- Original Medicare Parts A and B do not cover dental implants. Private insurance companies offer Medicare Advantage Plan or Part C, which can cover dental implants.
- Coverage for dental implants varies. Make sure your provider covers all necessary procedures and components of an implant.
- Be aware of the annual maximum amount your Medicare Advantage plan offers.
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Can you save money on dental implants with Medicare? Here's everything you need to know.
How to get Medicare to pay for dental implants?
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Medicare beneficiaries have other options to consider if they would like insurance coverage for implants. Some options include coverage for other services, so we caution you against focusing solely on 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 will likely have extra benefits not found in Original Medicare. This may include coverage for implants.
Advantage plans are offered by private insurance companies so that they can vary significantly from one company to another. 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 see if it includes 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 contracted dentists.
Lee explains: "Part C plans are the only viable path to getting assistance with implants. These plans often bundle extra benefits, including dental, but the coverage is highly variable. The most crucial detail to check is the Annual Maximum Benefit. Even if the plan says it covers implants, the average annual cap in 2025 is often around $1,000 to $2,500. Since a single implant can cost several times that amount, this allowance will only offset a portion of your total bill, not cover it entirely."
Implant procedure is not only the surgery
When you are searching for coverage, keep in mind that several procedure codes are involved in a single implant. At a minimum, you will need to check whether the insurance plan covers the implant, abutment, and implant crown.
Often, other procedures are involved in the placement as well. If you have already had a consultation with your dentist, you might already know if you need bone grafting or a membrane. Alternatively, you may consider implant-retained dentures. An insurance plan may cover some procedures, even if it does not cover all of them.
Alternatives to Medicare dental implants coverage
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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.
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 plan's annual maximum. 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, receive discounts on all their dental services. They must receive care from a dentist who participates in 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 plan’s summary of benefits to see whether implants are covered.
Are there any discounts on dental implants for seniors on Medicare?
Some dental offices offer discounts to seniors, but it is not standard practice. You may find that your dentist offers discounts to patients who pre-pay for services or pay with cash instead of credit cards.
Harry Lee, DMD
The first thing I tell any patient asking about Medicare and dental implants is this: Original Medicare (Parts A and B) does not cover the cost of dental implants. This lack of coverage is rooted in a decades-old policy that views routine dental work, including implants, as separate from necessary medical care. However, the picture changes entirely when we talk about Medicare Advantage (Part C) plans, which private insurance companies offer.