” is determining if they are medically necessary. Dental insurance companies might agree that a dental implant is medically necessary when other methods of repairing the tooth or replacing it have been unsuccessful.

For example, if a person has advanced gum disease, has visited the periodontist for root planing, and is still losing the tooth, then an implant might be medically necessary. On the other hand, if a person simply doesn’t like a discolored tooth and wants to replace it with an implant, this would be determined a cosmetic issue – not medically necessary – and it is unlikely that any dental insurance company would cover the cost.

How to Determine if Your Dental Implants Will Be Covered by Your Insurance

Talk to your dentist and ask them to get preapproval from your dental insurance provider. The dentist can request this preauthorization along with all the relevant data. The insurance company should then give you a straightforward answer to let you know if your insurance covers dental implants.

Remember That Dental Implants Can Include Many Costs

Even if your dental insurance does not directly cover the cost of dental implants, it likely covers some of the costs involved. For example, your policy might cover dental x-rays or a root canal required before your dental implant.

In the event that your insurance does cover all of some of your dental implants, it’s likely you will have some out-of-pocket cost. This might include a copay or deductible. Your plan likely has a cap that limits how much the insurance policy will pay each year, which could reduce how much the insurance company pays for your dental implant.

It could be that your policy covers the implant but not some of the costs that go along with it, such as anesthesia or bone grafts. Again, it is best to have your dentist find out what your insurance company will cover because your dentist will have the best understanding of specifically what your procedure will cover.

There Are Many Benefits to Dental Implants

In some situations, a person will compare the options of dental implants and crowns to decide which one makes the most sense for their particular situation. Some of the advantages of dental implants are as follows:

The moment the implant is installed, you will have instant improvement in your smile
The procedure can help preserve your jawbone, which could help reduce facial drooping associated with lost teeth
Unlike dentures or some crowns, you do not have to avoid any particular foods after implants are installed
Dental implants are fixed in place, which makes them a lifetime investment
Replacing decaying or diseased teeth with implants helps lower the overall risk of gum disease and tooth decay in other regions of your mouth

Do You Need an Affordable Dental Plan?

You never know when a dental emergency might emerge. You never know when expensive dental issues might arise. The best way to be prepared for these issues is to ensure you have a comprehensive dental insurance plan in place. The problem? Dental insurance can be expensive.

The good news is that members of AWA have access to affordable dental plans as part of their coverage. You can sign up online or contact us with any questions you have.