Understanding health insurance and dental coverage can be complicated and confusing, especially when it comes to how much and what parts of a specialty dental treatment like dental implants are covered. Our patients often ask us if their dental insurance will cover dental implants, but the answer, like insurance coverage, is complicated. The insurance provider and type of implant treatment you receive will determine how much is covered by your policy.
Newport News, VA dentist Dr. William Harper will work with you and your insurance company to create a treatment plan that fits your needs and budget.
Understanding Your Dental Coverage
Most insurance companies view the installation of dental implants as a purely cosmetic procedure, and not medically necessary. However, as anyone that is forced to live with missing teeth can tell you, a full, healthy set of teeth is vital to their oral health as well as their self-confidence and sense of well-being.
Covering your dental implant procedure may require utilizing both your medical and dental coverage, depending on the reason you need the procedure. You should review your insurance policy to see whether dental implants are listed in the materials you were given when you started the policy. Before agreeing to any procedure, it’s important to ask the insurance company questions to ensure there are no surprises:
- Does the plan cover implants?
- What percentage of the procedure does the policy cover?
- What is my annual maximum out-of-pocket cost?
- Does my plan require a referral before I receive dental implants?
The staff at Dr. Harper’s office will be able to work directly with the insurance company to determine your coverage based on the treatment plan.
Are Implants Covered By My Insurance?
To determine whether your insurance covers implants, it’s necessary to understand the different parts of the procedure and what kind of mouth preparation is needed for them. The amount of insurance coverage will also depend on if you will be getting a full arch of teeth restored or just one or two missing teeth.
Tooth Extraction: If you have a tooth that is damaged beyond repair, this procedure will have to precede your dental implant treatment. Most insurance companies will cover all or most of a tooth extraction regardless of whether it is part of an implant treatment plan or not.
Bone Grafting: Some patients have lost jawbone tissue beneath as well as having lost teeth. These people will need their underlying jawbone tissue strengthened prior to the implant procedure to ensure that the implant will stay securely in place. This portion of the procedure may not be covered, although it is a necessary step in the implant procedure.
Placing the Implant: The implant placement procedure is considered a “major” dental procedure by insurance companies. However, don’t be afraid of the word “major” though. This term is frequently used by insurance companies and does not always reflect the intensity of the treatment. Some plans cover up to 50 percent of major procedures.
Placing the Artificial Tooth: The artificial tooth that provides the appearance and functionality of natural teeth is a crown that is mounted atop the implant’s root. This part is also considered a major procedure. However, some insurance plans consider this crown no different than crowning a natural tooth and may cover more of the cost, so check with your insurance company to see which side they fall on.
Dental Implants in Newport News, VA
We understand that working with insurance and a budget to get necessary dental work completed can get confusing. Dr. Harper and his dedicated staff will work with you and your insurance company to make sure you get the best treatment based on your needs and budget — and a long-lasting smile. Call 757.414.7227 or contact us online to schedule a consultation with our office today!