While Medicare offers comprehensive coverage for most of your healthcare needs, you may be wondering if they cover dental procedures such as implants? After all, implants involve surgery, anesthesia, and other “medical” things, so shouldn’t they be included in your Medicare coverage?
Perhaps in a sense, though it may not be as simple as that.
Here’s what you need to know about Medicare dental implants, and what Medicare may cover for you.
What are Dental Implants?
When an entire tooth is either lost or never grew in the first place, your dentist may replace it with an implant, which is a false tooth that works just like a real one. It has a root that’s set into the jawbone just like the original, and may be used as an alternative to dentures, or if bridgework isn’t a viable option for the repair of broken or lost teeth.
Typically the “root” of an implant is a titanium post that’s affixed to the false tooth and works just like a real root in holding the tooth on the gum. The post and the tooth are held together with an “abutment,” and the post fits down into your gum and jawbone in the same manner as a natural tooth root would.
Of course, this takes some surgical work and prep from your dentist, which usually requires multiple outpatient visits over the course of a few months. Once your dentist performs any tooth removal, bone prep, and gum prep necessary, he or she may implant the post into your jawbone below the gum. After this, it may take a few months to heal completely enough for your dentist to install the new tooth.
This can be to replace a tooth for any reason, including physical damage, decay, or never having grown in the first place, such as from a genetic condition.
How Much do Dental Implants Cost?
Though many factors weigh into the cost of dental implants, you can typically expect to pay between $3200 – $6000 per implanted tooth. However, it’s very hard to give a specific number.
The reason for such a wide cost range is due to such factors as the health and condition of the jawbone and gums, and the extent of prep necessary to install the implant. For instance, a bone graft may be needed to replenish jawbone lost to decay, and gums may need regeneration or soft tissue grafts for a successful procedure to be performed. These procedures may give your dentist something to “work” with and install your new tooth in.
Since any of these procedures can alter the cost significantly, it prevents estimates from being completely predictable. You may also need more than one tooth implant performed, with each one’s unique complexities and cost adding to the full cost.
Does Medicare Cover Dental Implants?
While Medicare may pay for medical treatments related to implants, it won’t pay for the implants themselves.
For instance, if an oral surgery needs to be performed in a hospital to prepare for your implants, Medicare may cover costs related to the hospital, but not for the the surgery itself. This may include Medicare covering the costs of the hospital bed, surgical chamber, and the hospital’s equipment fees, though not the surgical treatment performed by a dentist.
What does Medicare Cover for Dental Care?
While Medicare may cover nearly all your medical care costs, the only dental costs they cover are those related to illness or injury.
For example, if your cardiologist needs a dentist to perform a checkup to clear you for heart valve or kidney surgery, Medicare may cover it. Likewise, if dental reconstruction of your jaw is necessary after an accident, Medicare may cover that too.
On the other hand, a routine dental checkup or treatment unrelated to any surgery, illness, or injury may not be covered.
However, while Medicare Part A (hospital) and Medicare Part B (medical) won’t cover dentistry, certain Medicare Advantage plans offered by private insurance companies may cover. If you’re considering getting implants, this might be your best option.
Does Medicare Include Medications for Surgery?
If your oral surgery needs to be performed in a hospital, Medicare Part A may cover your in-hospital medications, though nothing else is covered under original Medicare. This includes any antibiotics or pain medicine administered to you while in the hospital, though nothing prescribed to be used before or after your hospital stay.
But Medicare Advantage plans with prescription drug coverage, or a Medicare Part D Prescription Drug Plan, can likely cover your medication costs related to dental surgery. This includes antibiotics, pain medications, and other prescription drugs your doctor prescribes for use before or after the surgery.
Why Choose a Provider at Intermountain Healthcare?
Whether you need hospital care related to your Medicare dental implants or just a routine checkup at one of our myGeneration Senior Clinics, you deserve only the best, most comprehensive healthcare available. That’s why our caregivers at Intermountain Healthcare are committed to delivering top-quality healthcare that makes a difference in their patients’ lives.
*Please check with your plan for more information on details of your benefits coverage. This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician or qualified healthcare professional.