Will Medicaid Pay for Dental Implants?

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:

Dental schools

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.

Dental tourism

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.

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Comments

Renee kitts
prefix 1 month ago
My jaw was broken in 6 places have bone fragments in my gums and a not in roof of my mouth
I have dentures on top but have no suction and had to wittle sides off away down to teeth
Have Medicare medicade and humans insurance