Wednesday, June 15, 2022

Does Blue Cross Medical Insurance Cover Dental Implants

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Comparing Dental Insurance For Implants

Combining Medical, Dental and Vision Insurance Coverage with Blue Cross

Its important to shop around and compare the different plans and companies so you know that youre getting the coverage you need at the best available price. When comparing dental insurance for implants, you want to get a fair comparison so compare and contrast deductibles, monthly payments, services and procedures covered, waiting periods, and in-network providers. Make sure that coverage is offered in your state and research the companys reputation, reviews, and ratings.;

Medically Necessary Dental Work Makes A Difference

When Dr. Pottorff prescribes a dental treatment or procedure to restore your teeth or to help you maintain good oral health, his recommendation is dentally necessary. However, to foot the bill, your insurance company typically recognizes only medically necessary procedures. So, when most insurance providers deem dental work as medically necessary to repair your teeth and mouth after a traumatic injury, they pay for services.

The definition of a medically necessary dental procedure may vary somewhat from one insurance company to another, but typically, the need for medical, dental care includes:

  • Non-biting accidents, such as a knocked-out tooth
  • Certain diseases that affect your oral health
  • Tooth extractions as a result of disease

Dr. Pottorff is an expert at assessing your condition so he can prescribe the most effective medical and dental treatments.

What Does Dental Implant Insurance Typically Exclude

Dental insurance typically excludes procedures for cosmetic procedures such as teeth whitening and complicated oral surgeries that need to be handled in a hospital setting.;

While the insurance plans we highlighted do cover dental implants, its important to consider how much this coverage will help. Many dental insurance plans have annual maximum limits of a few thousand dollars, which will only cover so much when youre planning a pricey dental implant procedure. Deductibles can also apply, as well as coinsurance or copayments that require you to pay more out-of-pocket outside of your monthly insurance premiums.

Many dental implant insurance policies wont pay for implants for teeth that are already missing when you sign up. In the same way that you cant buy homeowners insurance once your house is already on fire, you cant buy dental implant insurance for teeth that are already missing.

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Blue Cross Medicare Supplement Or Legacy Medigap

Blue Cross Medicare Supplement plans do not include routine dental exams, cleanings and X-rays.; You may choose to pair a new or existing Blue Cross Medicare Supplement or Legacy Medigap plan with the Dental Vision Hearing Package that includes coverage for fillings, root canals, extractions, crowns and fluoride treatments.; It also includes vision and hearing benefits.

Learn more about how to get coverage;for your Blue Cross Medicare Supplement or Legacy Medigap plan.

This is a solicitation of insurance.; We may contact you about buying insurance.; Blue Cross Medicare Supplement plans arent connected with or endorsed by the U.S. government or the federal Medicare program.

Tip: You might need to pay a copay or coinsurance for your Medicare Advantage dental benefits. Check your plans;Summary of Benefits;for complete details.

Choosing Dental Insurance For Implants


There are several important consideration points to keep in mind when choosing dental insurance for implants. You will want to consider things like how easy it is to apply, get a quote online, how you can manage your account, and if the company offers any extra perks or discounts.;

Also keep the following in mind when choosing dental insurance for implants:

  • Coverage options: You want to research what type of coverage options are available, how many plans there are, what each plan offers, and their respective costs.;
  • Sign-up process: How easy it is to sign up is important. Can you sign up online or do you need to sign up with an agent over the phone?
  • Geographic availability: Find out where the company offers coverage and then check out the providers in your area that accept this type of insurance.;
  • Customization: Find out if plans can be customized and how you would do that. You want to pay for the coverage that you need and not things you wont use.

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Best Rewards Program: Ameritas

  • Procedures arent fully covered

  • Only one plan for implants

  • Must contact company for geographical coverage areas

Aetna is another company with a long history. The Hartford, CT-based company has been around since 1853. Aetna has 50 years of experience in the dental insurance business with almost 13 million members. Their PPO network includes 120,000 dental providers. The company has an “A ” rating with AM Best.

But according to their website, Aetnas dental insurance, Aetna®;Dental Direct, may not be the best option for implants. Instead, they suggest using Aetna® Vital Savings. For $110 per year, you get access to 15% to 50% discounts on dental procedures. Aetna® Vital Savings allows pre-existing conditions, like missing teeth, and you can skip waiting periods. Because Aetna® Vital Savings is a dental discount plan, there are no waiting periods and no annual or lifetime caps.

You can also sign up for the Dental Plus Rx for discounts on generic and brand-name prescription drugs. The card offers discounts from 12% to 60% at over 68,000 pharmacies, including chains like CVS® and Rite Aid®.;

Aetna® Vital Savings is the least expensive option on our list, and has generally positive consumer reviews. The plan has an A+ from the Better Business Bureau, and has 4 stars from 450 reviews on ConsumerAffairs.

Are Dental Implants Covered By Insurance

Basic dental insurance policies dont typically cover a dental implant procedure. Youll need to look into cosmetic dental procedure coverage, which covers a portion of dental implants. Your dental implant insurance coverage could be 50% of the cost, meaning your insurance covers half of the procedure. Remember your deductible, or how much you pay for a service before the insurance covers it, could apply depending on your other dental needs that year.

