Does Medicare pay for dental implants? Medicare part A, B, and C coverage on implants

Dani Dinkel

Written by Dani Dinkel RDH

It’s not uncommon to lose some teeth as we age. We use our teeth several times a day for many years, so we can expect them to break down eventually. The best way to replace them is with dental implants.

Medicare is a federal government program that was created for retired individuals age 65 and older. People with End-Stage Renal Disease (ESRD) and those who have been on disability for two years are also eligible for Medicare. Original Medicare consists of Parts A and B. Unfortunately, neither includes coverage for dental implants.

How to get Medicare to pay for dental implants?

Two single implants on lower arch technical picture

Picture by Authority Dental under CC 2.0 license

Medicare beneficiaries have other options to consider if they would like insurance coverage for implants. Some options include coverage for other services as well, so we would caution you from looking at only the implant aspect. Review the entire plan before enrolling.

Medicare Advantage Plan

Medicare Advantage is also known as Medicare Part C. If you enroll in a Part C plan, you’ll likely have extra benefits not found in Original Medicare. This may include coverage for implants.

Advantage plans are offered by private insurance companies, so the plans can vary significantly from one company to the next. There are hundreds, if not thousands, of them on the market. The ones you are eligible for are based on your zip code. You will need to look at each one to know if they include benefits for implants.

Also, Part C plans utilize provider networks. You will get the most out of your benefits if you receive care from a dentist within your plan’s network. The insurance company can provide you with a list of dentists that are contracted with them.

Implant procedure is not only the surgery

When you are searching for coverage, keep in mind that there are several procedure codes involved in a single implant. At a minimum, you’ll need to check if the insurance plan provides benefits for the implant, the abutment, and the implant crown.

Many times there are other procedures involved in the placement, too. If you have already had a consultation with your dentist, you might already know if you need bone grafting or a membrane. Or, maybe you are getting implant-retained dentures. It’s possible that an insurance plan will provide coverage for some of the procedures, even if they don’t cover all of them.

Alternatives to Medicare dental implants coverage

Dental implants

Picture by Authority Dental under CC 2.0 license

If you do not have a Medicare Advantage plan that includes coverage for dental implants, there are other ways to get financial assistance or lower the cost of implants.

DVH plan

Dental, Vision, Hearing (DVH) policies are popular among Medicare beneficiaries. As their name implies, they provide benefits for three aspects of your health. The dental portion of these plans is often the most robust and is usually the main reason someone purchases one of them.

As with any other type of insurance, you will need to read the policy summary to find out if the DVH plan includes implant coverage. You should also consider the annual maximum allowed by the plan. A larger maximum will be very helpful if you are getting an implant as they cost several thousand dollars.

Dental discount plans

You can also purchase individual dental plans that do not include the vision or hearing component. One type of plan is called a dental discount plan. Members with a discount plan pay an annual premium to the insurance company and in return, they get discounts on all of their dental services. They must receive care from a dentist that participates with the policy.

FAQ

Do all Medicare Advantage Plans cover dental implants?

No, not all Medicare advantage plans cover dental implants. Each plan can have significantly different coverage, so be sure to consult the plans’ summary of benefits to find out if implants are included in the coverage.

Are there any discounts on dental implants for seniors on Medicare?

There are some dental offices that offer discounts to seniors, but it’s not standard practice. You may find your dentist will give discounts to patients who pre-pay for services or pay with cash instead of credit cards.

References

  1. Medicare official website - Medicare
  2. How do Medicare Advantage Plans work? - Medicare