How Do Kaiser Medicare Advantage Plans Work
Medicare Advantage plans are sold by private insurance companies like Kaiser Permanente. Medicare Advantage plans provide coverage for all of the same services and items included under Medicare Part A and Part B while also typically adding coverage for things not found in Original Medicare, such as dental care.
Many Medicare Advantage plans with dental coverage have a $0 monthly premium. These plans work at the dentist just like traditional dental plans, with a network of participating providers and copayments for certain visits. Preventive dental care like exams and cleanings are generally covered in full.
Some Medicare Advantage plans may also offer an annual allowance for things like denture cream and related over the counter health products and items.
Preliminary Treatments & Dental Implant Surgery
You may need one or more teeth extracted and others need bone or tissue grafting procedures to ensure adequate support for the implant post. During your initial consultation with your implant dentist in Waverly at Smiley Family Dentistry, we will examine your oral cavity using advanced technology to determine if you need preliminary treatments. If so, you can expect these to add to the overall cost of your treatment.
Your dental implant surgery will also incur a fee however, because the entire procedure is performed in-house, under one roof, this eliminates the need for a referral and separate fee for an outside specialist. This can make the complete dental implant process much easier to financially manage.
Dental Insurance That Covers Implants
Dental insurance plans offer a variety of different coverage types. Full coverage dental insurance helps to cover routine visits, the basics, and more invasive treatments as well. There is a high demand for dental insurance plans that cover implants. Some of the most sought out treatments are implants and dentures. The term full coverage dental insurance refers to the plans ability to cover a variety of different dental treatments and procedures. Even so, it does not mean that all treatments and procedures are fully covered every time.
Unfortunately, some 74 million Americans do not have dental insurance coverage. According to the American Dental Association, the majority of dental-related emergencies can be directed to a dental office. Having a plan in place can protect your teeth and your wallet from unforeseen costs that can arise without regular dental hygiene maintenance. If you are prone to dental issues, full coverage dental insurance may be the right choice for you.
It is important to understand that full coverage dental insurance does not guarantee that youll be covered for everything. However, it will provide additional financial support for preventative services and major procedures that can save you money in the long run. Chat with an Aflac agent to see if you can get dental insurance that covers dentures and implants with no waiting period.
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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.
Do Any Kaiser Permanente Insurance Plans Cover Dental Implants
While some Kaiser Permanente Medicare Advantage plans may not cover dental implants, other types of Kaiser insurance can provide such a benefit.
For example, the Kaiser Permanente employer-based Oregon Public Employees Benefit Board plan offers 50% coverage of dental implants up to the benefit maximum. And the Kaiser Foundation Health Plan of the Northwest offers coverage of dental implants on a fee-for-service basis.
These are just some examples of Kaiser Permanente coverage that include coverage of dental implants. Contact Kaiser directly for information about plans available in your area that may include dental implant benefits.
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Dental Implant Coverage Restrictions
As insurance companies always have conditions and restriction in their fine print, its always best to make sure that your insurance policy covers dental implants. Dont get caught in a trap thinking that youre covered for cosmetic dentistry but you find out that its an exclusion to your policy.
Some advice would be to change the description of your treatment from, cosmetic procedure or surgical therapy to something like, restoration procedure. Some insurance companies will have a problem with cosmetic procedure but they might allow a restoration treatment.
In the end, its best to make sure that the procedure youre applying for fits the proper insurance code. You can take a look at a great list here: ADA Dental Implant Codes
If you dont use the right insurance claim code you could end up pay the complete cost out of your own pocket. Something that you dont want to do when it can be paid by your insurance.
What Is The Best Dental Insurance For Implants
What’s the best dental plan for implants? There is no one-size-fits-all answer.
What may be the best plan for some may not be the best plan for others. The truth is, there is no magical plan that has high annual maximums, low monthly premiums, low deductibles, no waiting periods, and no limit on preexisting conditions. No matter the plan you choose, you’ll end up payingthe only question is when. Despite the limitations of insurance, for some people this may be a good option for helping lower the costs for dental implants.
