Does Medicaid Cover Dental Implants?
If you want to know if Medicaid will help pay for your dental implants, it can make getting the treatment less stressful.
However, it’s not easy to say if Medicaid covers dental implants or not.
Medicaid might help with some dental costs, but if your dental work is seen as cosmetic (for appearance rather than health), Medicaid usually won’t pay for it.
Here are some basic things to know about whether Medicaid will cover the cost of dental implants.
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Are Dental Implants Covered by Insurance?
Usually, Medicaid doesn’t cover dental implants because it’s a government program meant to help low-income families afford medical and dental care.
Dental implants are seen as cosmetic and not crucial for a person’s health, so Medicaid often doesn’t pay for them. However, there are exceptions.
If you can prove you really need dental implants for medical reasons, with detailed paperwork from your doctor or dentist explaining why it’s necessary, Medicaid might approve it.
But even with all the paperwork, it’s often still denied.
If you’re under 21 and on Medicaid, there’s a chance they might cover part of the cost for dental implants through a program called Early and Periodic Screening, Diagnostic and Treatment (EPSDT).
But if you’re over 21, this coverage doesn’t apply to you.
Why are dental implants better than dentures?
Dentures are losing favor as more people opt for dental implants to replace their missing teeth.
The implant consists of three parts: the implant body (which anchors into the jaw), the abutment (which connects the crown), and the crown (which resembles the tooth).
The implant body mimics the natural teeth, which also have roots in the jaw, and prevents bone loss. (This is unlike removable dentures, which often cause a sunken appearance.)
The preservation of jawbone is one of the main reasons why implants are superior to dentures.
Another reason why dental implants are better than dentures is that they are more durable.
If you maintain good oral hygiene and visit your dentist regularly, the implant body can last forever.
The crown may need to be changed every 10 to 15 years due to wear and tear, but that is still longer than the average of 8 years for denture replacement.
Usually, dental implants also appear more natural and fit more comfortably than dentures.
The crown of the implant is customized to match your other teeth, so it blends in.
There is no need for glues that might erode and cause the teeth to slip or misalign since they are fixed to your jaw.
With dentures, you also face the risk of tooth decay or infection if they are not properly fitted.
Dental implants help support your adjacent teeth in a way that dentures do not.
Even if you only take off your dentures for brief periods, or just to sleep, you can still encounter problems with shifting teeth.
Think of it like wearing a retainer after the braces are removed.
Without something to help hold them in place, there’s a possibility your teeth will move.
Common types of dental implants
After your jaw has recovered from the implant body placement, and a mold of your teeth has been created, the next step is the installation of the crown. There are two available options:
- Fixed: This implant type involves permanently attaching or screwing the artificial tooth to the abutment. It cannot be removed for cleaning or during sleep. Typically, each crown is linked to its own implant, but they can be bridged together to replace multiple teeth with a single implant.
- Removable: As the name suggests, this dental implant can be taken out. It comprises one or more artificial teeth surrounded by fake gum, mounted on a metal frame that connects to the implant abutment. This type can be removed for cleaning or repair.
For those requiring multiple dental implants, a combination of fixed and removable implants is an option. It is crucial to consult with your dentist to determine the most suitable choice for your mouth. Regardless of the selected dental implant type, anticipate the following post-surgery experiences:
- Bruising around the skin and/or gums
- Minor bleeding
- Pain in the implant area
- Swelling in the gums and/or face
What Dental Procedures Does Medicaid Cover?
Generally, Medicaid provides coverage for dental treatments that are necessary for preparing individuals for upcoming medical procedures.
This might include procedures like tooth extractions to prepare for reconstructive surgery following a severe auto accident or providing dentures to address health issues related to missing teeth.
Medicaid coverage for dental care varies among states:
- Some states do not offer any dental care coverage through Medicaid.
- Others may set a dollar-amount limit on the dental care covered by Medicaid in their state.
- Coverage may be available for individuals under the age of 21, while adults may not receive the same benefits.
- Emergency-only dental services may be covered by the state under Medicaid.
- Certain states provide an optional plan that, for an additional monthly fee, includes dental, vision, and chiropractic services.
- In some states, there is an expansion of Medicaid to include basic dental care services, aiming to improve the overall health of patients and reduce the overall cost of Medicaid coverage in those areas.
Procedures Not Covered by Medicaid
Medicaid typically does not cover dental implants, and this extends to various other dental treatments.
Some of the excluded procedures include:
- Dental appliances such as dentures and dental retainers
- Extractions
- Bridges and crowns
- Teeth cleanings
- Routine examinations
- Fillings
These treatments may only be covered if deemed medically necessary for the protection of your health and well-being.
How much do dental implants cost?
The expense associated with dental implants depends on factors such as the chosen implant type, the number of teeth being replaced, and any additional dental procedures required before or in combination with the implant.