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If you have damaged or missing teeth, your dentist may recommend dental implants to replace them. If you’re a Medicare beneficiary, your first question may well be, “does Medicare cover dental implants?” This article explains the dental implant process and how your dental benefits work under Medicare.
According to the Mayo Clinic, dental implants are artificial teeth attached to a metal post or screw implanted in your jawbone, which serves to replace a tooth’s roots. Dental implants can be an alternative to dentures or help repair broken or missing teeth where bridge work isn’t possible.
There are several steps in the dental implant process, which is usually done on an outpatient basis and may take several months to complete. Your dentist may remove damaged teeth, if necessary, and prepare the jawbone to receive the implant. Then the dentist will implant the metal screw or post in your jawbone below the gum line. Once the bone has healed completely, your doctor attaches the replacement tooth to the implanted post.
Medicare doesn’t typically cover any dental services unless they are related to an illness or injury. For example, if you need a dental exam to clear you for heart valve surgery or organ transplant surgery, Medicare may cover it. If you need certain dental procedures as a result of oral cancer or injury to the face or jaw, those services are also generally covered. Medicare also typically pays for your inpatient care if you need to have a complex dental procedure done in the hospital, although the dental procedure itself isn’t covered.
In other words, Medicare doesn’t cover dental implants themselves, but it may cover some services related to dental implants. For example, if you have a health condition that requires your doctor to do your dental implant surgery in the hospital, costs associated with your hospital stay may be covered. If you have health complications such as an infection after your dental implant surgery, Medicare generally covers medically necessary care to treat you.
Some Medicare Advantage plans may offer additional benefits for dental care, including services related to dental implants. Medicare Advantage plans are offered by private Medicare-approved insurance companies, so they are able to include supplemental benefits not available under Original Medicare. For example, many Medicare Advantage plans include coverage for routine dental care such as annual exams and cleanings.
Some Medicare Advantage plans even offer supplement dental insurance with coverage for more complex dental procedures such as extractions, fillings, and other types of tooth replacement or restoration, which may include dental implants. You may have to get your dental care from a network provider, and your plan may only pay a set amount for these additional services, regardless of the actual charge. There may be a separate monthly premium for supplemental dental insurance with your Medicare Advantage plan.
If you have dental implant surgery in the hospital, Medicare Part A generally covers any medications you take while you are in the hospital. Otherwise, there is generally no coverage for prescription medications related to dental services under Original Medicare.
On the other hand, if you have a Medicare Part D Prescription Drug Plan or Medicare Advantage plan with prescription drug coverage, your plan will likely cover any antibiotics, pain medication, or other prescription drugs your doctor orders before and after your procedure. You can check your plan formulary to be sure your dental implant medications are covered.
To find a Medicare Advantage plan that may cover dental implants, enter your zip code on this page.
eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.