For many people, however, there are other options that are just as good, if not better. Let’s have a look at them now.
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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.
Resting After A Dental Implant Procedure
Once you are at home, you will need to rest a couple of days. In most cases, you will need two to three days about a quick rest. Around the 4th day, you should be well enough to go back to work or school. Only resume your regular routine if you feel up to it. Follow the recommendations of your dentist for rest. You may be given a prescription or over-the-counter medication to deal with any pain issues.
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What Is Involved In Getting A Dental Implant
The first step in the dental implant process is the development of an individualized treatment plan. The plan addresses your specific needs and is prepared by a team of professionals who are specially trained and experienced in oral surgery and restorative dentistry. This team approach provides coordinated care based on the implant option that is best for you.
Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of the missing tooth. As the jawbone heals, it grows around the implanted metal post, anchoring it securely in the jaw. The healing process can take from six to 12 weeks.
Once the implant has bonded to the jawbone, a small connector post — called an abutment — is attached to the post to securely hold the new tooth. To make the new tooth or teeth, your dentist makes impressions of your teeth, and creates a model of your bite . The new tooth or teeth is based on this model. A replacement tooth, called a crown, is then attached to the abutment.
Instead of one or more individual crowns, some patients may have attachments placed on the implant that retain and support a removable denture.
Your dentist also will match the color of the new teeth to your natural teeth. Because the implant is secured within the jawbone, the replacement teeth look, feel, and function just like your own natural teeth.
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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Eating A Healthy Diet
Healthy foods like lean proteins, leafy greens, fruits, vegetables, and low-fat dairy are vital components of any diet. Too much sugar and starch can lead to tooth decay and gum disease if youre not careful. While dental implants cannot decay, they can be affected by gum disease, which is detrimental to the success of permanent prosthetics. By incorporating healthier options into your daily diet, you can feel confident in the future of your smile.
Do Medicare Advantage Plans Cover Dental Implants
While not all Medicare Advantage plans cover dental implants, some do!
To find out if your current MA plan or a plan youâre considering offers dental implant coverage, you will need to look at the specifics of your plan.
Not all MA plans are the same, even within the same company. If you don’t know where to begin, ! Here at Medicare Allies, our services cost nothing to you, and we can find plans in your county.
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Are Dental Implants Worth The Investment
While youll likely pay more initially for dental implants than other options, youll also find that they can save you money in the long run. With an incredibly high success rate of over 95%, you can trust that your implants should last for decades to come. As long as you take good care of your implants, you shouldnt have to worry about getting them replaced.
Additionally, dental implants preserve your oral health by stimulating your jawbone in a way that dentures and bridges do not. This prevents you from losing any more jawbone mass. Dental implants also fill the gaps in your smile, stopping your remaining teeth from drifting into the space and lowering your risk for further tooth loss. This decreases your risk for expensive dental problems in the future.
Insurance Companies Want To Avoid The Cost
The most likely explanation for why insurance companies actually avoid covering dental implants is that they are in the business of making money, not of keeping people healthy. Dental implants can be expensive. From the standpoint of the person getting dental implants, the function of implants, their attractiveness, their durability, and their overall impact on quality of life makes them a great deal. But insurance companies dont see the benefits the same way. To them the main benefit would be if coverage induced more people to get dental insurance, which it probably wouldnt do, because people would be more apt to realize that the cost of insurance is more than the benefits offered.
The good news is that for many people, ditching insurance can actually save you money, especially on procedures that arent covered, such as dental implants.
If you want to talk to us about the benefits of working directly with your dentist on financing and affordability of dental implants in Houston, please call today for an appointment at the office of Dr. Scott Young, Purveyor of Fine Dentistry in The Woodlands.
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What Impacts Dental Insurance Costs
Why does the cost of dental insurance vary so much? The features of each plan also impact the cost. These include:
- Maximums. Plans often have an annual maximum. This is the most your plan will pay toward your dental care. If you have a plan with a $2,500 maximum, your dental insurance provider will pay $2,500 toward your dental costs each year. If your dental costs are more than $2,500, youre responsible for the difference. A lower annual maximum usually means lower premiums.
