Insurance Coverage for Dental Implants

Insurance Coverage for Dental Implants

Tooth loss may occur because of tooth decay, gum disease, accidents, congenital defects, excessive wear and tear, and root canal failure. A dental implant is an artificial replacement for a lost tooth. In fact, it is considered the best form of replacement. It uses titanium which fuses with the jawbone preventing bone loss. This process is called osseointegration. It is a permanent but expensive prosthetic solution.

Dental Implants Vs Cheaper Alternatives

Removable dentures and dental bridges are commonly suggested cheaper alternatives to tackle the problem of tooth loss. The latter generally lasts for 5 to 7 years and even longer with good oral hygiene, and are recommended in case fewer teeth need to be replaced. They use the adjacent teeth for support and may damage the teeth that act as anchors. They may fail in case the person suffers from gum disease. Whereas the former rests on the gum and may result in bone loss in the area where the tooth is missing. They are not a permanent solution and are a source of embarrassment to some people.

The cost of a basic implant is somewhere between USD 1,250 and USD 3,000. However, depending upon the complexity of the situation, the total cost can be as much as USD 30,000. Compared to this, traditional bridge costs between USD 500 and 900 (per tooth). Hence, the need for insurance arises.

Insurance Coverage

In the US, only 53% of the population has dental health coverage. Considering the exorbitant cost of dental care, this is a must. However, a dental insurance policy does not include all the necessary procedures. According to the Least Expensive Alternative Treatment (LEAT) clause, the insurance company is expected to pay for the treatment with the least cost. Moreover, dental implants also fall under the category of cosmetic dentistry. Hence, the company may not cover them.

In some cases, the company may agree to pay a portion of the bill, leaving the remaining cost of the procedure to be borne by the individual seeking treatment. Some providers offer a cover with an exclusion period of 1 year. Even if the provider agrees to cover the cost, the waiting period is very long. All these issues make dental implants a prohibitively expensive procedure, both in terms of money and time. Fortunately, there are ways of working around this problem.

Cost-effective Methods

  • Seeking Treatment Outside the US: The cost of traveling to a foreign country to seek medical treatment is a surprisingly affordable option. In fact, in Romania, a dental implant is available for as low as USD 500. The entire procedure, including travel expenses, would add up to less than one-third of the cost of the procedure in the US.
  • Approaching a Dental School: This is not a bad option for people who are in desperate need of treatment. A dental school may be willing to perform the procedure even for free, as a part of their research studies. Of course, the problem should be interesting and complicated enough to compel the school to handle the case.
  • Cosmetic Alternatives: Sometimes, women opt for implants to show more teeth while speaking or laughing. Those with small teeth generally face this problem. Injecting collagen into the lips can help achieve the same goal at a lower price.