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Does Dental Insurance Cover Dental Implants?

Navigating dental insurance: Our in-depth examination of whether it caters for dental implants.

Last updated on

October 30, 2024

Katharine Hall

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Does Dental Insurance Cover Dental Implants?

According to some health insurance companies, dental implants are a cosmetic procedure  — something we certainly disagree with. But depending on your dental insurance plan, getting coverage for an implant procedure might be difficult, if not impossible.

Fortunately, there are many ways to afford a dental implant procedure. Whether it’s partial insurance coverage or out-of-pocketing financing, you can find ways to pay that fit your budget.

This comprehensive guide from Flossy will discuss what goes into a dental implant procedure, what coverage dental insurance may provide, and the different ways you can pay for a dental implant.

What Are Dental Implants?

Dental implants essentially replace a missing tooth. An implant — typically a “screw” made out of titanium or ceramic — is inserted directly into the jawbone, which gives it the security of a natural tooth root. 

After inserting the implant, your dentist will place a “crown” (usually made of porcelain) on top. This crown will look and function like a real tooth. 

While several options exist for replacing a missing tooth, dental implants are among the most popular. They feel comfortable, look natural, and are held in place securely. Once a dental implant is in, it’s typically in for life.

Who Needs Dental Implants?

Anyone with a missing tooth is a candidate for a dental implant. And missing teeth are more common than we think. According to the CDC, more than half of US adults have at least one tooth missing.

Someone can lose a tooth for any of the following reasons:

  • Tooth decay 
  • Gum disease
  • Physical trauma:

Tooth Decay 

This is one of the most common causes of tooth loss — and also the most preventable. While the occasional cavity is unlikely to lead to a missing tooth, skipping out on dental checkups and neglecting your oral health routine can cause a serious infection. Once it spreads to the root, your dentist may be unable to save the tooth.

Gum Disease

The gums hold teeth in place. However, if they get severely infected — typically from an accumulation of plaque — they can become inflamed. Over time, infected gums won’t be able to hold teeth in place, leading to tooth loss.

Physical Trauma

Accidents happen. Unfortunately, they can affect the teeth by chipping off a significant part or causing them to fall out entirely. Some common accidents include contact sports, car crashes, and falls. 

While proper safety gear (e.g., mouthguards) can prevent some of these cases, other accidents are sadly unavoidable.

What Are the Different Types of Dental Implants?

The most popular type of dental implant is called an “endosteal implant.” It looks like a small screw made of titanium or ceramic and gets inserted directly into the jawbone where a tooth is missing.

Before inserting the implant, an oral surgeon must make a small incision in the gums. Then, they must drill into the jawbone to create a space for the implant. Only then can the implant be inserted.

Over time, the jawbone will grow into the implant. This is a process called osseointegration, an essential part of healing that takes about two months. Once the implant heals, all that remains is for the oral surgeon to place a “crown” on top, allowing you to regain the full function of your missing tooth.

The second type of implant is called a “subperiosteal implant.” This implant is great for those with less bone in their jaw since it is placed on top of the jawbone instead of inside it.

These implants use a metal frame that is placed over the gums. Like endosteal implants, subperiosteal implants will go through the process of osseointegration. However, one limitation of this implant type is that it’s not ideal for the front teeth.

How Long Do Dental Implants Last? 

They last forever because implants bond with the surrounding bone tissue through osseointegration. The only exception is when someone has an immune reaction to the implant, ranging from mild pain at the injection site to a full-body fever.

If you experience implant failure, your oral surgeon can remove the implant and replace it with a new one. If for whatever reason, your oral surgeon decides that a dental implant is not the right choice for you, then you may want to consider other options for replacing a missing tooth.

While the implant is a lifelong structure, you may need to replace the crown on top of it periodically. Due to normal wear and tear like we experience with our natural teeth, a crown or artificial tooth may become chipped, cracked, or become loose. In general, a crown lasts between five and 15 years.

What Affects the Cost of Dental Implants? 

