Does Medicare Cover Dental Implants
If you are looking to replace a missing or damaged tooth, then a dental implant may be an option for you. The dentist will place a titanium or zirconia post in your jaw bone to secure the dental crown or bridge in place. Now you want to know how you will pay for it. Can you use dental insurance? Or health insurance? Or do you need to pay out of pocket?
Does Medicare cover the cost of dental implants? The simple answer is no. In general, Medicare plans do not cover dental care. Dental care does include dental implants and the related procedures. The general policy of Medicare may not cover any dental exams but Medicare may cover different costs associated with getting dental implants.
First and foremost, no matter your dental concern, Medicare usually does not cover any dental service like cleanings or exams. But there is an exception. When your dental care is related to an illness or injury, Medicare may cover your appointment. If you need a dental exam to be cleared for organ transplant surgery or heart valve surgery, then Medicare will cover the appointment. If you suffer from oral cancer, Medicare will usually cover the related dental procedures. If you have a had an accident that resulted in face or jaw damage, Medicare will usually help you cover the dental related procedure you need to address those instances. Inpatient hospital care is nearly always covered by Medicare. If your dental procedure is complex enough to need to be completed in the hospital or your health history indicates that your procedure needs to be completed in the hospital, Medicare should pay for the hospital stay. The whole dental implant cost will not be covered by Medicare; you will still be responsible for the dental procedure.
Now that you clearly understand traditional Medicare will not cover the cost of the dental implants themselves, you may be able to count on Medicare to cover some associated costs. The dentist, your oral health, and medical history combined might push the dentist to do your implant procedure in the hospital. Costs associated with your hospital stay could be covered by Medicare. Furthermore, after your dental implant surgery if you struggle with health complications as a result, then Medicare will typically cover the medically necessary care. If you develop an infection from your dental implant surgery, then Medicare could cover the treatment.
What Does Medicare Cover For Dental Care?
While traditional Medicare does not offer dental benefits, some Medicare Advantage plans do offer benefits for dental care. The Medicare Advantage benefits can include any services related to dental implants, but those plans vary from company to company. Medicare Advantage plans are offered by private Medicare-approved insurance companies. Benefits that are not available through Original Medicare may be offered through private insurance companies in these Medicare Advantage plans. Currently, more than one of the Medicare Advantage plans include annual dental exams and routine cleanings. The other perk of some Medicare Advantage plans is that they even offer supplement dental insurance which will cover more complex dental procedures like tooth replacement and restoration, extractions, and fillings. It is important to review your Medicare Advantage options and take the time to ask if these types of policies include dental implants. Also, It is important to be sure that your preferred dental care provider is in network for your Medicare Advantage plan and that the policy you chose may only cover a percentage of the additional services. By taking the time to talk to the dentist now about the type of procedures you need, you can review your policy for their coverage. This planning will allow you to be more prepared when you receive the bill for your dental implants and you be able to make a more informed decision.
Does Medicare Cover Dental Medications Before or After Implant Surgery?
The details of the location where you have your dental implant surgery will help determine if Medicare will cover your necessary medications. Medicare Part A will cover any medications you need if you have your dental implant surgery in the hospital and you need to take the medication when you are in the hospital. Original Medicare typically does not offer any prescription medication coverage for dental services.
Medicare Part D Prescription Drug Plan will most likely cover antibiotics, pain medication, and the other medications the doctor prescribes whether it is for your procedure, prior to your procedure, or after your procedure. Medicare Advantage plans that include prescription drug coverage will offer similar opportunities as Medicare Part D Prescription Drug Plan, paying for medications related to your dental implant. If you are concerned about paying for your medications, talk to the dentist before you have the dental implant procedure. You can take this information to compare with your plan formulary to ensure the prescribed medications will be covered.
Original Medicare, Part A and Part B, do not provide coverage for routine dental care and more specifically dental implant. You can look to some Medicare Advantage plans for routine dental service coverage. If you use Medicare Part C, it is one way to secure your Medicare coverage through a Medicare approved private health insurance company. The same benefits as Medicare Part A and Medicare Part B offer must be offered by Medicare Advantage plans before they can provide any additional coverage. Prescription medication coverage, routine dental care and possibly dental implants can be a part of your Medicare Advantage plan. Prior to committing to a specific Medicare Advantage plan, ask specifically about dental implant coverage, other dental service coverage, and coverage of anything else you think you may need going forward. Keep in mind that the additional coverage may require additional premiums on top of your Original Medicare premiums.
When you and the dentist have determined that dental implants are the best treatment plan for you, you can start looking into the cost and the best way to pay for them. Obtaining dental insurance from a private insurance company might offer the coverage Medicare does not.