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Dental implants do the very important job of replacing missing teeth at the roots but the question on most patients’ lips is ‘Are dental implants covered by health insurance?’

And for good reason: this permanent tooth replacement is designed to last for a long time so it certainly doesn’t come cheap. At DDSS we make use of digital dental implants for greater precision and more accurate results.

The Case For Dental Implants

Dental implants outlast and outperform tooth replacements like bridges and dentures. They are the closest tooth replacement we have to natural teeth, and that’s because it takes a significant amount of engineering skill and dental technique to get them to look and function like natural teeth.

How Much Do Dental Implants Cost?

The cost for the implant procedure ranges vastly between patients, depending on their own particular cases. Finder.com.au says you can expect to pay in the region of $3000 to $7000 for the placement of a single, straightforward implant. This figure would increase if you needed a bone graft, multiple implants or a sinus lift.

If you were to book an All on 4/6 Full Arch Implant Solution, whereby an entire arch of teeth could be supported using only four implants positioned at an angle you could expect to budget in the region of $15 000 to $30 0000 for the procedure.

The cost of dental implants with insurance is more or less the same as without, and many practitioners do offer payment plans.

Why the big price range?

Well, in each dental implant procedure there are a number of variable factors. Your final price will depend on your dental practitioner’s charges, the materials and brand of implant that is chosen, the laboratory fees that apply.

Are Dental Implants Covered By Health Insurance?

Generally dental implants are not covered by health insurance. Having said that though, it’s not impossible to get it. Here are two avenues that could work for you:

When Dental Insurance Covers Implants

Dental implants falls under the periodontics category of dentistry, which is the dentistry of the gums. In the event that your policies mention cover for gums but does not specifically mention implants as an exclusion, you may be able to claim.

If this seems to be the case make sure to check it with your insurer before agreeing to any treatment plan. You will also need to find out what you can expect to pay out of pocket because it’s not likely that the entire treatment will be covered; there will be some additional costs to budget.

Consider Hospital Cover

Other policies may cover dental implants within your hospital cover portion – on condition that you have the procedure performed as an inpatient in a hospital. If you are having a complex procedure, require special anaesthetic or will be having a bone graft, this could be an option for you.

Why Aren’t Dental Implant Procedures Covered By Health Insurance?

Dental implants are pricey for insurers. Many procedures run into thousands of dollars and, even though the procedure might offer a longer lasting tooth replacement, private insurers aren’t prepared to outlay that much cover.

That’s the unofficial reason. The official reason that insurers provide is that dental implants are considered elective procedures (as opposed to being medically necessary). By contrast though, they often do cover bridges and dentures, which is not surprising because both of these tooth replacements cost significantly less than dental implants.

Short Term Vs Long Term Savings

Strangely enough though, a dental implant is a more cost effective long term solution, and that’s because in many cases a patient will only need that one dental implant. The patient’s bridge or dentures will not last that long, and will need to be replaced long before the dental implant.

What’s The Difference Between General And Major Dental Cover?

General dental cover

If you have a general dental policy with a local insurer, you will have cover for basic dental services such as dental cleaning, fluoride treatments and possibly even root canal therapy. Usually a two month waiting period applies on these policies.

General dental cover excludes major procedures like bridges, crowns, dental implants and bone grafts. These procedures are classified as extras, and in order to have cover for extras, you need a more expensive dental plan.

Major dental cover

Typically major dental cover does insure you for a number of more complex procedures that are excluded from general dental – however dental implants is not one of them. Plenty of insurers actually specify that they do not cover dental implant procedures.

Will Medicare Cover Dental Implants?

In the majority of cases, Medicare will not cover dental implants, purely because most dental work is excluded. There are two exceptions however, and those are:

  • When your dental health is negatively affecting your wellbeing

In this scenario, your general practitioner would write a referral letter to this effect and a GP Management Plan and Team Care Arrangement would need to be made. He or she would probably need to explain why other tooth replacements are not viable.

  • When you are a concession card-holder

In this scenario, if you were eligible, your dental vouchers could be used against dental implants (that are deemed medically necessary).

Are Dental Implants Worth The Cost?

Spending the money on dental implants is an investment in your long term dental health. Investing in a bridge or dentures will not prevent bone loss and only provides a cosmetic tooth replacement.

Having dental implants put in means that your replacement teeth feel, look and work just like the natural teeth in your mouth. You can bite and chew with the same force as your natural teeth, and smile with confidence without worrying about your dentures slipping around.

Remember though, that when you invest in implants, it’s not just a financial commitment. You also need to commit to a higher level of dental hygiene and care, to ensure that your implants can last for the rest of your lifetime, and that you can get maximum value and benefit from them.

How Do You Know If You Will Have Any Cover For Dental Implants?

Once you have consulted with one of our experienced dentists, you will be given a comprehensive treatment plan, outlining each step of the process. Each step will also be marked with codes that you can take back to your insurer, to cross check what your corresponding level of cover is for each line item.

Still have questions about whether dental insurance covers implants? The next step is to speak to a professional. Invest in your future dental health: call our practice today at (02) 8294 8656 (Gosford) or (02) 8294 5812 (Sydney) for the most convenient appointment.

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