Dental implants can be quite expensive. So if your dentist says you need dental implants, you may ask “does Medicare cover dental implants?” be wondering if Medicare covers the costs.
Below we look at this question and give you the info you need about implants and Medicare.
Does Medicare Cover Dental Implants?
Now, if you’re already a Medicare beneficiary, then that means you may already be enrolled in Original Medicare (both Part A and Part B.)
However, Original Medicare usually doesn’t cover any routine dental services. This includes routine dental care, teeth cleaning, oral exams, dental fillings, tooth extractions, and lastly, dental implants.
So, no, Original Medicare does not cover dental implants.
There is a possible exception. Original Medicare may cover dental services if they are an essential part of a Medicare-covered procedure.
For instance, if you need to have a dental exam before you get a procedure such as a surgery, kidney transplant, or heart valve replacement surgery, then Medicare will cover the necessary dental exam.
Medicare Advantage Plans and Dental Implants
There might be a way to get Medicare to cover your dental implants. This is through Medicare Advantage coverage.
Medicare Advantage, or Medicare Part C, is a Medicare program that can provide coverage for things Original Medicare doesn’t. To get Medicare Advantage, you will need to buy a plan from a private insurance company that partners with Medicare.
These Medicare Advantage plans are available to cover additional benefits that the Original Medicare plan doesn’t cover. This may include routine dental benefits, and even dental implants, depending on the private insurance company and the plan you get.
It’s important to note that the additional benefits you may get from your Medicare Advantage plan varies from one insurance provider to another. So it’s very crucial to review your plan before agreeing to it.
If you have a Medicare Advantage plan, you still get the benefits of the Original Medicare plans. The only difference is you’re getting all of these from a private, Medicare-approved insurance company.
With that said, you will still need to pay for the premium of your Original Medicare plan along with the new premiums of Medicare Advantage or Medicare Part C.
Additionally, there may still be plan deductible and out-of-pocket costs when getting your dental implants. Be sure to review your current plan or speak to a Medicare insurance agent to ensure that you have coverage before getting your dental implants.
Post Implant Surgery Coverage
While rare, it is possible to have complications from a dental implant surgery. In this case Original Medicare will cover the cost of your medical treatment. This includes getting an infection from dental implants, or other health issues you may get.
Infections are actually a common risk when it comes to dental implants. Other less common risks or problems can include injury to your gums, nerve damages, and sinus problems.
With that said, dental implants are actually a “low-risk” surgery, and the rates of success are actually high.
Additionally, post-surgery treatment and medication may also be covered by Medicare Advantage plans. It is highly likely that you will need painkillers and medications to avoid infection. Medicare Advantage plans will cover the costs of these medications. The pain and the infection rate are minimal, however. But these will still be prescribed as a precaution.