Medicare Advantage Plans That Cover Dental Implants
There’s a popular American myth that George Washington had wooden teeth. Thank goodness dentistry has evolved — that is, until you’re faced with the bill for dental implants and suddenly those wooden dentures don’t look nearly as bad!
Today, we’re going to explore your Medicare dental implant options and show you how to find a dental plan that won’t give you splinters.
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Where do I look in my plan for dental implant information?
Dental implants are usually done by prosthodontists or oral surgeons. That means this service can show up in your insurance information as prosthodontics or oral surgery.
Prosthodontics is the practice of removing and replacing damaged teeth. It also deals with crowns, dentures, and bridges.
Dental implant information is also frequently listed separately on your explanation of benefits. To make sure implants are covered, you need to thoroughly review your coverage for one of these three options to make sure you don’t miss something that could cost you money down the line.
Medicare options that do not cover dental services
Original Medicare does not cover dental procedures like dental implants. Medicare Part B coverage is notorious for not offering much in the form of dental care, except in very rare circumstances.
Likewise, Medicare Supplements do not cover dental implants, as their coverage is the same as Original Medicare.
For dental services and dental implant coverage, you’re going to have to look at Medicare Advantage options.
Do Medicare Advantage plans cover dental implants?
While not all Medicare Advantage (MA) plans cover dental implants, some do!
To find out if your current MA plan or a plan you’re considering offers dental implant coverage, you will need to look at the specifics of your plan.
Not all MA plans are the same, even within the same company. If you don't know where to begin, call us! Here at Medicare Allies, our services cost nothing to you, and we can find plans in your county.
Examples of how dental implants might appear on your plan
We know it can be frustrating to hear that all Medicare Advantage plans are different. To help, we've randomly selected three Medicare Advantage plans from popular insurance providers.
We'll show you how dental implants are covered with these three examples so you can see just how much it can vary!
Note: While the following plan examples do exist, please be aware that they might not be available in your area. This information is only meant to show an example, not to recommend plans.
Example 1 – Partial Coverage with a PPO
This example, a PPO offered in western Virginia, offers partial dental implant coverage. This plan covers 50% of prosthodontics and oral surgery, including dental implants, when in network. They only pay 25% of the total cost when out of network.
Example 2 – Limited Coverage with an HMO
Another example, a Pennsylvania-based HMO, offers 20-50% off dental procedures, including dental surgery. This plan requires approval prior to the surgery and may have limits on how much they will cover per year.
Example 3 – 70% Coinsurance with Approval
Our final plan example, offered in Illinois, offers a 70% coinsurance for prosthodontics services. The plan requires approval from the carrier and a written referral from your primary care physician prior to the procedure. They may also limit the amount of work you are able to do per year.
Why the fine print matters: A cautionary tale
When looking for plans with dental implant coverage, I came across an AARP plan that appeared to cover prosthodontics with a 0% copay. It wasn’t until I examined a detailed list of covered items that I found this was not the case. Dental implants were not covered for this plan. The prosthodontics service only covered items that attached to existing teeth.
It is important to review all the documentation when looking at insurance options. Just seeing they cover a certain type of care does not guarantee they will cover the specific service you need.
Sound overwhelming? That's why you can call us! We're your Medicare Allies and will review all the fine print so you know what's covered in your plan.
It is possible to find Medicare Advantage options that cover dental implants. But just like with any aspect of your plan, you’ll want to review your plan details for specific information.
We can help you review plan options. Give us a shout and we’ll help you sort through your options and help you find the coverage you want and need.
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