Medical insurance coverage for dental implants depends on a patient’s individual plan, carrier, and qualifying conditions. We’ll guide you through your coverage options and help you maximize every benefit available.
Medical insurance can reimburse dental implant costs, which many people don’t realize. If your tooth loss was caused by an accident or a medical condition, you may have better chances of getting coverage. Implant procedures may qualify for medical coverage when they meet the criteria for medical necessity.
An example would be where implants restore function by addressing a compromised ability to chew. They may also be considered medically necessary when oral disease contributes to, or causes, other health issues—such as digestive or nutritional problems stemming from impaired chewing function. Implants may also be deemed medically necessary when they help preserve bone and prevent further bone loss in patients with other medical conditions, such as digestive disorders, diabetes, or osteoporosis.
These are general guidelines; keep in mind that coverage varies quite a bit between different insurance companies and plans, and your specific medical condition. It’s worth having a thorough conversation with your insurance provider to understand exactly what your policy includes.
Patients with out-of-network coverage from providers such as United Healthcare, Aetna, Humana, Blue Cross Blue Shield or Cigna may see reimbursements for dental implant treatment.
Generally, Medicare and Medicaid do not provide coverage for dental implants. Read our guide for more on Medicare coverage and dental implants.
In order to proceed, you will be provided a consent form by your Patient Ambassador at your first consultation who will outline the terms and eligibility. The process is as follows:
*If your medical insurance provider reimburses for any portion of your procedure, you will be notified immediately and advised of the criteria required to apply for the program. Most payments will be sent directly to the patient/policy holder, however, please note there are no guarantees regarding the outcome of the insurance claim, as reimbursement is at the discretion of your insurance provider. You also may be required to forfeit your eligibility for other Smart Arches discounts, as only one program at a time may be applied. Eligibility will vary by state regulatory guidelines detailed by the provider and insured patient’s benefits.
Depending on your coverage, dental insurance may provide some assistance with dental implants, however maximums typically range from $1,000 to $2,500 of coverage.
Dental insurance typically covers the cost of regular cleanings and maintenance after the implant procedure.
The process varies by insurer, patient and eligibility. If your medical insurance provider reimburses any portion of your procedure, you will be notified promptly and provided with the necessary criteria to apply for the reimbursement program. In most cases, payments are sent directly to the patient or policyholder. Please note, however, that reimbursement is not guaranteed and is subject to your insurance provider’s discretion. Most of our patients who submit claims for medical insurance choose to pay out-of-pocket or with financing, and then await any reimbursements directly so that they are able to proceed with their procedures in a timely fashion.
If you’ve lost teeth because of an accident or a health condition, dental implants may qualify as a medical treatment rather than just a cosmetic procedure. In some cases, parts of the implant process may be covered as medically necessary.
Patients with out-of-network coverage with United Healthcare, Aetna, Humana, Blue Cross Blue Shield or Cigna may see reimbursements for dental implant treatment. Again, depending on your specific condition and coverage. In addition, there may be other insurers that also provide medical coverage.
After your initial consultation, our patient ambassadors will work with you to determine your treatment plan, treatment cost as well whether any insurance coverage applies, and submit all necessary paperwork to submit the claim.
Smart Arches patients save
33-40%of the cost of full mouth implants vs. other implant providers.
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Includes: Implant + Abutment + Crown
Titanium Implant
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0% APR Financing Available
Actual loan pricing is determined by personal credit score. Most patients are approved with a credit score of 650 or above. Co-signers are accepted but must be present. Pricing is subject to change and may vary by location. Offer valid for new patients only. APR and final price may vary by patient.
As low as $9/day (per arch)
Lightweight premium zirconia teeth
Includes general anesthesia.
Customized, natural-looking appearance
5-year warrranty
Lasts a lifetime with proper care
Zygomatic implants may increase treatment fees. Actual loan pricing is determined by personal credit score. Most patients are approved with a credit score of 650 or above. Co-signers are accepted but must be present. Pricing is subject to change and may vary by location. Offer valid for new patients only. APR and final price may vary by patient.
As low as $9/day (per arch)
Lightweight premium zirconia teeth
Includes general anesthesia.
Customized, natural-looking appearance
5-year warrranty
Lasts a lifetime with proper care
0% APR Financing Available
Zygomatic implants may increase treatment fees. Actual loan pricing is determined by personal credit score. Most patients are approved with a credit score of 650 or above. Co-signers are accepted but must be present. Pricing is subject to change and may vary by location. Offer valid for new patients only. APR and final price may vary by patient.
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