This seems like an easy yes or no question. However, it is a little more complicated than that. When you ask your insurance company or your oral surgeon if your dental implant procedure will be covered by insurance, the actual answer is “It depends” or perhaps “partially.”
Because dental implants tend to be on the higher end of the spectrum for dental work, many insurance companies will only cover the procedure or a portion of it after a deductible has been met. There’s also a possibility that part of the cost could be covered by dental insurance and part may be covered by medical insurance.
Ask Your Insurance Provider
The best place to start is to ask your dental insurance provider what your plan covers. You can communicate the extent of the procedure with your provider or ask your oral surgeon to provide a summary of the procedure for your insurance company to review and provide an estimate. It may be partially covered or not at all. There’s always a possibility that there’s a deductible or a maximum out of pocket that must be met before a portion or all of the procedure is covered. In some cases just the crown portion is covered by insurance but the abutment is not.
Get an Estimate from your Oral Surgeon
In many cases your oral surgeon’s office has an insurance specialist who can look up your dental insurance coverage and review your current plan to see whether or not any of the procedure is covered and what portion you may have to pay out of pocket. They can often offer you an estimate that may not be exact, but will be pretty close to give you a general idea of the portion you’ll need to pay.
Inquire About Dental Implants with your Medical Insurance Provider
Sometimes the severity or related complications that contribute to the need for a dental implant, which can qualify under medical insurance. If there are severe medical complications that result from tooth loss or if the loss of a tooth is the result of an accident or injury, medical insurance may step in and cover some or all of the procedure.
How to Afford a Dental Implant Without Insurance
In the event that your dental and medical insurance don’t cover dental implants or the portion that is covered leaves you with more to pay out of pocket than you can afford, don’t let that prevent you from getting the procedure. There are some payment options to make the procedure more affordable.
- Establish a Payment Plan. Some oral surgeons will allow you to pay in installments, whether monthly or a portion of the total at each visit, knowing that a few visits may be required in order to complete the procedure (initial consultation, procedure, follow-up evaluations, etc.)
- Financing. Apply for financing so that you can make affordable monthly payments. CareCredit offers financing for medical/dental procedures with no interest for a certain period of time (usually 12 months). Other loans are available through your financial institution that can be used to finance dental work.
- Credit Card. If you have a credit card with a high enough available limit, you can pay for the procedure using an existing credit card.
Don’t Let Lack of Insurance Coverage Keep You From a Healthy Mouth
Proper replacement for a missing or damaged tooth is crucial to your oral health. Even if a dental implant is not covered by your insurance, it is still a worthwhile procedure. It prevents bone loss in the jaw and keeps existing teeth in proper alignment. It also allows you to properly speak and chew your food. Financing makes it affordable by spreading the cost out over several months.
If you’re in need of a dental implant procedure, call Rio Grande Oral Surgery today at (508) 821-2111 to schedule a consultation or request an appointment.