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    Does Medicare Cover Dental Implants?

    Find out if Medicare covers dental implants, which plans will help with dental implants, and whether Medicare covers medications and surgery for implants.

    HOME > DOES MEDICARE COVER DENTAL IMPLANTS?

    DOES MEDICARE COVER DENTAL IMPLANTS?

    Learn about dental implants and which Medicare plans help pay for them.

    Updated: April 16, 2022

    Contributing Expert: Kelly Blackwell

    Certified Senior Advisor®

    Jump to section:

    Does Medicare Cover Dental Implants?

    Which Medicare Plans Will Be Most Helpful If You Need Dental Implants?

    What Does Medicare Cover Related To Dental Implants?

    Does Medicare Cover Medications Before Or After Implant Surgery?

    Learn More From Our Sources

    Does Medicare Cover Dental Implants?

    Original Medicare, Part A (hospital insurance) and Part B (medical insurance) do not provide dental coverage. Most Medicare Advantage (MA) plans, which are an alternative to Original Medicare, offer some dental coverage for many dental needs, but not all plans help pay for dental implants.

    Dental implants fall under a branch of dentistry called prosthodontics, which includes designing, manufacturing, and fitting artificial replacements for teeth. Dental implants are an alternative to dentures or bridgework, providing solid support for your teeth – and you don’t have to worry about ill-fitting dentures.

    Getting a dental implant involves surgery. The whole process can take months from start to finish. There are three main components of dental implants:

    Surgical placement of a metal post, usually made of titanium, which replaces the root portion of a missing tooth.

    Installation of an extension of the post called an abutment.

    Placement of an artificial tooth (crown) on the abutment, giving you the look and feel of a real tooth.

    Depending on the type of implant you get and the condition of your jawbone, the process can involve several procedures. Part of the reason it can take months is because the bone has to heal around the implant.

    Dental implants can be an extensive and expensive process. Choosing dental implants is a big decision that is made between you and your dental provider. You will take into account the health of your jawbone, the process involved, and the pros and cons of dentures. Another important piece of the puzzle is whether or not your insurance will help pay. Even though you will incur out-of-pocket costs, the functionality and look of dental implants may make it worth it to you.

    Which Medicare Plans Will Be Most Helpful If You Need Dental Implants?

    Medicare Advantage (MA) plans with supplemental dental coverage that includes dental implants will be most helpful. You may have to pay an additional monthly premium, and there will always be a maximum dental benefit amount allowed, along with either a copay or coinsurance. If you need dental implants, you will incur some amount of out-of-pocket expense.

    Not many MA plans cover dental implants. Some MA plans specifically exclude dental implants, even if they offer other comprehensive dental benefits. Some MA plans offer artificial posts or crowns, but not the surgical placement of the metal post required for an implant.

    MA plans may list “dental implants” or “prosthodontics” as either a covered item or an exclusion in the Evidence of Coverage (EOC) document associated with each plan. If dental implants are covered, you will be responsible for a copay or coinsurance until the max annual benefit is reached. You will then be responsible for the remaining costs of the dental services you receive that year.

    Dental coverage is detailed in the EOC, but the terminology, codes, and lists of dental procedures can be overwhelming. It is best to talk with a dental provider who routinely works with insurance companies and understands all the terms and codes associated with prosthodontic procedures.

    A review of the EOC of some of the larger MA plan insurance companies in the U.S. shows that one major carrier (Blue Cross Blue Shield/Anthem) has some benefits for dental implants in 2022. Check to see if this company has plans available in your area. You can search the Medicare website or contact your dental provider to ask if they are a DentaQuest network provider.

    BlueCross BlueShield/Anthem’s HMO optional supplemental package #3 includes enhanced dental and vision benefits. You pay a monthly premium between $50 and $70 depending on your plan and county of residence.

    The plan will pay up to $2,000 for all dental benefits each year. You must use DentaQuest providers only. For implants, you pay 50% as your portion of the covered charges until your maximum benefit is reached. Then you pay for any other costs. Any dental services expenses you incur do NOT apply to your in-network out-of-pocket maximum.

    What Does Medicare Cover Related To Dental Implants?

    There are other expenses related to dental implants, such as exams, x-rays to determine the state of your gums and teeth roots, and tooth extractions. If your MA plan has dental benefits, routine exams and x-rays are generally covered at least in part. Depending on your plan, tooth extractions may be partially covered as well. Crowns are sometimes covered, but if a plan excludes dental implants, the crowns associated with them are typically excluded as well.

    The majority of dental implant procedures are done on an outpatient basis. Your MA dental plan may partially cover costs associated with the procedures, such as anesthetic or nitrous oxide.

    The best way to determine if your MA plan with dental benefits pays for these other expenses related to dental implants is to talk directly to your dental provider/biller who works with insurance and understands which codes to apply to your claim.

    Source : www.medicareplans.com

    Does Medicare Cover Dental Implants?

    Original Medicare does not cover dental implants, but there may be other plans available to help cover dental implants. Read more to find out.

