Does Medicare Cover Dental Implants?
If you receive Medicare benefits and your dentist recommends dental implants to replace your missing teeth, you may have questions about the types of coverage, if any, you’re eligible for. Dental implants require surgery, using a tiny screw implanted in the jawbone to support prosthetic teeth, but the procedure is considered an elective procedure and is not covered by original Medicare, though some elements of the procedure might have coverage under Medicare A or B, and some Medicare Advantage plans provide coverage for dental implants. To better understand how Medicare might subsidize the costs of dental implants, it’s helpful to understand the ins and outs of dental implants.
What Kinds of Procedures Are Required for Dental Implants?
In essence, dental implants are tiny titanium posts that mimic the roots of a healthy tooth, supporting the tooth through its day-to-day tasks. Like the natural tooth roots, dental implants stimulate the bone that surrounds them while they bite and chew, helping keep the bone strong and healthy. They do this because of a process called osseointegration, in which the bone permanently fuses to the implant as it heals; complete osseointegration can take anywhere from three to six months after the implants are placed. Before implants can be placed, certain preparatory treatments might be necessary. For example, your dentist will remove any damaged teeth that need to be replaced, and they may refer you to a periodontist for treatment to ensure that the oral cavity is healthy and free from gum disease. If the bone quality has diminished, which happens when there is no tooth root to stimulate it for an extended period, it may be necessary to prepare the jawbone with grafts and then wait for the bone to regenerate before placing implants. For the implant procedure itself, the implant dentist makes an incision in the gums and bone and inserts the implant post into the bone tissue. After the bone has healed, the dentist will make another incision in the gums to expose the implant and affix an attachment device to the implant, giving the gums a couple of weeks to heal before attaching the dental prosthetic.
How Much Do Dental Implants Cost?
There are several factors that influence the cost of dental implants, including the materials used, the complexity of the restoration, and the expertise and geographical location of the implant dentist, to cite just a few. In general, however, each dental implant restoration costs between $3000 and $6000 per tooth. When additional preparatory procedures are needed, these procedures add to the cost of the overall dental implant treatment. Of course, any existing gum or periodontal disease must be treated before implants can be placed, and bone grafts, gum regeneration treatments, and soft tissue grafts might be needed to replenish and support the oral tissues before implants can be placed. These preparatory procedures are crucial to the overall success of dental implants, but they also come with their own costs, few, if any, of which will be covered by Medicare. When more than one implant is needed, the cost multiplies accordingly.
What Parts of the Dental Implant Procedure Might Medicare Cover?
Original Medicare will only cover dental services that are related to an illness or an injury. Medicare may also pay for inpatient care when complicated or emergency dental procedures need to be performed in a hospital. When dental surgery is performed in a hospital, Medicare will usually cover surgery-related medications taken in the hospital, though Medicare Part A doesn’t generally provide coverage for dentistry-related prescription medications. Patients who opt for certain Medicare Advantage plans or who choose a Medicare part D Prescription Drug Plan, on the other hand, can access antibiotics, prescription pain medication, and any other prescription drugs your dentist might order before and after your dental implant procedure. While Original Medicare doesn’t offer coverage for routine dental care, some Medicare Advantage plans, provided by private insurance companies approved by Medicare, could include dental procedures like dental implants. If you’re considering dental implants and decide to opt in to a Medicare Advantage plan, carefully review your benefit details to ensure your chosen package offers a dental coverage plan that works for you.
What Types of Dental Procedures Will Medicare Cover?
Original Medicare doesn’t cover routine cleanings, tooth extractions, fillings, or dental restorations, as the primary focus of coverage is medical, rather than dental, health. When patients have to undergo an emergency dental procedure in a hospital setting, or if hospital support for a dental procedure is required due to an underlying medical condition, Medicare should provide coverage. Additionally, there are some specific dental procedures that are required to ensure the success of certain medical procedures, and these procedures are usually covered by Medicare Part A. Oral examinations and dental treatments are required before any organ or bone marrow transplants, and they also precede heart valve replacement surgeries. When oral infections are present, these infections must be treated before cancer treatments like chemotherapy; this may require extracting a tooth or treating gum disease, for example. Some head or neck cancer treatments can also cause complications with dental and oral health, and procedures to treat these complications can be covered by Original Medicare.
Final Thoughts
Dental implants can make a significant difference in the oral health of patients who are missing their natural teeth, and they also help provide confidence and support a healthy lifestyle. Despite these benefits, dental implants aren’t considered a medical procedure and are therefore not covered by Original Medicare. With more and more options opening up in the Medicare Advantage marketplace, however, Medicare beneficiaries who want dental implants should closely investigate all their options before committing to a specific plan. Talk to your dentist about the details of your desired treatment, and read the fine print closely as you’re choosing the right dental benefits for your needs. While you may not find a plan that completely covers dental implant treatments, your research could help you defray the costs of dental implants and support you in your investment into a healthy future full of confident smiles.
