Medicare Parts A and B don’t cover dental services unless determined medically necessary as part of another treatment plan
Most Medicare Advantage dental coverage will include routine services like cleanings and x-rays but some may also include services like dental implants
If you have Original Medicare without a dental plan, you may want to consider a Medicare Advantage that includes dental coverage
Like dentures, dental implants replace your natural teeth but typically cost significantly more. A dental implant replaces a missing tooth with a screw that acts as a tooth’s roots—the screw bonds with the surrounding bone before being capped by a crown.
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Medicaid in some states does offer some dental coverage not provided by Original Medicare, but no Medicaid program explicitly covers dental implants. In the cases where Medicaid does provide some dental coverage, the help typically is for more affordable solutions like dentures.
Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age. The Center for Health Care Strategies has compiled how each state addresses dental care with Medicaid beneficiaries. [i]
Costs for dental implants vary widely given many factors, including the extent of dental work to prepare for the implant. As a result, estimates vary widely from $1,500 to $13,000.
If you have Original Medicare, you will pay 100% out of your pocket for the costs. The one situation where Original Medicare might help is if a hospital stay is necessary related to the procedure. Still, even that wouldn’t reduce your financial responsibility for the routine operations related to getting a dental implant. [i]
Finding dental insurance covering implants and dentures or bridges (two more affordable options than implants) will require looking beyond Original Medicare, but opportunities do exist.
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Seniors have options to find dental coverage that works alongside Medicare. What’s the best dental insurance for implants? The ideal solution for you will depend on several factors and require research, but here’s where to start.
Medicare Advantage plans that include dental coverage
Medicare Advantage is an alternative to Original Medicare. Medicare Advantage plans replace Original Medicare and have the benefits of Part A (hospital insurance) and Part B (medical insurance) while bundling drug and supplemental coverage and coverages like dental.
Stand-alone dental plans
Suppose you have Original Medicare and decide against switching to Medicare Advantage for dental coverage. In that case, your next option is turning to private insurance companies for a stand-alone dental plan that helps pay for implants. Like other private insurance options, you will be able to shop around for the one that is the right fit for your dental needs.
How much does a tooth implant cost with insurance? It will depend on your plan specifics.
If you are interested in choosing a Medicare Advantage plan that includes dental implant insurance, a GoHealth licensed insurance agent is ready to help. An agent, without obligation, can search for the Medicare Advantage plan that provides the best benefits for your situation, helping you figure out what costs may still be your responsibility.
How can I get Medicare to pay for dental implants?
Knowing what Medicare Advantage plan fits your need is important, but it’s not the only consideration. You also need to know when you’re eligible to enroll in a Medicare Advantage plan.
- When you’re first eligible for Medicare: Sign up during your Initial Enrollment Period, which is the seven months surrounding your 65th birthday. Once you enroll in Parts A and B of Original Medicare, you’re eligible to replace it with Medicare Advantage.
- When you first enroll in Medicare: If you didn’t enroll during your Initial Enrollment Period, you could alternatively sign up during the General Enrollment Period (January 1 to March 31) or the Annual Enrollment Period (October 15 to December 7) offered each year.
- If you’re enrolled in Original Medicare: The Medicare Annual Enrollment Period also allows you to switch from Original Medicare to a Medicare Advantage plan.
Suppose you’re already in a Medicare Advantage plan but it doesn’t meet your need for dental implant insurance. In that case, you can switch to a different Medicare Advantage plan each year between January 1 and March 31.
How can I get free dental implants?
How much does a tooth implant cost with insurance? It will likely cost you more than zero, but make sure you understand your policy so you can make the decisions that save you the most money.
Your bottom line will be impacted by your monthly premium, in addition to the portion of costs you may incur in the form of coinsurance and depending on your deductible. Also check to see if the policy has a waiting period before it will pay for a specific service or if the cost might go down if you’re able to wait until you’ve had the plan for a certain length of time.
Dental implants aren’t cheap, and they aren’t covered by Medicare. Still, assistance could be just a phone call away.
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