Since March 2023, over 65 million people havenrolled in Medicare. This is an increase of nearly 100,000 since the previous report was released in September 2022.
Medicare is beneficial to seniors because it can cover hospital stays, hospice care, doctor services, and more. But, which Medicare Advantage plans cover dental implants?
If you are considering this procedure, you need to know if you have coverage. Keep reading to learn more.
Does Medicare Advantage Provide Dental Benefits?
Medicare Parts A and B (Original Medicare plans) don’t provide dental benefits unless you meet extremely limited circumstances.
Part A (Hospital Insurance) and Part B (Medical Insurance) may cover costs if health concerns arise after a dental implant procedure.
So, which Medicare Advantage plans cover dental implants?
One Medicare Advantage plan, Medicare Part C, provides options for dental services. If dental implant coverage is important to you, this plan is likely your best option.
Most Medicare Advantage beneficiaries have access to preventative and extensive dental benefits, such as dental implants.
Medicare Advantage plan providers are private insurers. This means they can offer many benefits among the minimum requirements of Medicare. However, you might have to pay additional premiums for things like dental care.
If you don’t want to pay for the premium, consider purchasing a stand-alone dental insurance plan. In some instances, this could be the more financially feasible option.
Veterans might be eligible for free or low-cost dental implants through certain programs or charities. Midwest Health Insurance Solutions offers special plans for veterans.
It’s important to research the different possibilities to avoid overpaying for dental implants. Some providers use bonus payments or rebate dollars to help cover supplemental benefits.
Medicare plans offering extensive dental coverage typically charge a premium. This is an extra premium in addition to the already set Medicare Part B premium and other Part C benefits.
Dental Implant Medicare Advantage plan costs can vary widely.
There are Medicare Advantage plans that cover dental benefits with a cost-sharing approach. Certain plans will cover most of the cost. Others require flat co-pays or a flat coinsurance rate of up to 70% for extensive dental services.
Because dental implants aren’t technically necessary, they are classified as extensive.
Caps and Limits
If your Medicare Advantage plan comes with extensive dental benefits, the total amount provided will likely be capped.
Most plans have limits of about $1,000 on average. Some plans will limit the number of services this amount covers as well.
Oftentimes, seniors can benefit from dental coverage for dual eligibles. Seniors covered by Medicare and Medicaid can access dental benefits through Medicare Advantage plans.
Although, it can be difficult to determine which coverage options pay for some services. Additional premiums or cost-sharing expenses are factors that go into this method.
Supplemental Dental Insurance
Supplemental dental insurance can help you pay for cleanings and routine exams if your Medicare Advantage plan doesn’t cover them. It can also help cover the costs of root canals, x-rays, fillings, etc.
Your insurance plan might cover the entire cost of these procedures. It all depends on your provider and the qualifying criteria.
You should never neglect dental insurance. Poor dental health can cause serious complications and lead to other health issues. Dental problems may impact your quality of life as you experience tooth pain, which could impair your ability to eat.
How Do I Know if My Plan Covers Dental Implants?
To find out if you have dental implant coverage through your Medicare Advantage plan, check your Evidence of Coverage notice. This notice comes with every plan.
The Evidence of Coverage will specify whether your plan covers dental implants. It also discusses how much beneficiaries must pay on their own for dental implants.
Once you know that you have dental implant coverage, you need to find a dentist that accepts this insurance. Use the Medicare Plan Finder to do this.
Type in your zip code and look for your Medicare Advantage plan’s title. Click the “Benefits” tab and look for the colored circles with a ‘D’ to see which plans offer dental coverage. From there, you should see a list of network dental providers.
If you have a regular dentist that you see, ask the office if your Medicare Advantage plan is accepted there.
How Much Do Dental Implants Cost?
The cost of dental implants can vary. There are different parts to the procedure, each part requiring its own fees. The parts of a dental implant procedure include:
- Dental exam with 3D imaging
- Extraction of problem teeth, if necessary
- Dental implant installation
- Abutment placement
- Dental crown fabrication
- Crown placement
A single dental implant can cost anywhere from $3,000 to $4,500. Implants for multiple teeth can cost up to $10,000.
A full-mouth replacement is the most expensive option. This service can be anywhere from $60,000 to $90,000.
How to Get Medicare Part C Coverage
Medicare Advantage plans are offered by private health insurance companies. They must follow the rules set by Medicare, which instruct them to cover the benefits of Medicare Part A and Part B.
Medicare Part C can help close the insurance gaps of the first two Medicare Parts. Still, the costs should be lower than a traditional insurance plan.
In addition to dental coverage, Medicare Part C typically includes prescription drug coverage. If you need dental implant prescription drugs after your procedure, this is an added benefit of having Medicare Part C.
An insurance agent can help you compare benefits, coverage plans, and prices to ensure you get the best deal. If dental implants are a must-have, let your insurance agent know before choosing a plan.
Which Medicare Advantage Plans Cover Dental Implants? The Bottom Line
Medicare Advantage plan (Part C) is your only option for dental implant coverage.
Original Medicare plans don’t cover most dental services, even the basics. However, it might pay for services related to covered medical services within the plan.
Midwest Health Insurance Solutions is your one-stop shop for everything insurance. When you need to know about Social Security benefits, retirement benefits, and Medicare Advantage plans, we can help.
When you are ready to apply for Medicare Advantage plans, one of our trusted health insurance agents will help you enroll. Get started now.
Do you need help comparing Medicare Advantage Plans vs. Original Medicare in the context of your situation? Our professional staff offers expert, bilingual guidance to help make the best choice for your needs. Let’s make sure you get the insurance coverage that you deserve!