Does Insurance Cover The Cost Of Dental Implants?

Key Takeaways

• Most dental plans do not cover the cost of dental implants fully.
• Your dental insurance may cover part of your dental implant treatment cost.
• You may be able to get coverage for any dentist of your choice, depending on your chosen dental insurance plan.
• The coverage level also depends on the type of implants recommended for you.

Does Insurance Cover Dental Implant Treatment?

Most dental insurance plans do not cover the cost of dental implants, although in some cases, you may find something of the sort under your cosmetic dental coverage. The insurance could cover a small percentage of the dental implant cost or 50%, which is half the cost. Your health insurance may cover dental implants under the extras coverage policy. If your health insurance does not include a dental plan, you could seek a policy that covers dental implants or go for discount dental plans.

The level of coverage that your insurance company will include takes the different steps of a dental implant treatment into account.

Tooth Extraction: If your teeth are missing, they won’t fall under this category. However, if you still have damaged teeth that need to be pulled out, your dental insurance will likely cover it, as most plans cover it in full or partly.

Bone Grafting: This procedure strengthens your jawbone density and is not covered by most dental insurance plans.

Implant Placement: This part of your treatment is termed a “major” operation by most insurance companies, and most plans will cover up to 50% of the cost.

Fitting The Permanent Prosthesis: This is typically the last surgery in the dental implant procedure, and insurance companies may also consider it a major one. You should check with your insurance provider to see how much of the cost they would cover.

Dental Insurance Coverage Explained

1. What Dentists Do You Have In Your Network?

   The dentists in your network depend on the type of dental insurance you opt for. Sometimes, these dentists can refer you to specialists within or outside your network. Your dental coverage will cover preventive dental care from these dentists and sometimes extend into non-preventive dental care.

2. Can You Choose Who Your Dentist Is?

   Sometimes, your dental insurance plan will let you choose any dentist within your network, which may extend to out-of-network dentists. While in others, you may have to settle on a primary care dentist who can give specialist referrals.

3. How Is Coverage Structured?

   Dental coverage in Australia is typically divided into two categories: general dental and major dental. The general dental cover comprises preventive dentistry like teeth cleanings, minor filings etc. At the same time, the major dental cover includes major procedures like dental implants or root canal treatment.

   Your dental need will determine what coverage you will be eligible for.

4. Can You Choose When You Want To Go To The Dentist?

   You will likely be able to choose when to go to the dentist regardless of your dental insurance. However, you may need to keep your annual maximum coverage in mind.

What Are The Different Types Of Dental Insurance?

There are different types of dental insurance in Australia, and settling on one isn’t that hard. Although highly unpredictable, you should consider your annual dental needs to the best of your ability when selecting dental insurance.

Dental Preferred Provider Organisation (DPPO)

DPPO plans usually have a network of dentists accepting discounted dental treatment payments. This leads to a much lower or no out-of-pocket cost for members.

This plan does not require you to have a primary care dentist. You may also avail yourself of insurance with a dentist outside your network. However, the dental coverage will be less than with an in-network dental care provider.

Dental Indemnity

This plan offers a lot of freedom and is sometimes called traditional insurance or fee-for-service. With a dental indemnity plan, there is no network, no need for a primary care dentist, and you may not need referrals to see specialists depending on your plan.

This plan has you make an initial payment for your dental care then the insurance company will reimburse you according to what the insurance company deems reasonable and customary. That means, in some cases, the coverage may not cover the actual cost of the treatment.

Dental Health Maintenance Organisation (DHMO)

The DHMO plan has a network of dentists offering lower fees, reducing members’ dental payments. The insurance typically provides 100% coverage for preventive dentistry like teeth cleanings, exams, etc.

This plan requires you to choose a primary care dentist from their network. In most cases, there is no deductible and just a set fee for non-preventive dental care like dental implants. DHMO typically do not have an annual limit for dental services.

Dental Point Of Service (DPOS)

The DPOS insurance plan works like a combination of the DPPO and DHMO. Ir requires a primary care dentist, but you may enjoy the coverage with a dentist outside your network.

The plan will also cover the cost associated with a specialist referral from your primary care dentist.  However, dental coverage will be reduced when you see dentists outside your network.

Dental Exclusive Provider Organisation (DEPO)

The DEPO plan focuses on in-network care but does not require you to choose a primary care dentist.  You can choose to see a general dentist or a specialist and do not need specialist referrals.

These plans usually feature a deductible and coinsurance. You may be able to avail the out-of-network coverage for some dental emergencies.

Cost Of Dental Implants

The cost of dental implants in Australia varies from patient to patient. It also depends on whether you are getting a single tooth, several teeth All-on-4 or All-on-6, and several other factors like the implant material, number of appointments, etc.

A single tooth implant cost starts at around $1,999 and could go much higher for full arches or full mouth restorations.

Your dentist should inform you of any payment plans or financing options to help you spread the cost. And, of course, you should reach out to your dental insurance provider to see if they cover any percentage of the dental implant cost.

Visit Moorooka Dental Care To Get Your Dental Implants

Moorooka Dental Care is equipped with skilled and detail-oriented professionals committed to making your dental implant surgery successful. We also offer payment plans to make the treatment more suited to your budget. Call our dental clinic to book an appointment today.

FAQ

1. 1. 1. Are Dental Implants Necessary?

         Dental implants restore the function of your natural teeth, so they are necessary if you have missing or damaged teeth. Your dentist will thoroughly undergo a consultation with you to see if you are a good candidate for dental implants.

      2. How Long Do Dental Implants Last?

         If you care for the implants properly with routine checks at the dentist, your dental implants should last a lifetime.

      3. How Painful Is Getting A Tooth Implant?

         You will feel no pain during your dental implant surgery as your dentist will give you an anaesthetic to numb the pain. Over-the-counter medications will solve any afterpains you get following the implant surgery.

      4. Is Dental Covered In Health Insurance?

         Dental coverage in health insurance varies depending on the specific insurance plan. Some health insurance plans offer dental coverage as an additional benefit, while others may require a separate dental insurance policy. It is important to review your health insurance policy or contact your insurance provider to determine the extent of dental coverage included in your plan.

      5. Does Medicare Cover Dental Implants?

         No, Medicare does not typically cover dental implants in Australia. Medicare mainly provides coverage for essential medical services, and dental treatments, including dental implants, are generally not covered under Medicare.