Your medical insurance may also cover dental implant procedures, but that will vary based on your policy. If you dont have dental insurance or coverage under your existing insurance, you can either seek a policy that covers dental implants or look into discount dental plan memberships.

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Your Dentist For Dental Implants

At Kraft & Schrott Dental Associates, we want to see you smile. We offer the affordable dental implants you need to gain a complete smile. We work with most dental insurances and offer flexible payment plans to permanently solve your tooth loss with implants.

If youre ready to regain your confidence, smile, and quality of life with dental implants, call our office today at 977-5266 to schedule a consultation.

Who Is A Candidate For Dental Implants

Blue Cross Dental Coverage for Employees

To be a candidate for dental implants, you must have:

  • Missing or loose teeth

  • A strong enough jawbone to withstand the healing process

  • Good overall health

  • No existing oral health problems

During a consultation, our periodontal specialists can determine whether or not dental implants will improve your oral health.

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Can Dental Implants Be Billed To Medical Insurance

In fact, dentists can bill medical insurance for any procedure or treatment that is within the scope of their license. Implant procedures are eligible for medical billing when they meet threshold of medical necessity. Examples include cases that restore function by resolving a compromised ability to chew.

Dental Treatments That Health Insurance Might Cover

What dental procedures might your medical insurance cover? Many patients ask this question because they do not have a dental plan and need help paying for treatment.

Your healthcare policy may pay for specific dental work that it deems medically necessary: care arising from non-biting accidents, certain diseases, and treatments considered integral to other services included in the plan.

Dental implants, orthodontic braces, and oral surgeries such as wisdom tooth extractions and some jaw operations sometimes fit the definition.

However, most oral care does not qualify unless you have an infection resulting from a root canal or periodontal disease or need anesthesia for pain. ;

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What Does Medicare Cover Related To Dental Implants

There are other expenses related to dental implants, such as exams, x-rays to determine the state of your gums and teeth roots, and tooth extractions. If your MA plan has dental benefits, routine exams and x-rays are generally covered at least in part. Depending on your plan, tooth extractions may be partially covered as well. Crowns are sometimes covered, but if a plan excludes dental implants, the crowns associated with them are typically excluded as well.

The majority of dental implant procedures are done on an outpatient basis. Costs associated with the procedures such as anesthetic or nitrous oxide may be partially covered by your MA dental plan.

The best way to determine if your MA plan with dental benefits pays for these other expenses related to dental implants is to talk directly to your dental provider/biller who works with insurance and understands which codes to apply to your claim.

If you have a MA plan that would pay for dentures as an alternative to implants, it is worth exploring whether or not some of those benefits could be applied to your dental implant costs.

Best Overall: Delta Dental Insurance

Insurance Friendly Little Elm: We are happy to assist you ...

;Delta Dental Insurance

Delta offers multiple different dental policies, is available nationwide, and you can apply for a quote online.;

  • Apply online for a free quote

  • Many plans cover dental implants

  • Coverage tailored to your needs

  • Pre-existing conditions not always covered

  • 50% coverage for major procedures like dental implants

Delta Dental, founded in 1954, has grown into a well-known dental insurance provider that currently insures more than 80 million Americans. Plans are designed for individuals, families, retirees, and small businesses. You can choose from among PPO, HMO, and Direct Dental Plans with varying coverage options and deductibles to accommodate your needs.;

Delta Dental plans vary in cost and coverage depending on where you live, but you can apply for a free quote online by heading to the Delta Dental website and entering your zip code. There are four types of plans for individuals that you can purchase to cover implants:

  • PPO plans cover preventative care and discounts on dental services.
  • A Dental Health Maintenance Organization plans focus on preventative dentistry, so it comes with minimal or no copayments on preventative care.
  • Patient Direct plans offer discounts for a panel of dentists in your area.
  • Dental Premier plans charge a fee per service, meaning you wont pay more than your copay and deductible in any given year for covered services.;

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What Does Your Insurance Cover

The type of insurance you have will affect the extent of dental care cover. Medical insurance that includes dental benefits could be convenient but may have limitations. In contrast, a direct dental insurance plan offers flexibility and more coverage options. Here are the dental care procedures that insurance may cover:

  • Preventative care: Includes routine office visits and professional dental cleaning.
  • Basic Restorative care: For dental treatments like fillings and crowns.
  • Endodontics: For root canals.
  • Oral Surgery: Tooth extractions, tissue biopsy, drainage of bacterial infections, and placement of dental implants.
  • Orthodontics: Palatal expanders, braces, aligners, and retainers.
  • Periodontics: Scaling, root planing, gum grafting, periodontal surgery, and placement of implants .
  • Prosthodontics: Dentures, bridges, and dental implants

A Plan For Every Type Of Traveller

While travelling outside your own province, some medical and paramedical expenses may only be partially covered by your provincial health insurance program. Depending on your needs, you can opt for coverage on a daily or annual basis. Whether you travel frequently during the year, take regular sun destination trips or do only occasional short trips, there is a plan thats right for you.

