However, cosmetic surgery, dentures, dentures, dental implants, orthodontics, orthognathic surgery, jaw alignment, or treatment for temporomandibular (jaw) or upper and lower jaw surgery and temporomandibular (jaw) related surgery, unless necessary for traumatic injury acute or cancer, is not. There are some circumstances in which your health insurance may provide coverage for at least some aspects of dental implant surgery. If the loss of your teeth has led to medical complications, your health insurance may provide coverage. Dental implants required after oral cancer may also be covered by health insurance.
If your health and dental insurance plans provide coverage for dental implants, the benefits of each can be combined to minimize your out-of-pocket costs. When you need to preserve a sick tooth with proper oral hygiene, and it hasn’t helped, dental implants may be considered medically necessary. There are some reconstructive dental services that we can bill your insurance that will be covered, such as extraction or orthodontic services for fractured teeth. However, there are times when dental implant surgery can be considered cosmetic and is therefore not covered.
Our team can work with you and your insurance, so that you know the estimated costs of services provided before committing to any procedure. Dental implants are covered by health insurance when you can prove that treatment is medically necessary. Qualifying services are “appropriate for the evaluation and treatment of a disease, condition, illness, or injury” and are consistent with the applicable standard of care. Unfortunately, most dental insurance policies don’t cover dental implants because most companies classify them as a “cosmetic procedure.”.
Many insurance companies are beginning to see the importance of these implants. However, from now on, it is unlikely that your insurance company will cover the cost of dental surgery. However, you can file a claim to try to get some kind of refund. Most dental insurance covers routine cleanings 100%, but they only pay a small fraction of the cost of other treatments.
Dental insurance also tends to have a low annual maximum benefit, so patients with complex problems can quickly exhaust their dental benefits during the year. If you have patients whose medical and dental problems are related, billing health insurance for procedures can help them pay for needed care. When is a procedure a doctor? When used to diagnose or treat a medical condition. For example, “overbite” is a dental condition, but not a medical condition.
It may seem a little confusing at first, but with practice and training, you can learn to identify which of your procedures are used to treat medical conditions. The key is that treatment must be linked to a diagnosed medical condition covered by the insurance policy. Cosmetic treatments such as teeth whitening are not covered as medical procedures. Patients with medically necessary reasons can get their health insurance to pay for most of their dental implant expenses, excluding deductibles, copays, etc.
Free dental implant grants offer less help than getting your health insurance to pay a portion of the bill, so pay close attention to these details. After dental implantation, mild pain can be treated with over-the-counter pain relievers, such as Tylenol or Motrin. Dental crowns, dentures, and dental implants are important procedures that tend to be covered in the lowest percentage, such as 50%. First, there are some plans that don’t cover dental implants at all, as they consider them a cosmetic procedure.
The Dental Maintenance Organization (DMO) and the Preferred Dental Provider Organization (PPO) are the two most common types of plans. Instead of asking if Blue Cross health insurance covers dental implants, start working with your doctor and dentist to verify that you have a medically necessary reason. For example, if dental problems have made it impossible for a patient to eat solid foods, that person has gone from a dental problem to a medical one. Instead, get your current health insurance to pay for dental implants showing that they are medically necessary.
Success rates for dental implants vary, depending on where in the jaw the implants are placed, but in general, dental implants have a success rate of up to 98%. They include exams, consultations, medical images, models, stents, and bacterial tests, including tests used to discover the sources of pain. Biopsies and extractions of soft and hard tissues, as well as surgical placement of dental implants, are also covered. Unfortunately, there is a great deal of variation from plan to plan, which can make it difficult to provide universal advice as to what is covered.