Are Dental Implants Covered By Dental Insurance?

Dental implants have a reputation as being an expensive procedure. While the results should last you much longer than other restorative dental procedures, there are higher upfront costs. If you have dental insurance, you may wonder whether your insurance plan will cover dental implants. Unfortunately, the answer isn’t straight forward. It depends on a number of different factors.

A decade ago, few dental insurance companies provided coverage for dental implants. It was considered a cosmetic or luxury procedure; many plans specifically excluded the procedure. However, this has changed in recent years, as more dental insurance providers now recognize the long term benefits of dental implants. 

As some of the plans vary even from the same insurance company, it is important to review your plan coverage documents to see what your plan covers. You can also call your plan’s member service line to clarify whether or not it covers dental implants. Some dental insurance companies will cover some aspects of dental implants, such as the crown, even if it won’t cover the actual implant itself.

Many dental insurance plans require members to pay an annual deductible before the plan will pay for a portion of the procedure’s cost. If you haven’t had other dental work completed in the calendar year that counted toward your plan’s deductible, you will need to pay your deductible in full and then any co-insurance that may apply to the procedure.

Some policies have annual or lifetime maximums for how much the policy will pay out in total. If you hit the annual maximum before your dental implant or if you underwent other procedures earlier in the year, you may need to pay out of pocket for any amount that’s over the annual maximum.

There may also be a waiting period in place for certain dental procedures, such as dental implants. This means that you may need to have the plan for 12 months or so before it will provide coverage. Some aspects of the dental implant procedure, like crowns, could be covered before the waiting period is over.

As you can see, there isn’t an easy answer in determining whether or not your dental insurance plan will cover dental implants. The best way to determine eligibility is to review your plan documents or to call your insurance provider directly. You can ask about the specific coverage for your plan and about any waiting periods, deductibles, and copays that you can expect to pay.

Holzinger Periodontics & Implant Dentistry is a father-daughter practice serving patients in Middletown and New Britain, CT. If you are seeking compassionate dental care from a team that treats each patient as an individual, contact us today at 860-347-8457 (Middletown) or 860-224-0433 (New Britain) to schedule your first appointment.