    Does Medicare Cover Dental Implants

    Home / FAQs / Medicare Coverage / Does Medicare Cover Dental Implants

    Posted on March 1, 2022

    Dental implants permanently anchor prosthetic teeth into the gum line. Unfortunately, Original Medicare does not provide coverage for dental implants or any dental services at this time. Luckily, Medicare beneficiaries are not out of options when it comes to dental implant coverage. There are a variety of plans available to help cover dental implants when enrolled in Medicare.

    Medicare Coverage for Dental Implants

    Original Medicare does not cover the cost of dental implants. However, those on a Medicare Advantage plan may find dental implant coverage built into their plan. If you are on Medicare and wish to have this procedure performed, you will need to ensure you have a secondary form of coverage, like a stand-alone dental plan, to avoid paying the full cost.

    There are several stand-alone dental plans available that will help cover the cost of dental implants. These plans often group with additional coverage for vision and hearing as well, as Original Medicare also does not cover those services. However, not all dental plans will cover the cost of dental implants, so it is important to speak with an agent to understand your plan’s coverage before enrolling.

    Does Medicare Cover Costs Related to Dental Implants?

    Following a dental implant procedure, if health concerns arise as a result, Original Medicare will cover those costs. For example, if you experience excess pain in your jaw and a hairline fracture results from dental implant surgery, Original Medicare will cover those costs.

    Further, if complications arise during your initial consultations and your oral surgeon deems it necessary to perform the procedure in an inpatient setting, Medicare Part A will cover the hospital expenses.

    Medicare Advantage Coverage for Dental Implants

    The most coverage for dental implants you will find with Medicare comes from Medicare Advantage Plans. Some Medicare Advantage plans provide dental benefits for policyholders which can include coverage for dental implants.

    To receive this extra benefit, you may pay a higher monthly premium. However, you will need to keep in mind the maximum dental benefit. Medicare Advantage plans almost always require copayments and deductibles for dental services. On most plans, you will be responsible for 100% of the cost after you meet the plan’s maximum benefit.

    When choosing a Medicare Advantage plan to cover dental implants, you want to first be sure your plan offers dental coverage. Secondly, ensure the plan covers dental implants as well. Some Medicare Advantage plans with dental coverage explicitly exclude dental implant coverage. To verify coverage eligibility, you will need to review the plan’s Evidence of Coverage.

    Medicare Supplement Coverage for Dental Implants

    Medicare Supplement plans do not provide policyholders with dental coverage. Thus, Medicare Supplement plans do not cover dental implants. However, like original Medicare, if your procedure occurs in an inpatient setting or additional health issues arise due to dental implants, your Medicare Supplement plan will cover those related costs.

    Keep in mind, Medicare Supplement plans only pay secondary to Medicare. So, if Medicare does not pay first, your Medicare Supplement plan will not cover any costs.

    Medicare Part D Coverage for Dental Implants

    Medicare Part D does not provide beneficiaries with health care coverage. This includes coverage for dental procedures or dental implants. However, Medicare Part D will cover costs related to medications prescribed as a result of dental implants.

    If you require painkillers, antibiotics, or any other medication after receiving dental implants, Medicare Part D will help cover those costs.

    How to Get Help with Medicare Coverage for Dental Implants

    If you need help with coverage for dental implants, do not hesitate to reach out to our licensed Medicare agents. At MedicareFAQ, our agents are Medicare experts who are trained to give you all the information you need regarding Medicare and dental coverage. We work with many dental plan carriers and can review your needs to recommend the best plan.

    Give us a call at the number above or complete our online rate comparison form for further information regarding Medicare and dental coverage.

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    Jagger Esch

    Medicare Expert

    https://www.medicarefaq.com/

    Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

    Source : www.medicarefaq.com

    Does Medicare Cover Dental Implants?

    Learn whether or not Medicare covers dental implants.

    Does Medicare Cover Dental Implants?

    Does Medicare Cover Dental Implants? What is a dental implant?

    A dental implant is a structure in the mouth anchored to the jawbone, meant to serve in place of a failed natural root, according to the Centers for Disease Control. It’s generally attached to a replacement tooth or bridge.

    Does Original Medicare cover dental implants?

    Some Medicare Advantage plans may include routine dental services. Medicare Advantage (Medicare Part C) provides a way to get your Original Medicare coverage through a private, Medicare-approved health insurance company. Medicare Advantage Plans must provide the same benefits as Medicare Part A and Part B, and many plans include other coverage such as routine dental care and prescription drug coverage.

    Medicare Part A still covers hospice care if you have a Medicare Advantage plan.

    If you’re interested in looking at Medicare Advantage plans, you may want to ask the plan about its coverage of dental implants and other dental services. Be aware that you still need to continue paying your monthly Part B premium, along with any premium the Medicare Advantage plan may charge.

    You may also want to consider dental insurance (outside of Medicare) from a private insurance company. Some dental insurance plans might cover some of the costs of dental implants. To look at plans in your area, see eHealth’s plan finder tool.

    This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

    Source : www.ehealthinsurance.com

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    John 16 day ago
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    Yes, here's a list of plans that covers dental implants https://www.eternalinsuranceagency.com/blog/does-medicare-cover-dental-implants-in-2022

    James 4 month ago
    4

    Guys, does anyone know the answer?

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