Does Blue Cross Medical Insurance Cover Dental Implants?

Published On - May 16, 2023

Dylan Whitman Insurance

Understanding Dental Implants and Their Significance

Understanding dental implants and their potential need is crucial before delving into insurance coverage details. Dental implants are titanium replacement tooth roots surgically inserted into the jawbone. They support a variety of prostheses, including crowns, bridges, and dentures, which successfully restore oral function and replace lost teeth.

Due to their resilience, realistic appearance, and capacity to stop bone loss, dental implants are frequently chosen as the method of tooth replacement. However, some patients may find the operation prohibitive, making insurance coverage a significant consideration when making a choice.

Choose dental implants because…

Missing teeth can be bothersome, frequently resulting in problems with speech or eating/digesting, and they can even have a psychological effect if the patient’s self-esteem is impacted. Many people use partials, bridges, or dentures to replace missing teeth. Many people find these solutions excellent choices, but not everyone may.

 Dental implants may help those who:

  • These individuals cannot wear partials or dentures
  • Losing one or more teeth
  •  Possess a sufficient, fully-developed jawbone structure to support the implant.
  •  If the existing bone structure is insufficient to sustain the implant, a bone graft may be required.
  • Possess wholesome gum tissue
  •   Avoid tobacco usage and other illnesses that interfere with healing.

What type of Insurance for dental implants?

Every insurance does not cover dental implant types equally. Dental implants may be completely excluded from coverage under some insurance policies, while others may only pay a fraction of the cost. Reviewing your unique insurance policy will help you determine the scope of dental implant coverage.

Blue Cross Medical Insurance covers dental implants

As one of the leading health insurance providers in the United States, Blue Cross medical insurance covers dental implants that may include other types. However, the specific coverage details can vary depending on the plan and individual policy.

Blue cross-cover dental implants

Blue Cross dental policies typically pay a percentage of dental implant expenses. This covers the surgical installation of the dental prosthesis, the abutment, and the implant. It’s critical to remember that coverage levels can vary and restrictions and exclusions might apply.

Limitations and exclusions

Blue Cross dental implants often come with specific dental implant limitations and exclusions. Some of the most common restrictions include:

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  • Not covering clinically unnecessary procedures
  • Excluding dental procedures performed solely for cosmetic reasons
  • Denying coverage for procedures not performed in a dental setting
  • Limiting coverage for experimental procedures or those not accepted by the American Dental Association (ADA)
  • Excluding dental implant-related drugs or medications, unless used during the dental office visit
  • Imposing waiting periods or frequency limitations on certain procedures, such as denture relines or periodontal surgery

It’s essential to carefully review your Blue Cross dental plan to understand the specific limitations and exclusions to dental implant coverage.

Alternative Options for Dental Implant Coverage

If your insurance does not cover dental implants or only provides limited coverage, there are alternative options to consider for affordable dental implant treatment. Some of these options include:

Dental Discount Plans

An alternative to typical health insurance that lowers dental implant therapy costs is dental discount programs. In exchange for an annual premium, these plans offer discounts on a range of medical services, including dental implants. Dental discount plans can help some people afford dental implants even though they might not fully cover the operation cost.

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs).

These tax-advantaged accounts, known as flexible spending accounts (FSAs) and health savings accounts (HSAs), can be used to pay for certain medical expenses, such as dental implants. Patients can lower the overall cost of dental implant therapy by funding these accounts with pre-tax money.

Payment Plans and Financing

Many dental practices offer payment plans or financing options to make dental implant treatment more affordable for patients. By spreading the cost of the procedure over several months or even years, patients can make dental implants a more feasible option for their budget.

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Tips for Maximizing Dental Implant Coverage

To ensure you’re getting the most out of your insurance coverage for dental implants, consider the following tips:

  • Review your policy carefully to understand the specific coverage details, limitations, and exclusions.
  • Obtain a pre-treatment estimate from your dental provider to determine the anticipated costs and insurance benefits for your dental implant procedure.
  • Discuss alternative treatment options with your dentist, as some plans may cover a more cost-effective, clinically acceptable alternative procedure.
  • Stay in-network with your dental provider, as out-of-network services may result in higher out-of-pocket costs.

What Should I Expect After an Implant?

You might need to see several dental specialists to prepare for surgery, including:

  • Surgery of the mouth and face
  • Periodontist (expert in teeth and bones)
  • Prosthodontist (expert in prosthetic teeth)

To allow healing time between each surgery, the dental implant procedure is typically conducted in phases over many months. You might require a bone transplant to develop and strengthen the jaw bone at the implant site to prepare for the treatment.

Following the extraction of the damaged teeth, screw-like posts are surgically inserted into the jaw bone to replicate tooth roots and create a stable foundation for the fake tooth or teeth.

The dentist can surgically reveal the implant and attach a healing cap or an abutment to the post. This is after the post has been inserted and the surrounding bone has healed completely around it. The base to which the artificial tooth or teeth will be attached is this abutment, which will be visible above the gum line.

A fixed crown or removable implant-ready denture/partial can be inserted into the mouth to finish the procedure when the gum tissue has recovered from the implantation of the healing cap or abutment and the dentist has determined that the jaw bone is strong enough to support the implant.