Let Blue Cross travel coverage take care of any unexpected medical emergency costs so you can travel worry free. To learn more, select your province or territory to leave the Association website and be redirected to the appropriate regional site.

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Are Dental Implants Medically Necessary

When you need to preserve a diseased tooth with proper oral hygiene, and it hasnt helped, dental implants can be considered medically necessary. There are a few reconstructive dental services that we can bill to your insurance that will be covered, such as extraction or orthodontic services for fractured teeth. However, there are times where dental implant surgery may be considered cosmetic and, therefore, not covered. Our team can work with you and your insurance, so you know your estimated costs for services rendered before you commit to any procedure.

Best For Convenience: Renaissance

Horizon Blue Cross Dental Centurion – Individual Dental Insurance
  • Essentials Plan
  • Health Savings Card

Both Plan II and Plan III cover prosthodontic servicesincluding implantsat 50% after twelve months. These plans offer coverage for one implant per tooth, per lifetime. The Essentials Plan doesn’t offer coverage for implants. Renaissance Dental has a cap of $1,000 in benefits per year. But the plan pays 100% for preventative services like exams and cleanings twice per year.

One of the best perks of Renaissance Dental is access to hassle-free benefits. Their nationwide PPO network files claims on your behalf. This allows you to skip the paperwork and inconvenience of waiting for reimbursements.;;

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Do You Need Dental Insurance For Implants

Its always a good idea to explore your options to determine if dental insurance for implants is the way to go for you. First, assess your needs and determine if implants are the best choice or if you should consider some other options such as dentures. Then, get some prices for implants with and without insurance.;

Typically, having dental insurance is advisable if youre going to get implants because it can save you money. Even if dental insurance covers 50% or more of your implants, it may save you thousands of dollars.;

Medical Insurance And Dental Implants

In some cases, your medical insurance policy may pay for a dental implant. However, that is usually because of the reason for the implant, such as damaging a tooth in an accident. While most health insurance companies will not cover dental implants, and Medicare does not do so, it is always worth pursuing coverage with your health insurer if the circumstances of your tooth loss might warrant consideration.

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What If I Have Medicare

Medicare usually covers breast implant removal for any of these conditions:

  • Painful capsular contracture with disfigurement
  • Implant rupture
  • Implant extrusion
  • Interference with the diagnosis of breast cancer
  • Siliconoma or granuloma

Medicare coverage can differ depending on the state where you live.;You can check the specific Medicare policies on breast implants removal in your state;here.

You can learn more about getting Medicare to cover your explant surgery here on our breast implant information website.;

You can learn more about getting Medicaid to cover your explant surgery here on our breast implant information website.;

How Can I Get Dental Insurance Without A Job

What does the Blue Cross Blue Shield dental plan cover ...

In order to get dental insurance through the Marketplace, youll also need to purchase health insurance through there. Being unemployed qualifies you to sign up for coverage within 60 days of losing your job-based health coverage. You dont have to wait for open enrollment. This is known as a Special Enrollment Period.

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What Are The Other Options

If you don’t have any insurance, now might be the perfect time to find a plan that fits your budget. Dental insurance can cover regular dentist visits, which are vital for good oral health. It also helps minimize the cost of more extensive procedures like dental implants. But what happens if you can’t afford insurance? You can speak to your dentist about alternative financing; they may suggest a payment plan option where the cost is divided into installments. Your dentist could also get you in contact with organizations that offer financial payment plans for oral care treatments.

Having missing or decayed teeth can make you feel self-conscious about your smile. Luckily, dental implants are a treatment option that can give you a natural smile. While the procedure’s cost may seem daunting at first, a good dental insurance plan can assist in covering the cost. Be sure to check if your current medical insurance or dental insurance includes dental implants. If you have had the plan for over a year, you might be pleased to find out that it does!

How To Get Insurance To Pay For Dental Implants

If you have dental insurance, you know that it generally has an annual maximum benefit and that it typically will not cover most of the costs related to major procedures. If you have standard dental insurance, it’s unlikely to cover dental implants, period. Thats because dental insurance companies usually consider such implants a cosmetic procedure. However, you can proactively seek a type of dental insurance that may pay for implants and other dental procedures. If you suspect youll need dental implants, start looking for indemnity dental plans now.

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Are Dental Benefits Part Of My Plan

Who is this for?

If youre shopping for a Medicare plan or need to find out if your current coverage includes dental care, this information is for you.

You may be used to traditional health insurance that covers routine dental care. But Medicare works a little differently.

Whether you have dental benefits will depend on what type of Medicare coverage you have.

  • Original Medicare is run by the U.S. government. It doesnt cover routine dental exams, cleanings, procedures or dentures. It does cover some dental care related to hospitalizations, surgeries and the treatment of diseases. Youll pay for routine dental care and dentures out of your own pocket with Original Medicare.
  • Private health insurance companies offer Medicare Advantage plans that include everything Original Medicare offers, plus extra benefits. They may include routine dental care. Whats covered depends on your plan.

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