Dental implants are an option to replace missing or broken teeth, this process involves a few steps which can take several months to complete. Usually, Medicare does not cover dental implants unless the procedure is needed due to oral cancer or an injury. But it may cover certain costs related to implant surgery in specific instances. While all implants restore the function of the teeth, which is vital, they are not considered medically necessary in most cases.
Does Medicare Cover Any Services Related to Dental Implants?
While Original Medicare does not cover dental implants, there are certain situations where specific costs may be covered. Medicare may cover the following costs:
- Medicare Part A will cover an inpatient hospital stay that occurs due to complications from implant surgery. For example, if an infection develops after implant surgery that requires a hospital stay, Part A covers the inpatient costs.
- If you have a Medicare Part D Prescription Drug Plan, it will likely cover the costs of antibiotics needed after implant surgery or pain medication.
- Medicare Part A may also cover certain expenses related to dental implants if the procedure is performed during an inpatient hospital stay. In most cases, the dental implant process is performed in steps at a dental office. But if you have a medical condition that requires dental implant surgery to be performed in the hospital, Part A covers the costs associated with your hospital stay.
Do Medicare Advantage Plans Cover Dental Implants?
Some Medicare Advantage Plans have dental coverage built into their plan. The exact amount of coverage provided varies greatly by the specific plan. For example:
- Some Medicare Advantage Plans only cover basic care, such as fillings, cleanings, and annual exams.
- Some Medicare Advantage Plans may offer coverage for complex dental procedures, such as tooth replacements and restoration, such as a bridge or dental implant.
- Most Medicare Advantage Plans that offer dental insurance may require deductibles and copays for dental services. You will likely have a maximum amount of benefit coverage. This means once the plans cover their maximum amount, you will be responsible for the additional costs. Plans that offer extensive dental coverage usually charge an extra premium.
If you have an Advantage plan, talk with the dental provider to determine the costs and what your plan will cover before the procedure.
Dental Implant Payment Options
There may be instances when you do not know that you will need dental implants. But in some cases, you might have an idea that you will want to opt for implants to replace missing teeth.
If you think you will choose dental implants, it may be helpful to select a Medicare Advantage Plan. At least with a Medicare Advantage Plan, you may have a certain amount of coverage for the procedure.
Other options to cover the costs of dental implant surgery include the following:
- Ask for a payment plan: Many dentists may offer a payment plan for you to break up the costs over a few months.
- Consider financing: Specific credit cards are available to finance medical and dental procedures. Your dental provider can provide information on this type of financing.
- Go to a dental school: Some dental schools perform dental procedures at a low cost to the public as part of their dental training. Call a dental school near you to learn more.
- Dental Implants: What You Should Know, FDA.
- Dental Service Coverage, Medicare.