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Dental Insurance Covering Implants

By Insurance Industry Expert & Author
Updated on

Contents

Dental Insurance Implant Coverage

While commonly thought of as an artificial tooth, a dental implant technically is the instrument (e.g. a metal post) surgically inserted into the jaw (or skull if it's an upper tooth). The instrument functions similar to the original tooth root and on it a crown (or other device such as a bridge) is attached. Dental implants are a common restorative procedure for patients with a missing tooth. If an implant requires extensive work on the part of the dentist, the cost may reach several thousand dollars. Comprehensive insurance coverage with implant benefits can greatly reduce a patient's out-of-pocket costs in this scenario.

The benefits of implants go beyond aesthetics. They can help a patient with chewing as well as preserving the health of the jaw, gums, and surrounding teeth. Lost teeth that go untreated can lead to changes in diet and a resulting decline overall health.

Dental insurance plans vary on their coverage of implants. Many plans classify implants as a form of “major” dental care. Major care represents higher cost dental services. These services often come with a requirement of a copayment or a coinsurance fee (a coinsurance fee is an out-of-pocket charge equal to a percentage of the overall cost of the dental care).

Dental Insurance for Implants - Benefit Conditions

Dental plans can cover implants in different ways. They can vary by the range of services insurance will pay for as well as the out-of-pocket cost obligations for the patient. Below are examples of differing coverage of implants among plans.

Example 1

Implants:

$1500 for surgical placement of implant body
The $1,500 limit includes the cost of, and placement of, a healing cap when required.

Example 2

Implants:

12-month waiting period before coverage begins.

50% coverage of cost after deductible is satisfied.

Implants are covered on teeth extracted while on the plan.

Implants and implant supported prosthesis covered under this plan are limited to:

1) the replacement of permanent teeth extracted while insured under this plan, or
2) the replacement of a prior Implant if it has been at least seven years since the prior insertion and is not and cannot be made serviceable.

In the above example, the enrollee must have been participating in the dental plan for at least a year before the plan will cover implant care.

Example 3

Implants:

In-Network Coverage
1st year – 20% after deductible
2nd year – 30% after deductible
3rd year and after – 50% after deductible

In this example, the insurance plan increases its coverage for implant care the longer the enrollee belongs to the plan. The plan will only pay for care delivered by an in-network plan dentist.

Dental Implant Covered by Insurance

Now that you are educated on the basics of implant coverage, it’s time to start reviewing plans. There are many dental plans whose insurance benefits include implants. The below list provides examples of dental plans covering implants. Please make note that:

  • This is not a exhaustive list
  • Out-of-pocket costs (e.g. copayments) and waiting periods may apply
  • Always review the plan details to confirm implant coverage & identify any waiting periods
  • The dental plans below include traditional PPO and HMO dental insurance as well as a dental discount plan

One last reminder - some plans listed may not be available in every region of the state in which it’s offered.

State Insurance Company Plan
Alabama NCD Nationwide 5000 Plan
  Ameritas Dallas Smile Plan
Alaska MetLife TakeAlong Dental Medium
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
Arizona Ameritas Dallas Smile Plan
  NCD Nationwide 1500 Plan
Arkansas Renaissance Dental Plan III
  Guardian Direct Advantage Diamond
California California Dental Network Plan 595
  Dental Health Services Super SmartSmile
Colorado Anthem Essential Choice Premier
  Renaissance Dental Max Choice
Connecticut Anthem Essential Choice Platinum
  Guardian Direct Advantage Achiever
Delaware Dominion National Select Plan Basic
  Dominion National Select Plan Premium
Florida MetLife TakeAlong Dental High
  Guardian Direct Advantage Achiever
Georgia MetLife TakeAlong Dental Medium
  NCD Nationwide 3000 Plan
Hawaii Ameritas Dallas Smile Plan
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
Idaho Renaissance Dental Plan II
  Guardian Direct Advantage Core
Illinois MetLife TakeAlong Dental High
  Ameritas Dallas Smile Plan
Indiana Anthem Essential Choice Platinum
  Anthem Essential Choice Incentive
Iowa Careington 500 Series Dental Savings (Discount Program, Not Insurance)
  NCD Nationwide 1500 Plan
Kansas Renaissance Dental Plan III
  Guardian Direct Advantage Diamond
Kentucky Delta Dental of Kentucky Bright smiles
  Delta Dental of Kentucky Vibrant Smiles
Louisiana Ameritas Dallas Smile Plan
  MetLife TakeAlong Dental Medium
Maine Anthem Essential Choice Incentive
  Renaissance Dental Plan III
Maryland Dominion National Select Plan Basic
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
Massachusetts Guardian Direct Advantage Core
  Renaissance Dental Plan II
Michigan Ameritas Dallas Smile Plan
  MetLife TakeAlong Dental High
Minnesota Careington 500 Series Dental Savings (Discount Program, Not Insurance)
  Guardian Direct Advantage Achiever
Mississippi NCD Nationwide 5000 Plan
  Renaissance Dental MAX Choice Plus
Missouri Ameritas Dallas Smile Plan
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
Montana Renaissance Dental Plan III
  MetLife TakeAlong Dental Medium
Nebraska NCD Nationwide 1500 Plan
  NCD Nationwide 5000 Plan
Nevada Anthem Essential Choice Platinum
  Guardian Direct Advantage Core
New Hampshire Anthem Essential Choice Incentive
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
New Jersey MetLife TakeAlong Dental Medium
  Ameritas Dallas Smile Plan
New Mexico NCD Nationwide 5000 Plan
  Ameritas Dallas Smile Plan
New York Empire BlueCross BlueShield Essential Choice Platinum
  Ameritas Life of NY Dallas Smile Plan
North Carolina Renaissance Dental Max Choice
  NCD Nationwide 1500 Plan
North Dakota Ameritas Dallas Smile Plan
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
Ohio Anthem Essential Choice Platinum
  Guardian Direct Advantage Achiever
Oklahoma MetLife TakeAlong Dental High
  Renaissance Dental Plan II
Oregon Dental Health Services SmartSmile
  NCD Nationwide 1500 Plan
Pennsylvania Dominion National Select Plan Basic
  Ameritas Dallas Smile Plan
Rhode Island Careington 500 Series Dental Savings (Discount Program, Not Insurance)
  Guardian Direct Advantage Core
South Carolina Anthem Essential Choice Incentive
  Anthem Essential Choice Platinum
South Dakota Renaissance Dental Plan III
  MetLife TakeAlong Dental Medium
Tennessee Delta Dental of Tennesee Brighter Advantage
  Delta Dental of Tennesee Superior Advantage
Texas NCD Nationwide 3000 Plan
  Guardian Direct Advantage Diamond
Utah Ameritas Dallas Smile Plan
  MetLife TakeAlong Dental High
Vermont Ameritas Dallas Smile Plan
  Renaissance Dental MAX Choice Plus
Virginia Dominion National Select Plan Basic
  Dominion National Select Plan Premium
Washington State Guardian Direct Advantage Achiever
  MetLife TakeAlong Dental Medium
Washington D.C. Dominion National Select Plan Premium
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
West Virginia Ameritas Dallas Smile Plan
  Careington 500 Series Dental Savings (Discount Program, Not Insurance)
Wisconsin Anthem Essential Choice Platinum
  Anthem Essential Choice Incentive
Wyoming Renaissance Dental Plan III
  NCD Nationwide 1500 Plan

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