How to Get Dental Implants Covered by Insurance

Are you thinking about getting a dental implant? While it’s a great way to replace a lost tooth, implants are one of the more expensive dental treatments you can undergo. As a result, it can be hard to find a dental insurance policy that’s implant-friendly. Even many plans that cover implants exclude coverage for implants that are deemed to be for cosmetic reasons. 

To help you get your smile restored as soon as possible, here’s a guide on the ins and outs of finding a competitive dental insurance policy that covers implants. 

Key Takeaways

• Dental implants are permanent medical devices that replace lost teeth.
• Insurance can reduce the cost of dental implants by 10% to 50%, after your deductible is paid.
• Not all dental insurance covers implants, and some plans that do cover them have restrictions.
• When reviewing dental insurance that covers implants, pay attention to maximum coverage limits, deductibles, waiting periods, implant coverage percentages, and crown coverage percentages. 
• If you decide implants aren’t right for you, consider bridges or dentures. 

Are Dental Implants Covered by My Dental Insurance?

Dental implants may or may not be covered by your dental insurance provider. Many plans will cover them if you need them due to an accident, but not if the reason is cosmetic. 

If your plan does cover your implants, it will typically only cover a percentage of the costs, often 25% to 50%. And you may need to wait six months, a year, or more to get the highest amount of coverage.

What Are Dental Implants?

Dental implants are medical devices that are surgically inserted into a person’s jaw to replace a lost tooth. The full dental implant system is composed of the following three pieces:

• The implant body: A screwlike device that’s inserted into the jawbone in place of the tooth’s root
• The abutment: A device that attaches to the implant body and extends through the gums to support a crown
• The crown: An artificial tooth that’s attached to the abutment 

Reasons for Lack of Coverage

Dental insurance companies may exclude or limit coverage for dental implants because the procedure is considered cosmetic and not medically necessary. Some may also exclude coverage if you were missing the tooth before coverage began.  

Different parts of the procedure also may be excluded or only partially covered.

• Tooth extraction: If you still have a tooth that’s damaged and needs to be pulled before the implant can be placed, this procedure is often covered by insurance companies.
• Bone grafting: Grafting involves reinforcing the jawbone, which is a procedure some patients need to be sure the implant will be secure. But it may not be covered.
• Placing the implant: This is the main part of the process and is often considered a “major” procedure, meaning it’s one of the more expensive services you can get. Insurance that covers implants may cover up to 50% of the cost, but many plans cover less.
• Placing the crown: The crown is the artificial tooth that goes on top of the implant. Crowns are another major dental procedure, so again, your provider may cover up to half of the cost. 

Factors That Affect the Amount of Coverage 

When insurers cover implants, they often limit the coverage in a variety of ways. For example, you may have to wait a certain amount of time after obtaining coverage before your insurer will cover an implant. Most policies have annual coverage maximums and may also have annual or lifetime limits on implants specifically. Further, insurers often set coverage limits at 10% to 50% for implants and crowns, which means you’re responsible for the remaining amount. 

How to Know If Dental Implants Are Covered

As you’re reviewing a policy for purchase or speaking to a dental insurance provider, ask: 

• Are full dental implant systems covered, including the implant, abutment, and crown?
• Do I have to wait a certain amount of time before an implant is covered?
• Is there a maximum coverage limit on the plan?
• Is there a limit on the dollar amount you’ll cover for implants per year and/or in my lifetime?
• What percentage of the implant system’s cost will I have to pay? 
• Is there a different percentage for the implant and the crown?
• Do I have to pay a deductible before my coverage goes into effect? If so, how much is it?
• If I need an extraction or bone graft, is it covered? If so, does it require a copay or coinsurance?
• Is pre-op and post-op care covered?

“There are several aspects to dental implants, including the abutment, the crown, and pre-op and post-op care. You’ll need to ask about each one separately to fully understand what you will be responsible for paying,” said Dr. Michael Gorlovsky, an orthodontist at Windermere Orthodontics in Georgia.

How Much Do Dental Implants Cost Without Insurance?

Without dental insurance, the average costs you can expect for dental implants are as follows.

• Extraction: $135
• Bone graft at the time of implant placement: $552
• Dental implant: $2,013
• Prefabricated abutment: $718
• Implant-supported crown: $1,511
• Total cost for one tooth: $4,929

If you’re missing multiple teeth, you can opt for an implant-supported bridge, which comes with an average cost of $6,200, according to Aspen Dental. Further, implants can be used as supports for full dentures, which cost $6,800, on average. 

How Much Do Dental Implants Cost With Insurance?

