Medicaid might cover dental implants, but this is not common. The public health insurance program treats artificial tooth implantation as a cosmetic procedure unless warranted by a medical condition. Even in states with generous Medicaid dental benefits, the provisions rarely cover the medical expenses related to implants. Fortunately, there are a variety of options to make this procedure affordable.
Why would you need dental implants?
Dental implants are often a preferred way to replace teeth. People choose them because they want or need a permanent, more natural-looking oral solution instead of dentures or fixed bridges.
Implants are medical devices surgically inserted into the jaw to replace missing teeth. Tooth loss can happen due to decay, infection, or injury. Implantation surgery aims to:
- Restore the ability to chew
- Improve cosmetic appearance
- Help keep nearby teeth stable
- Preserve the health of bone and gums
- Help prevent shrinking of the jawbone due to bone loss
Will Medicaid cover dental implants for adults?
Medicaid may or may not cover dental implants for adults, as each state’s Medicaid program has different provisions regarding dental care. Further, implants are an elective procedure, and Medicaid typically denies coverage.
Medicaid requires documentation of the medical need for implants for health improvement. Your healthcare provider and dentist must provide a comprehensive treatment plan. However, Medicaid may still elect to deny request for dental implants.
Even states with extensive Medicaid dental coverage might only pay for dental implants that address serious dental health problems stemming from non-oral issues, including illness, disability, injury, disease, or developmental condition. Medicaid would then act as health insurance to help cover the entire dental implant treatment.
For instance, the health insurance component of Medicaid might pay for dental implants to:
- Strengthen the jawbone after surgery, accidental fractures, or removal of cancerous growths.
- Stave off bone atrophy caused by diabetes, osteoporosis, or digestive disorders.
Dental implantation involves several steps, which can vary according to your needs. What your Medicaid plan covers depends on the benefits available in your region.
Can you get free dental implants with Medicaid?
It's unlikely you get free dental implants with Medicaid. If implantation is the most viable treatment option in an emergency, Medicaid might approve the procedure.
Some beneficiaries under age 21 might qualify for the procedure at no cost under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. The state's Medicaid program must include dental implants, and the patient's condition must require such treatment.
How much will dental implants cost?
The cost of dental implants depends on your provider’s location and treatment plan. They can cost thousands of dollars for just one tooth replacement. Even if your health or dental insurance covers some costs, you can expect additional out-of-pocket expenses.
Many dental care providers offer free consultations to discuss budget considerations such as:
- Treatment needs and goals
- The number of implants needed
- The type of implant used
- Number of appointments necessary to complete the implant process
- Costs of preliminary procedures, diagnostic tests, and anesthesia
How else can you get affordable dental care
Implant dentists can offer third-party financing options to manage costs. Ask about options when you consult an implant specialist. Your local health department or United Way office may have information regarding free or reduced-cost dental care in your area.
Consider these other ways to find affordable dental services:
Medicaid and most dental insurance providers may help cover care provided at dental schools. Dental schools often offer a low-cost dental implant solution on a sliding scale. Student care providers must be under the supervision of schools accredited by the American Dental Association.
Dental savings plans
Major health insurers offer dental savings plans discounting cosmetic procedures like dental implants. Dental savings plans may also be used for treating preexisting conditions, such as missing teeth. Make sure your dental plan offers dental implant coverage and has a Missing Tooth Clause.
Many people have gone beyond the borders for affordable dental implants. Popular destinations include Mexico, Costa Rica, Romania, and Columbia. The Centers for Disease Control and Prevention advise would-be medical travelers to follow these guidelines before going abroad:
- Discuss this option with a health provider based in the U.S. to understand the risks.
- Ensure the dental professional you plan to visit is board certified or belongs to the American Dental Association or International Association of Cosmetic Dentists.
- Buy comprehensive traveler’s health insurance.
- Understand that post-procedure travel can increase the risk of blood clots.
- Be prepared to deal with potential language barriers.
If you have Medicaid and want dental implants, finding coverage under your state's program may be challenging. Consult your Medicaid administrator to see if this benefit is available in your area. You can also ask a dental care provider or local community services agency about getting the procedure at a cost you can afford.
Are teeth implants covered by Medicaid?
In rare instances, Medicaid may approve implants if a patient can show a documented medical need. Your healthcare provider must show implants are the least expensive remedy for the health condition being treated. A portion of dental implant costs may be covered for eligible Medicaid beneficiaries under age 21.
Does health insurance cover dental implant surgery?
Whether a health insurance plan covers dental implant surgery depends on the insurer, plan coverage details, and the plan’s annual limits. It may help pay for the procedure if needed due injury, gum disease, tooth decay, or a failed root canal. Review your policy for details.
Can you get free dental implants?
The chances of getting free dental implants are slim because of the surgical expertise and professional time involved. You may need to see a dentist and an oral and maxillofacial surgeon. You would require multiple visits for each step of the procedure. Be aware that costs often go beyond fees for the surgery.
In what states will Medicaid provide dental implant coverage?
Any state Medicaid program may provide dental implant coverage in cases that fall under the health insurance criteria of medical necessity. However, Medicaid is more likely to help cover less costly oral solutions where dental benefits are available.
Medicaid is a joint federal and state-sponsored healthcare program for individuals and families with limited income and resources.
Medicaid may help pay for dental implants to replace teeth lost to health conditions such as illness, injury, or medical complications.
While states must provide comprehensive dental coverage for children receiving Medicaid, the scope of coverage for adults varies greatly.
Although Medicaid coverage for dental implants is rare, dental specialists often offer ways to save on the procedure.
- Food and Drug Administration. Dental Implants: What You Should Know.
- CareQuest Institute for Oral Health. Medicaid Adult Dental Benefit Expansion.
- National Association of Medicaid Directors. Striking a Balance During Medicaid's Unwinding.
- American Academy of Implant Dentistry. Value and Cost.
- American Academy of Implant Dentistry. Trends in Dental Implants 2022.