Does Insurance Cover Dental Implants? – Burbank Implant Dentist Advice

Usually not.

It is really unfortunate that dental insurance usually does not cover this very common procedure.

What most patients don't know is that dental insurance has a "cap" or "ceiling" of money (benefit) on a yearly basis.  Unlike medical insurance, most dental insurances max out at $1500 per year!  That means anything above that amount is owed by you.

Medical insurance may cap off at the 1 – 2 million dollar mark!

This maximum of $1500 has been the same since the 1970's! If it would have kept up with inflation, the maximum yearly benefit would be about $8800.

Dental insurance just has not kept up with the times!

About 75% of my patients in Burbank do not have dental insurance for their dental implants or bone grafting procedures.  They seek me out as an authority of the dental implant procedure. I do not suggest you "shop" around by price, but rather pick the best implant dentist and check out their credentials very carefully.

That said, I have had written extensive narratives for my patients and got their insurance to pay for implants many times over the last ten years.  I have also gotten them to pay for it when it wasn't even a covered benefit.

Bottom line…don't let your insurance dictate the proper treatment you need or want.  You control your health care.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Burbank, California
http://www.burbankdentalimplants.com

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4 Responses to Does Insurance Cover Dental Implants? – Burbank Implant Dentist Advice

  1. Cathy Wendler says:

    I have implant coverage but the ins. co. has decided a more conservative approach is better. So, why am I paying ins. that I can’t use! I’m not a happy camper. What points should a narrative cover when I appeal this to the ins. co.? Tooth 19 & 20 were removed due to infection and failed root canals. I have periodontal disease and local anesthetic does not work on me 90% of the time, I’m female and 53. Am I all alone or does anyone else have these problems with ins.?

  2. Hi Cathy,
    I can definitely relate! EVERYONE has these problems with dental insurance. The policy is a contract between your employer and the insurance company and has nothing to do with “you.”
    How the policy is written makes a big difference. Most times you may be sold a plan that has “dental implant coverage” but it has many exclusions and your situation must fit their specific criteria.
    I always include pre-operative photographs and surgical photos in a narrative to increase the success of having them cover dental implants and bone grafting.
    Regardless, your dental insurance will only make a small dent in the total cost of your treatment.
    I am interested to know what you meant by a “more conservative” approach. Implants are the most conservative option since they don’t affect or damage your other teeth like bridges and partials!
    Does this help?
    Dr. Amin

  3. Katherine says:

    Cathy, I’m sorry for your troubles. I have “dental insurance” however it does not cover the implants and crowns I need. I would like someone to answer why has the deductable amounts for dental insurance been the same since 1970. How in the world has this been allowed to happen ?

  4. Most employers focus on the medical benefit plan. They spend 98% of the time negotiating the medical plan and the dental plan is a quick “afterthought.”
    Not enough people raise issues about their dental plan so the insurance company just continues to do nothing since no one complains. This lack of care into dentistry has gone on for decades.
    At times, it lowers the quality of care you receive if you try to stay within the plan

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