The cost of a dental implant with insurance will depend on your dentist’s fee and the percentage of the cost that your insurer covers. In reviewing 13 insurers, dental implant and crown coverage percentages ranged from 10% to 50% after each plan’s deductible was paid. So if the implant cost is in line with the average of about $2,000, the cost with insurance would range from $1,000 to $1,800 per implant, assuming you’ve already reached your plan’s deductible. However, that only covers the cost of the implant body. 

You also have to pay for the crown and abutment that accompany the implant. With insurance, the estimated average cost of an implant-supported porcelain crown ranges from $755 to $1,360, while a pre-fabricated abutment ranges from $358 to $645. Together, the average post-insurance cost of an implant, abutment, and crown ranges from $2,113 to $3,805, depending on your policy’s coverage percentage. Additional costs would apply if you need a bone graft or extraction.

Best Dental Insurance for Implants

How to Choose a Dental Insurance Company for Implants 

If you decide to move ahead with an implant, consider the following factors when shopping around for a dental insurance plan: 

• Premium: The monthly cost to maintain coverage through the plan
• Deductible: The amount you have to pay before the insurer begins to cover your costs
• Annual max benefit: The maximum amount the plan will cover per year
• Annual implant maximum: The maximum amount the plan will cover per year in implant expenses
• Lifetime implant maximum: The maximum amount the plan will cover in implant expenses over a policyholder’s lifetime
• Implant coverage percentage: The percentage of an implant’s cost that the insurer will cover
• Crown coverage percentage: The percentage of a crown’s cost that the insurer will cover
• Waiting period on implants: The amount of time you have to wait before your insurer covers your implant costs
• Waiting period on crowns: The amount of time you have to wait before your insurer covers your crown costs
• J.D. Power Dental Plan Satisfaction ratings: J.D. Power’s ratings show how a provider ranks in overall customer satisfaction.

All of these factors play a role in how much you’ll have to pay for an implant with insurance.

Alternatives to Dental Implants

Not sure if dental implants are right for you? Consider dental bridges and dentures. 

Dental Bridges

Dental bridges offer another permanent way to replace missing teeth. Traditionally, they consist of two crowns on either end and artificial teeth (pontics) in between to fill a gap. You can also opt for a Maryland dental bridge, which uses metal wings, instead of crowns, to attach a bridge of artificial teeth to the backs of neighboring teeth. And if you only have one natural tooth on the side of a gap, you can opt for a Cantilever bridge. It consists of a crown on your natural tooth and an artificial tooth that hangs over a gap. According to Aspen Dental, the average cost of a dental bridge is $4,313. 

Dentures

Denture prostheses offer a natural-looking, removable tooth replacement option. They can be full or partial, depending on how many teeth you need to replace. The gum-colored base can be made of resin or metal, and the teeth can be made of polymer or porcelain. Dentures rest on your gums and rely on your jawbone or the roof of your mouth for support. In some cases, denture adhesive is also used to keep them in place. The average cost range of traditional full dentures ranges from $1,000 to $3,000, according to Authority Dental. 

How Much Are Dental Implants With Insurance vs. Without Insurance?

The cost of dental implants varies depending on the dentist and insurance plan you choose. However, the average cost without insurance is about $2,000, while it typically ranges from $1,000 to $1,800 with insurance. 

How Can I Know the Exact Costs of My Dental Implants?

You can find the exact costs of a dental implant by asking the dental practice that is going to perform the procedure. If you have insurance, you should also contact your provider to find out how much of the procedure will be covered by your policy. 

Is There a Cheaper Alternative to Dental Implants?

Tooth replacement solutions tend to be on the more expensive side, but you may be able to get dentures for less than it costs to get a full implant system.

Are Dentures Better Than Implants?

Dentures can be better in certain situations. Non-implant dentures are less invasive and can be more affordable. However, they are a temporary solution, while implants are permanent. The American College of Prosthodontists recommends that you replace dentures every five years. 

How Long Do Dental Implants Last?

Dental implants can last a lifetime with proper maintenance, but crowns are typically rated for 10 to 15 years. An implant is more likely to fail if you develop gum disease, have a preexisting medical condition like diabetes, or don’t brush and floss properly. 

The Bottom Line

If you’re thinking about getting a dental implant system for yourself or a loved one, it’ll typically cost a couple of thousand dollars per tooth. That said, an insurance policy may be able to help you shave off 10% to 50% of the cost. To maximize your savings, shop around and review different policies. Along with the normal factors like the deductible amount and monthly premium, be sure to take note of the implant coverage percentages, crown coverage percentages, maximum coverage limits, and waiting periods.