Do Medicare Benefits Pay For Dental Implants

Dec 05, 2022 By Triston Martin

If you're missing teeth or damaged, your dentist may suggest dental implants as a solution. Whether or whether Medicare will pay for your dental implants may be the first thing on your mind if you're a Medicare recipient. Learn about the steps involved in getting dental implants and how Medicare handles dental care benefits.

What Exactly Are Dental Implants?

Dose Medicare cover dental implants, AS described by the Clinic, dental implants consist of prosthetic teeth affixed to a metal post or screw surgically inserted in the patient's jawbone to act as an artificial tooth's replacement root. Dental implants are a viable option when bridgework isn't an option due to damage or missing teeth.

Dental implant surgery is complex and can take many months to complete, even when performed on an outpatient basis. To make room in your jawbone for the implant, your dentist may recommend removing any damaged teeth.

The metal screw or post is implanted below the gum line by the dentist. When the jawbone has completely healed, your dentist secures the replacement tooth to the implanted post.

Does Medicare Cover Dental Implants?

Medicare usually does not pay for dental treatment unless it is directly tied to treating a disease or accident. Medicare may pay for a dental checkup if it's necessary to clear you for major surgery, like a heart valve replacement or an organ transplant.

Oral cancer and facial/jaw injuries are two common reasons people seek dental care; both are often covered. If you need a complex dental operation done in the hospital, Medicare will generally fund your inpatient care, but the dental surgery itself will not be reimbursed.

Therefore, while Medicare does not pay for dental implants, it may pay for some associated procedures.

What Are Dental Implant Coverage Options Available Through Medicare?

Does Medicare cover dental implants for seniors. As Medicare Advantage (MA) plan offers additional dental coverage for dental implants dramatically assists. A maximum dental benefit is always permitted, plus a copay or coinsurance, and a monthly premium may be required.

A personal financial investment is needed if dental implants are desired. Medicare or Medicaid does not often cover dental implants. However, even if other dental procedures are covered, specific MA plans do not cover dental implants.

Regarding dental implants, some MA plans cover the artificial post or crown but not the surgical insertion of the metal post.

Medicare: What Are the Benefits for Dental Implants?

Exams, x-rays of the gums and tooth roots, and tooth extractions are additional costs associated with dental implants. Your MA plan should partially cover your regular dental checkups and x-rays. Tooth extractions may be partially covered as well, depending on your policy.

In some instances crowns will be covered by insurance, but if a plan does not cover dental implants, the peaks that go with them will also not be covered. Outpatient care is the norm for dental implant surgeries. As with medical treatments, anesthetics and nitrous oxide may be covered in part by your MA dental plan.

Advantages cover dental implants but It is advisable to consult with your dental provider/biller who is familiar with insurance and knows which codes to use to see if your MA plan with dental coverage covers these other charges linked to dental implants.

Which Medicare Covers Dental Services?

Additional dental benefits, such as those associated with dental implants, may be included in the coverage of some Medicare Advantage plans. Compared to Original Medicare, Medicare Advantage plans offer a more comprehensive range since private, Medicare-approved insurance firms provide them. Medicare Advantage plans often cover standard dental services like checkups and cleanings.

Dental implants, in addition to extractions, fillings, and other forms of tooth replacement or restoration, may be covered by the supplemental dental insurance offered by some Medicare Advantage plans.

The dental treatment you receive may be limited to those in the plan's provider network, and the amount your plan pays may be a flat rate rather than a percentage of the total cost.

Does Medicare Cover Dental Medications Before Or After Implant Surgery?

Medicare Part A often covers any drugs you may need during hospitalization after dental implant surgery. Original Medicare does not often cover dental prescriptions.

Antibiotics, pain medicine, and other prescription drugs ordered by your doctor before and after your procedure are likely to be covered by your Medicare Part D Prescription Drug Plan or Medicare Advantage plan with prescription drug coverage. To ensure your project covers your dental implant meds, you may look them up in the formulary.

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