- Many dental insurance plans cover dental implants, but coverage varies by plan and provider.
- When choosing an insurance plan, look for annual maximums and deductibles, cost-sharing amounts and access to in-network providers. Also pay attention to the insurance provider's reputation.
- Some of the top dental insurance providers for implants in 2022 include Delta Dental, Spirit Dental, Ameritas, Cigna Dental and Renaissance Dental.
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How can you choose the best insurance provider to cover the costs of your dental implants? Here's everything you need to know.
Does dental insurance cover implants?
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If you are searching for dental insurance, one thing you should find out is if the plan covers the dental implant procedure. Not too long ago, this was rare. Today, many plans include implant coverage. You may find them grouped into other "major" dental services, or listed in a section of their own.
Even if the insurance policy offers implant benefits, you should take the time to learn how the coverage works. But more on that below.
Harry Lee, DMD, explains: "The landscape of insurance coverage for dental implants has thankfully improved, but in my experience, it remains a minefield of fine print. I always tell my patients, 'Do not ask if the plan covers implants; ask how much and when.' Most major carriers, like Delta Dental and Cigna, now categorize implants as 'Major Services,' but the two biggest hurdles are the Annual Maximum and Waiting Periods."
Best dental insurance for implants
As we researched the best dental insurance for implants, we reviewed the websites of multiple insurance carriers. We compared several aspects, including annual maximums and deductibles, cost-sharing amounts, and access to in-network providers.
We also considered each company's ratings and reputations from unbiased sources. We urge you to explore each provider's website to learn more about your specific circumstances, including your current dental health and where you live.
Delta Dental
Annual maximum: $1,000 - $2,500
Implant coverage level: 0% - 70%
In-network providers: varies, but Delta Dental has the most significant number of dentists nationwide
As with the rest of the plans, your coverage will vary based on where you live and whether you have a self-purchased individual plan or an employer-provided plan. For our purposes, we will discuss the ones purchased individually.
Delta's Platinum plan is the only individual policy that includes implant coverage. It is the best plan they offer and provides 70% coverage for dental implants and other primary restorative treatments. It also includes 80% coverage on basic treatment and 100% coverage on all preventive services. The annual maximum of $2,500 is much higher than the maximums for their other options, making this plan a great choice for those who need implants or other extensive treatment.
Large provider network
Low cost-sharing (for the insured)
High premiums
Low annual max compared to other plans
Spirit Dental
Annual maximum: $1,200 - $5,000
Implant coverage level: 25% - 50%
In-network providers: varies by state; underwritten by Ameritas
Spirit Dental offers a wide variety of plans under different names. Ameritas underwrites all of them, so if you choose one of these plans, you will want to search for a dentist who is in-network with Ameritas. Many dental insurance carriers do this.
Since there is such a wide variety of plans, coverage for implants varies. However, most plans use an incremental coverage table. The longer you have the plan, the less your cost-sharing portion is. For example, implant coverage typically begins at 25% in year one and increases to 50% in year two. Other services do not max out coverage until year three.
Option for large annual maximum
Can add vision and hearing benefits
Provider network sparse in some areas
Incremental benefits start low in first year
Ameritas
Annual maximum: $1,000 - $2,500
Implant coverage level: 20% - 50%
In-network providers: vary by state
Ameritas offers dental-only plans or plans that include vision insurance. Some states have more plans available than others, but most people typically have at least three options.
All Ameritas plans have incremental benefits, including an annual maximum that increases each year. Plans will either maximize their benefits after two or three years. The nice thing about Ameritas is that it does not have waiting periods for any of its covered services.
No waiting period
Low monthly premiums
Incremental benefits start low in first year
Provider network sparse in some areas
Cigna Dental
Annual maximum: $1,000 - $5,000
Implant coverage level: 0% - 60%
In-network providers: 92,700 dentists and dental specialists nationwide
Cigna's individual plans are often underwritten by Careington, which can be confusing, as providers who are in-network with Cigna may not be in-network with Careington. However, their individual policies do have out-of-network benefits.
Cigna is a popular choice for older adults on Medicare, as its plans can include vision and hearing benefits, all included in one premium. Most of their plans offer incremental benefits and can go up to 90% coverage on basic treatment. However, primary coverage starts at 0% in the first year, so most plans do not have implant coverage until the second year.
Large annual maximum
Option to add vision and hearing benefits
Most plans have 0% implant coverage in year 1
Plans are often underwritten by Careington
Renaissance Dental
Annual maximum: $1,000
Implant coverage level: 0% - 50%
In-network providers: vary based on region and zip code, but include several plan names
Renaissance Dental offers coverage through a few insurance carriers, including Maximum Care, Maverest Dental Network, Connection Dental, Stratose, Premier Dental Group, and DDS, Inc. Members can add a vision rider to individual policies.
All of these policies have a 12-month waiting period for primary services, including implants. After the waiting period has been met, implants are covered at 50%. However, the annual limit is capped at $1,000, which may not go very far given the cost of implants.
Out-of-network coverage
No waiting period for preventive services
Low annual maximum
12 month waiting period for implants
Denali Dental
Annual maximum: up to $6,000
Implant coverage level: 25% - 50%
In-network providers: vary by state, but have out-of-network benefits
Denali Dental offers two plans with implant coverage: the Denali Summit Plan and the Denali Ridge Plan. Like the other plans we discussed, this one also has incremental coverage that caps after 4 years. The Summit Plan has the best dental implant coverage.
The Denali Summit plan starts with 30% implant coverage in year one, then increases by 10% each year for a total of 4 years. Dental implants max out coverage at 60% in year four.
