Medicare Dental Insurance That Covers Implants

Does Medicare Cover Dental Implants?

Medicare, the federal health insurance program primarily for individuals aged 65 and older, does not typically cover dental implants. Original Medicare (Part A and Part B) excludes routine dental care, including implants, dentures, and other common procedures. However, some Medicare Advantage (Part C) plans may offer dental coverage that includes implants.

How to Find Medicare Dental Insurance That Covers Implants

If you are looking for a Medicare dental plan that covers implants, consider the following options:

1. Medicare Advantage Plans (Part C)

Medicare Advantage plans are offered by private insurance companies and may include dental benefits. Some plans provide partial or full coverage for dental implants, but the extent of coverage varies by provider. To find a plan that covers implants:

• Check your current plan’s Summary of Benefits.
• Compare different Medicare Advantage plans in your area.
• Contact the insurance provider for specific coverage details.

2. Standalone Dental Insurance Plans

Medicare beneficiaries can also purchase standalone dental insurance plans that cover implants. These plans, offered by private insurers, typically include:

• Coverage for major dental procedures, including implants.
• Annual benefit limits ranging from $1,000 to $5,000.
• Monthly premiums that vary based on the provider and level of coverage.

3. Discount Dental Plans

While not insurance, discount dental plans offer reduced rates on various procedures, including implants. Seniors on Medicare can enroll in these plans to lower out-of-pocket costs.

Proving Medical Necessity for Dental Implants

In some cases, Medicare may cover dental implants if they are deemed medically necessary. For example, if the implants are required due to:

• Jaw reconstruction after an accident or illness.
• Severe medical conditions that impact oral health, such as cancer treatment affecting the jawbone.
• Congenital defects requiring surgical correction.

To prove medical necessity, your healthcare provider must submit documentation, including:

• Detailed medical history.
• X-rays and other diagnostic reports.
• A statement from a dentist or oral surgeon explaining why implants are necessary.

Best Dental Plans for Seniors on Medicare

For seniors looking for comprehensive dental coverage, the following insurance providers offer plans that may include dental implants:

1. Aetna Medicare Advantage – Some plans cover implants with cost-sharing options.
2. UnitedHealthcare Medicare Advantage – Offers plans with dental benefits, including implants in select areas.
3. Cigna Medicare Advantage – Includes dental coverage with some plans offering implant benefits.
4. Humana Medicare Advantage – Provides extensive dental benefits with implant coverage in certain plans.
5. Delta Dental PPO Plans – A standalone dental insurance option that offers implant coverage.

Final Thoughts

While Original Medicare does not cover dental implants, Medicare Advantage plans and standalone dental insurance policies may offer coverage. To ensure you get the best plan for your needs, compare different options, check for implant benefits, and consult an insurance specialist.