- Deductible. A deductible is the amount you pay for covered services before your plan starts paying. If you have a plan with a $500 deductible, you pay the 1st $500 for covered services. After that, your plan will pay according to its terms. A higher deductible typically means lower premiums.
- Coinsurance. Coinsurance is the percentage of costs your insurance plan will cover. Dental insurance plans typically have a range of coinsurance percentages based on the type of services. Preventive services may be covered at 100%, while major services like implants may be covered at 50%. A lower coinsurance often means a lower premium because youre paying a higher share of the costs.
Before You Get Dental Implants
Its important to understand what dental implants are before you get them. An implant is a frame or metal post that is surgically positioned into your jawbone beneath the gum line. Once this is in place, the dentist can mount any replacement teeth on to your implant. This is fused to the jawbone and will give support for any artificial teeth. If you have a bridge or denture mounted, its not going to shift or slip in the mouth. This will help you speak and eat properly. Here are two main types of dental implants, which are called endosteal implant and subperiosteal implants.
Your dentist will speak to you about dental implants you will learn about the procedure before it takes place. In some cases, you may not be a candidate for the procedure. The dentist will need to do a thorough examination of your mouth to determine whether or not you can receive dental implants. If you cant receive one of these implants, the dentist will use other techniques to correct any oral hygiene problems.
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Dental Insurance Plan Types
If youre shopping for dental insurance you will come across a variety of plans. Preferred Provider Organization and Dental Maintenance Organization are the most common kinds. There is also a third optionDental HMO plans, which are a less expensive option.
In a DMO plan, you choose a primary care dentist and need a referral to see a specialist such as an oral surgeon. However, in a PPO plan, no referral is needed and you can go to any dentist you wish. However, its cheaper to go to a preferred dentist within the network. There is also a Dental Indemnity Plan, which has no restrictions on which dentist you see and requires no referrals.
What If I Dont Have Insurance?
If you are without insurance and considering dental implants, its wise to seek out coverage ASAP. Dental insurance not only can cover routine visits that are critical for good oral health but also extensive procedures. Dental implants are one of those procedures some policies cover up to a certain amount.
However, what if you cant afford dental insurance? Fortunately, at Comprehensive Dental Group, we offer financing options for dental implants. Care Credit and Lending Club, and Greensky are the financial institutions that help many of our patients. These plans offer varying lines of credit or installment loans to make your dental implants a reality.
How Long Is The Procedure And What Is Involved In The Process
Dental implant surgery takes less than one hour after which the healing process can take anywhere between six and 12 weeks, or longer depending on your bodys recovery rate. Patients typically require three to six months of healing time before they get implants after extraction. However, there are cases in which an implant can be placed on the same day a tooth is removed. This allows patients to leave with a fixed tooth rather than a temporary one. This same-day treatment is only offered by highly trained professionals, and you will need careful evaluation and 3D imaging to determine if you are a suitable candidate.
One key thing to note is that dental implant therapy is a team effort. You, your dentist and the periodontist must all be on the same page regarding diagnosis, planning, and treatment.
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What’s Included In The Total Cost Of The Implant Procedure
Be sure when comparing costs, you compare everything involved with the procedure. Many times, an advertisement for a cheap implant does not include everything required in the procedure. The cost to cover all expenses associated with the planned treatment usually includes the following:
- Removal of infected tissues
- Implant placement
- Temporary and final dentures/bridges
Why The Fine Print Matters: A Cautionary Tale
When looking for plans with dental implant coverage, I came across an AARP plan that appeared to cover prosthodontics with a 0% copay. It wasnât until I examined a detailed list of covered items that I found this was not the case. Dental implants were not covered for this plan. The prosthodontics service only covered items that attached to existing teeth.
It is important to review all the documentation when looking at insurance options. Just seeing they cover a certain type of care does not guarantee they will cover the specific service you need.
Sound overwhelming? That’s why you can call us! We’re your Medicare Allies and will review all the fine print so you know what’s covered in your plan.
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