Which Medicare Advantage Plans Cover Dental Implants? At the age of 74, about one in four adults lost all their permanent teeth. When a permanent tooth falls or needs to be removed due to injury or decay, a dentist usually recommends replacing it with a dental implant. Although traditional health insurance does not cover most basic or prosthodontic care, such as dental implants, some Medicare Advantage plans may provide assistance in paying for this service.
The original health insurance plan (Parts A and B of the Medicare Plan) does not offer dental benefits except in extremely limited circumstances. Fortunately, some Medicare Advantage plans (Medicare Part C) offer options to cover basic dental services and major dental services. Approximately 42% of Medicare Advantage beneficiaries had access to extensive preventive and dental benefits, such as dental implants in 2016.
As private insurers, Advantage health insurance providers can offer a variety of benefits beyond the minimum requirements of Parts A and B of the health insurance plan, can charge additional premiums for supplements such as dental care. Businesses may also use premiums or dollar refunds to help cover the cost of these additional benefits.
Plans that offer extended dental coverage usually charge an additional premium. Dental premiums are added to Health Insurance Part B premiums and other Part C benefits In 2016, these costs ranged from approximately $72 per year to more than $720 per year.
Some Medicare Advantage plans use a cost-sharing approach to cover dental benefits such as dental implants. Some plans may cover most of the cost, while others require fixed copayes. Others charge a fixed co-insurance fee of 20 -70% for any extended dental service.
Medicare Advantage plans with extended dental benefits often limit the total amount provided. Most plans have limits of approximately $1,000. Plans often limit the number of services covered.
In some cases, seniors covered by Medicaid and Medicare may have access to dental benefits through Medicare Advantage plans. However, it can be quite complicated to determine which coverage options pay for certain services. Additional premiums or cost-sharing costs would also be an important factor.
Diets vary considerably, so careful research is essential to understand the availability and scope of dental implant coverage. Kaiser Permanente’s Senior Advantage Plus plan includes basic and important dental restoration services. After obtaining a $50 dental deductible, participants pay 50% co-insurance up to $1,250 in annual benefits.
Medicare Advantage plans give members a proof of coverage notice that specifies whether they pay for dental implants. This notice will also address the amount that beneficiaries will have to pay for their own prosthodontic services.
Seniors can consult the Medicare insurance search tool, write their postal code and search for Medicare Advantage plans. Then they can select the title of a plan and click on the “Benefits” tab. Plans with dental coverage have coloured circles with a D; a list of dental providers in the network must be available. Elderly people can also ask their dental office what regimens are accepted there.
Many seniors who require dental implants can expect to pay significantly for prosthesis services, plus premiums, co-insurance, co-payments, annual caps and other fees charged by their Medicare Advantage Plan. You may consider buying independent dental insurance or a discount plan if this is financially feasible. Veterans and other populations may be eligible for free or low cost dental implants through various charities and programs.
The Cosmetic Dentistry Grant Program (CDG) provides partial grants to individuals who require cosmetic services such as dental implants. Although CDG does not pay the total cost of obtaining dental implants, its partial subsidies can make implants much more affordable.
Your health insurance may also cover dental implant interventions, but this varies depending on your insurance policy. If you do not have dental insurance or coverage under your existing insurance, you can search for a policy that covers dental implants or search for discount plans for dental plans.