High annual maximum
Low cost-sharing at year four
Smaller provider network
Higher cost-sharing initially
Anthem
Annual maximum: $1,000 - unlimited
Implant coverage level: 0% - 50%
In-network providers: one of the largest PPO networks in the United States
Anthem offers many different plans, some with an unlimited annual maximum. However, they will either have a six or 12-month waiting period for all major services, including implants.
Many Anthem plans do not include dental implant coverage unless the implant is paired with a dental prosthesis, such as an implant-retained denture. In that case, the dental insurance plan will pay towards the implant or prosthetic.
Lower monthly premiums
Large provider network
Waiting periods for major services
Limited coverage for implants
How to choose the best dental implant insurance?
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The first step in choosing dental insurance is deciding if you even need it. It can be beneficial to many people, but that is not always the case. Your dentist might offer other discounts or payment arrangements that make dental insurance not worth the money. You should compare the cost of the recommended treatment to the premiums and cost-sharing you will have with an insurance policy.
If you have decided that dental insurance is a good idea, there are a few things to compare among policies to choose the one that makes the most sense for your situation.
Insurance coverage
What do you want dental insurance for? If it is for dental implants, make sure they are covered by the policy you are considering. Plus, remember to read the fine print to ensure the implant is covered in your specific situation.
Annual limits
A plan with a limit of $1,000 is unlikely to be very helpful, since a single dental implant can cost several thousand dollars. If you need any other treatment, you will be well over the limit, and the insurance will be useless.
Coinsurance amounts
What are the coinsurance or cost-sharing amounts? Many of the plans we discussed had incremental benefits. If you need major procedures right away, how much coverage will you really have? This is especially important if you are considering a plan that has no coverage for major services in the first year.
Deductibles
Deductibles are typically no more than $100, but if you can find a plan that offers a $0 or $25 deductible for the same price as one with a $100 deductible, it makes sense to pick the former. In addition, some policies do not apply the deductible to preventive care services.
Sign-up process & waiting period
Most plans allow you to enroll online these days, but some are easier to navigate than others. You will want to pay close attention to the waiting period on these plans. Some apply the waiting period only to basic procedures and/or major services, while others include preventive care.
Some plans waive the waiting period if you have had other dental insurance in place prior to enrollment, as long as there was no lapse in coverage.
Requirements & LEAT clause
There are two main requirements you should consider.
First is the missing tooth clause. This condition states that if the tooth was missing prior to the plan's effective date, the policy will not pay for any treatment used to replace the missing tooth. This clause is not seen as often anymore, but it does still exist, and you should check for it, especially if you have any missing teeth.
The second clause concerns insurance downgrades and is called the LEAT clause. LEAT stands for Least Expensive Alternative Treatment. Regarding replacing missing teeth - whether by an implant or a dental bridge - the plan could downgrade the treatment to a partial denture in some cases.
For example, let us say you are missing #29 and #20. Each of these teeth is on the lower arch - one on the left and one on the right. Instead of paying for an implant or bridge on each side, your insurance will downgrade to a partial denture, since you could have replaced both of those teeth with a denture. This may not be very clear, but it is common practice across all insurance companies.
Geographic availability
The plans on our list all have out-of-network benefits, but you will pay less out-of-pocket costs if you use an in-network provider for your dental care. Insurance carriers use UCR (Usual, Customary, and Reasonable) fees to calculate their payments. If your primary care dentist or oral surgeon has higher-than-average fees, you might be responsible for a significant portion you were not expecting.
Customization options
Many carriers allow you to customize your policy. You can add extra benefits or remove ones you will not need. Any of these changes will impact your monthly premium.
We also mentioned that you can add vision and/or hearing benefits to some of these plans. This is useful for those who do not have these benefits included in their health insurance. For example, this is a common need among older adults on Medicare who have only medical insurance, which often does not include many routine dental, vision, and hearing benefits.
Alternatives to dental implant insurance
Getting dental insurance is not a wise choice for everyone. There are several alternatives you should consider before making a final decision about your dental coverage.
Dental Discount Plans are often overlooked. You pay a premium for these plans, but instead of any cost-sharing benefits, these plans give you discounts. This can often save you at least 20% off their standard charges. There are no limits, waiting periods, deductibles, or fine print in these plans, which makes them very simple. They even cover cosmetic procedures and all pre-existing conditions.
Other alternatives can include cash-pay discounts, senior or military veteran discounts, or third-party financing. Your dental office can tell you which of these options they offer. Some even offer an in-house membership plan that typically includes a monthly membership fee in exchange for free cleanings and a discount on restorative work.
FAQ
How do you prove dental implants are medically necessary?
To prove a dental implant is medically necessary, your dentist will need to take an X-ray and write a narrative explaining why dental implant surgery is needed for proper oral health and overall health.
What does dental implant insurance typically exclude?
Dental insurance for implants often excludes implants for teeth that were previously missing and for other dental treatment that might be needed to place the implant such as bone grafts and sinus lifts.
Is paying for dental implant insurance worth it?
Dental insurance plans are not always worth it. You have to consider the premium, maximum benefits, cost-sharing amounts, and provider network. You will also need to determine whether the implant coverage applies to your specific situation.
Harry Lee, DMD
The Annual Maximum is the single most frustrating detail. While a plan might say it covers 50% of the implant cost, the annual limit is often capped between $1,500 and $2,500. Since a single implant procedure can cost several thousand dollars, the patient still pays the lion's share. Furthermore, many plans have incremental benefits, meaning coverage starts at 0% or 25% in the first year and only gradually increases, forcing the patient to delay necessary treatment.