  • Geographic location
  • Expertise
  • Patient’s condition
  • Implant placement
  • Anesthesia

Many factors determine how much a dental implant costs. These include the following:

Geographic Location

To support higher operating costs, dentists in metropolitan areas may charge more than those in rural locations. The state where you get your implant makes a difference, too. Some people may even travel abroad for the procedure, as certain countries have significantly lower medical costs.

Expertise

The individual doing your implant can also make a difference. Those with a higher level of skill or experience may charge more than those new to the profession. Dental schools — which allow students to perform procedures under supervision — charge significantly less than licensed oral surgeons.

Patient’s Condition

Some patients may have a complex case that requires multiple visits and additional procedures. For instance, those with missing bone tissue might need to undergo bone grafting, which might cost as much as $1,000.

Implant Placement

The price of the implant may go up depending on its placement. In general, implants in the front of the jaw require a more complex procedure and tend to cost more than those in the back.

Anesthesia

Depending on the complexity of the procedure, the patient might require sedation with general anesthesia. This can significantly raise the cost of the procedure.

So, how much do dental implants cost? While the exact cost varies, you can expect to pay anything between $2,000 to $6,000 for a single-tooth dental implant.

Does Dental Insurance Cover Dental Implants?

Although many dental or medical insurance plans may cover: preventative care, cleanings, and X-rays without batting an eye, some won’t cover dental implants at all. While we know dental implants aren’t “cosmetic,” some insurance companies disagree.

In addition, because they haven’t been around for very long, dental implants are still considered an experimental procedure by some insurance policies. This makes them less likely to be covered than other tooth replacement options, such as dentures.

Because dental implants are a major procedure involving complex oral surgery, it’s hard to say with 100% certainty if your health insurance provider covers them. There is a great deal of variation between different insurance plans.

For instance, some dental plans may cover the procedure partially. If preliminary procedures like tooth extraction are needed to prepare for a dental implant, insurance companies might pay for those procedures while still declining coverage for the actual implant.

In addition, other components of the dental implant, such as the crown, may also be covered by insurance. Unfortunately, dental implant surgery remains the most expensive part of the procedure if it’s not listed under your dental insurance coverage policy.

Some dental plans may cover the cost of an implant entirely but only under certain conditions. For instance, tooth loss caused by an injury may be covered under dental implant insurance, while tooth loss caused by decay may not be.

Alternatively, some plans with implant coverage may cover the cost entirely, but with certain exclusions. For example, they might not cover implants for teeth that were missing before your insurance coverage start date.

Lastly, if your dental insurance covers the cost of implants, you may still have to pay something out-of-pocket to meet your deductible or coinsurance costs. Ensure you understand your plan’s annual deductible and any other annual maximums before you embark on a dental implant procedure.

Ways To Pay for Dental Implants

Here are some options to consider:

  • Credit card
  • Health savings accounts
  • Dental school

If your insurance doesn’t cover implants, the thousands of dollars you’re potentially looking at for dental care may seem overwhelming. Luckily, there are other affordable ways to pay for implants. 

Credit Card

One option is to charge the entire dental implant procedure to a credit card. If you can get a card with a 0% APR introductory offer, you can avoid paying interest while you make regular payments to pay off your balance. As a bonus, you may earn travel points or cash back rewards at the same time.

Health Savings Accounts

This is a type of savings account that your employer may offer. It essentially allows you to use pre-tax income to pay for various health expenses, including dental implants. A health savings account can offer you significant savings if your income tax rate is high.

Dental School

A dental school can offer savings of up to 70% on common dental procedures. While students perform the procedures, they are closely supervised.

Takeaways

For those who lose a tooth due to tooth decay, gum disease, or physical trauma, a dental implant is a great way to regain the function and appearance of a natural tooth. Unfortunately, many dental plans don’t recognize that implants are necessary medical procedures and do not provide insurance coverage. If your insurance doesn’t cover implants, you still have options for finding a low-cost procedure.

Sources:

Tooth Loss in Adults (Age 20 to 64) | National Institute of Dental and Craniofacial Research

Risk Factors Related to Late Failure of Dental Implant — A Systematic Review of Recent Studies | PubMed

Systematic Analysis on the Efficacy of Bone Enhancement Methods Used for Success in Dental Implants | PubMed

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