Many older adults who need to replace lost teeth consider dental implants over dentures or bridges. However, dental coverage with Medicare can be a confusing process to navigate.
Dental implants are expensive, but they’re an effective way to replace missing teeth. Your dentist will attach a permanent false tooth to your jaw. Unlike dentures, you don’t ever have to remove dental implants — and they make it easy to eat all the foods you enjoy. Many dentists recommend implants over dentures because they may cause fewer problems with fit and cleaning.
In many cases, Medicare does not cover dental implants. But some types of Medicare may cover part of the costs of this smile-saving procedure. Learn about Medicare dental coverage and how to get help paying for dental implants.
Which Medicare Plans Cover Dental Implants?
In general, Medicare does not cover dental implants. Medicare is federal health insurance for people ages 65 and older, and for some younger people with end-stage kidney disease or certain disabilities. It includes different parts (A, B, C and D) that offer different types of coverage, and you can choose the parts and plans that work best for you.
Original Medicare (Part A and Part B) doesn’t include any dental coverage at all. Some Medicare Part C plans (also called Medicare Advantage Plans) offer dental coverage that may help pay for dental implants.
Part C plans are private insurance plans that allow older adults to access their Medicare benefits through a more conventional, all-inclusive health insurance model. These plans may include coverage for vision, hearing and dental care. But Medicare Advantage plans vary widely, so you need to check each plan carefully to see if it offers the type of dental coverage you need.
I Have Medicare Dental Coverage. Will It Pay for Dental Implants?
Although some Medicare Advantage Plans include dental coverage, there’s no guarantee that they’ll cover the cost (or the entire cost) of dental implants. Some dental plans won’t cover implants because they categorize them as a cosmetic procedure. Make sure to read the fine print on your plan to see exactly what dental services it includes.
Even if your plan does cover dental implants, you’ll probably still have to pay part of the costs out of pocket. You may have a copay or a deductible (an amount you have to pay out of pocket each year before your plan will pay for dental care). Some dental policies also have a waiting period for major procedures like implants, so you may have to wait to get coverage for implants.
As far as coverage goes, dental insurance is not always as generous as medical insurance. There is usually some out-of-pocket cost beyond the copay — like coinsurance, or a portion of the costs for a procedure that you have to pay yourself. Since dental implants are such an expensive procedure, coinsurance can be quite costly.
If you’re considering dental implants, talk with your dentist and your insurance company about the costs. You should be able to get an estimate before scheduling the procedure, so you’ll know exactly how much you’ll need to pay.
How to Get Dental Implants If Your Medicare Plan Won’t Cover Them
If your Medicare plan doesn’t cover dental care or dental implants, you may be able to find coverage through a separate dental insurance plan. Just like Medicare Advantage plans, these stand-alone dental plans may have copays, deductibles or coinsurance — so make sure to read all the details before you purchase a plan.
Since so many people don’t have dental coverage through their insurance, many dentists offer in-house financing options. Some allow customers to pay an annual fee in exchange for free cleanings and discounts on dental procedures. Others allow people to finance the cost of their dental visits and procedures, paying off the bill monthly rather than in one upfront payment.
Why Dental Care Is Key to Healthy Aging
Dental care is about much more than a bright white smile. When you lose teeth or you’re dealing with tooth pain, it can be hard to chew and get the nutrition you need. And your oral health affects your overall health. For example, tooth loss and untreated gum disease are linked to a higher risk of heart disease.
Regular dental visits can stop many of these problems before they become more serious. Getting your teeth cleaned can help remove bacterial buildup on your teeth and along your gum line. And your dentist can find cavities and gum problems early, when they’re easier to treat.
Dental visits are especially important for older adults. On average, people over age 65 only have about 19 of their own teeth remaining — and nearly one in three has no remaining teeth. That’s why it’s so important for older adults to have affordable options to replace missing teeth.
If you’re an older adult dealing with tooth loss, dental implants may be the best option for your health and comfort. Just be sure to talk with your dentist about the costs, risks and benefits of this procedure — and confirm your coverage with your insurance company, so you don’t get a surprise bill along with your new smile.
- “Dental Implant Surgery” via Mayo Clinic
- “What’s Medicare?” via Medicare.gov
- “What’s Not Covered by Medicare Parts A & B” via Medicare.gov
- “What is Medicare Part C?” via Department of Health and Human Services
- “Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage” via Kaiser Family Foundation
- “Gum Disease and the Connection to Heart Disease” via Harvard Health
- “Tooth Loss in Seniors” via National Institute of Dental and Craniofacial Research