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Insurance Insights | Are Dental Implants Covered by Insurance

February 1, 2024

Missing teeth can be a burden, impacting not just your confidence and smile but also your overall health and ability to chew and speak properly. Dental implants, the gold standard for tooth replacement, offer a permanent, natural-looking solution, but the question lingers: "Are dental implants covered by insurance in Kissimmee, FL?"

The answer, much like the Florida sunshine, can be a bit unpredictable. Understanding your specific policy and the various components of the implant procedure is key to navigating the financial aspect and making informed decisions.

Understanding Dental Insurance Coverage 

Many insurance companies view dental implants as purely cosmetic and, therefore, deem them medically unnecessary procedures, leading to non-coverage. However, individuals with missing teeth understand the crucial role of replacing them in maintaining their health and overall well-being.

Covering dental implant procedures may necessitate utilizing both medical and dental insurance coverage, depending on the underlying reasons for treatment. It's advisable to allocate time to review your insurance policy to ascertain whether dental implant coverage is included in the information provided at the initiation of the policy. Before commencing treatment, it's essential to pose pertinent questions to your insurance company to prevent any unexpected surprises:

- Does your plan encompass implant coverage?

- What percentage of the procedure does the policy cover?

- What is the annual maximum out-of-pocket cost?

- Is a referral necessary before undergoing dental implant procedures?

The dental staff at your provider's office can liaise directly with your insurance company to determine coverage based on your treatment plan.

Does Dental Insurance Cover Dental Implants? Does Dental Insurance Cover Dental Implants

Determining whether your insurance covers implants requires understanding the various components of the treatment and the extent of mouth preparation necessary for the implant. Coverage also hinges on whether you are undergoing a full restorative arch procedure or simply replacing one or two missing teeth.

  1. Tooth Extraction: The necessity for tooth extraction depends on whether you are already missing teeth or if a damaged tooth requires extraction before replacement. If the damaged tooth remains, this procedure is typically part of your dental implant treatment and is covered, either fully or partially, by most insurance companies.
  2. Bone Grafting: Some patients require reinforcement of their underlying jawbone before the implant procedure to ensure stability and security. Despite being a crucial step, this part of the procedure may not be covered by insurance.
  3. Implant Placement: The placement of the implant is considered a "major" dental procedure. However, the term "major" primarily reflects cost rather than treatment intensity. Some dental insurance plans cover up to 50 percent of major procedures.
  4. Artificial Tooth Placement: The placement of the artificial tooth, known as a crown, mimicking the appearance and functionality of a natural tooth, is also considered a major procedure. However, certain insurance plans may categorize it similarly to crowning a tooth to halt decay, potentially covering a greater portion of the cost. It's advisable to check directly with your insurance company for clarification on coverage details.

Are Dental implants covered by Medical Insurance? 

Your medical insurance could potentially contribute to the expenses associated with your dental implant procedure. Certain circumstances may prompt medical insurance to cover dental implants, particularly if tooth loss resulted from:

  • Physical trauma sustained in an unforeseen accident.
  • Congenital absence of teeth.
  • Medical conditions leading to tooth loss.

As coverage details may vary among insurance plans, it's advisable to consult your provider directly to ascertain whether your medical or dental plan includes coverage for dental implants.

Why Dental Implants Are Worth Every Single Penny? 

Dental implants might seem pricey at first glance, but think of it as an investment in your smile's future. They boast a lifespan of 30 years or even a lifetime with basic care, unlike bridges or dentures that need frequent replacements, draining your wallet over time.

Not only are dental implants financially advantageous, but they also benefit your jawbone health. By preventing bone loss, they ward off associated oral problems that can incur costly treatments later. Worried about affording them? Talk to your dentist! They're ready to work with you, exploring financing options and alternative solutions to make a healthy, confident smile a reality on any budget.

Both options emphasize the long-term financial benefits of dental implants while acknowledging the initial cost concern. They also encourage discussing financial options with a dentist for a personalized approach.

Conclusion 

Are you ready to discover your options for dental implant coverage in Kissimmee, FL? Our team at Parkway Dental Care is here to guide you every step of the way. Don't let uncertainty hold you back from achieving the smile you deserve. Contact us today to learn more about dental implant procedures and insurance coverage.

Schedule your appointment online or give us a call at (407) 635-1196 for new patients or (407) 932-2273 for existing callers. Let us help you take the first step towards a brighter, healthier smile. Your journey to dental wellness starts here with Parkway Dental Care!

FAQ 

Which parts of the implant procedure are typically covered by insurance?

Most plans cover tooth extraction if part of the implant process, but bone grafting often isn't covered. Implant placement and crown placement are considered major procedures, with some plans covering up to 50%.

I'm missing one tooth. Will my insurance cover replacing it with an implant?

Coverage might be different from for a full restorative arch. Contact your insurance directly for specifics.

Are dental implants covered by insurance if I lose teeth due to an accident?

Yes, medical insurance may cover implants if tooth loss stems from trauma, congenital absence, or specific medical conditions. Check your policy details.

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Parkway Dental Care Kissimmee
1064 E Osceola Parkway
Kissimmee, FL 34744
New Patient: (407) 635-1196
Current Patient: (407) 932-2273
Avalon Commons Dental Care Orlando
14811 E. Colonial Dr. Suite 100
Orlando, FL 32826
New Patient: (407) 606-7209
Current Patient: (​407) 601-4206
Avalon Commons Dental Care Orlando
14811 E. Colonial Dr. Suite 100
Orlando, FL 32826
New Patient: (407) 606-7209
Current Patient: (​407) 601-4206
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