Dental implants are the best tooth replacement option currently available, which means they’re also the most expensive solution for your smile. You know you’ll need help offsetting some of the costs, so you’re trying to figure out whether your dental insurance will provide coverage for treatment. There’s only one thing stopping you from finding the answer: dental insurance is confusing!
Many patients feel the same way, but don’t worry. This post will gladly tell you what you need to know.
Dental Insurance Can Cover Dental Implants – Sometimes
This clarification probably doesn’t make dental insurance sound any easier. Rest assured, all it means is that dental insurance rarely pays for 100% of implant costs. More often than not, policies are designed to cover certain preliminary treatments (such as gum disease therapy or bone grafting). They also might cover around 50% of your restoration expenses if you’re getting an implant bridge or implant dentures.
Your coverage will simply depend on the details of your plan, and fortunately, your dental team can help paint a clearer picture of what you can expect to pay out of pocket.
Deductibles, Annual Maximums, and the January Reset
To make matters more complicated, you’ll also need to keep an eye on your deductible, annual maximum, and the timing of your treatment. Here’s a brief overview of how each factor could impact your savings:
Deductibles
An insurance deductible is the amount of money you’ll have to pay on your own terms before your benefits will actually take effect. If you have a $1,500 deductible, for example, you’ll have to spend $1,500 on dental care – then your insurance will start covering treatments.
Annual Maximums
This is the highest amount of money your insurance company is willing to pay out during a given calendar year. If you use your benefits to cover more than that amount before the year is over, you’ll have to start paying out of pocket again until January 1st.
Timing The Reset
All of these little details completely reset when it’s time to renew your policy – in other words, typically on January 1st. Depending on how you time your dental implant treatment, you may have to start over on building up to your deductible, or you might fall back under your annual maximum.
Basically, it’s completely reasonable to find dental insurance coverage confusing, especially when it comes to dental implants! If you’re ever unsure of how much you can expect to pay, don’t hesitate to ask your dentist for clarification. They’re familiar with the ins and outs of various policies and would be happy to help you maximize your benefits.
About the Author
Dr. Nicholas Baldelli earned his dental degree from the prestigious Boston University Goldman School of Dental Medicine. He has pursued several unique continuing education opportunities, including extensive oral surgery training in Guatemala! Dr. Baldelli’s experience makes him a skilled implant dentist, and he and his team would gladly help you determine what your insurance will and won’t cover. To contact his office for a consultation, call 401-847-7662.