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Insurance Coverage for Dental Implants

posted in Dental Implant News

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Is this the start of a big trend?
Delta Dental of Michigan, Ohio and Indiana (Delta
Dental) will begin covering dental implants as part of its standard
benefits beginning January 1, 2007. That means enrollees will have the
option of choosing an implant to replace a missing tooth instead of a
conventional fixed bridge.

"Although implants have been available for
many years, advances in dentistry have greatly increased their rate of
success," said Thomas J. Fleszar, D.D.S., M.S., president and chief
executive officer of Delta Dental. "Today, they are often the best
method for replacing a single missing tooth in a healthy patient.
Therefore, we feel it’s the perfect time to incorporate implant
coverage as part of our standard benefits."

Delta Dental was one of the first carriers to offer contract riders
to employers wishing to cover this service and has closely monitored
advances in implant materials, training, and technology.

Fleszar said the company will cover endosteal implants, the most
commonly used type of implant, which is placed into the jawbone. The
other type of implant in use today, subperiosteal, fits on top of the
bone under the gums and will not be covered because they have a high
failure rate. Endosteal implants now have a success rate of 98 percent
over 10 years.

Delta Dental of Michigan, Ohio, and Indiana was a pioneer in using
evidence-based research to evolve dental plan designs. It was the first
dental benefits provider to change coverage for dental X-rays in the
mid-1980s based on research that recommended reducing the frequency of
X-rays for those not at high risk for tooth decay; as a result, many
patients have been protected from unnecessary radiation exposure.

Source: www.deltadentalmi.com

6 Responses to “ Insurance Coverage for Dental Implants ”

• James W Bentley, DDS November 20th, 2006

  
  

  This has an obvious benefit for many patients and practitioners, especially when dealing with the patients who only want “what my insurance covers”. However, I predict it won’t be long before they muck around with OUR fees, and try to control the financial aspects of implants, just like they do in standard dentistry. Personally, I would prefer that insurance companies NOT cover implants, except via the “alternative benefit clause” provision.

• Clark Brown November 21st, 2006

  
  

  I have gotten insurance coverage for implants since the mid-80s. The insurance companies have traditionally told me that I can certainly do what I wish, but they will pay coverage equal to a partial. That’s worked well for me since I tell them exactly what we’re doing and the patient gets some coverage. This change in Delta’s part will only serve to the dentist’s detriment. The insurance company may say they’ll pay, but they still have a $1,000 - $2,000 annual maximum benifit. This hardly pays for an implant case and will not be the deciding factor as to whether a patient accepts a treatment plan or not. But since it’s now covered, if you are a PPO provider, you’ll have to abide by their fees. I guarantee you’ll not like Delta’s fees.

• Zev Kaufman DDS November 21st, 2006

  
  

  Way to go Dr. Bentley! I agree. For the longest time I was hoping that insurance companies cover implants so that more and more patients could afford them. However, what I noticed after over a decade of practice is that if a person wants an implant badly enough, they will pay for it, as long as they are properly educated about the advantages of dental implants. People are much more apt to spend money on fancier cars, TVs, brand name clothing, and other, completely, non-essential items… all you have to do is show up at BestBuy on Black Friday this week at 3AM and see how much people are willing to pay for another big screen TV. Unfortunately most dentists interpret insurance company policies as standard of care. It is not true! Standard of care should be dictated by the American Dental Association and its affiliate specialty organizations. It should be evidence based, not finance based, as the insurance companies want you to believe. Insurance companies think that a crown should cost about a third of what most of us need to charge in order to make a decent living. The same will happen When insurance companies get their greedy hands on implants: the quality of our work and care is bound to go down, our fees will have to decrease and the level of frustration will increase. What we need to do is to re-educate the public on what they should spend their discretionary icome on. Don’t forget that the less lucrative dentistry becomes as a profession, the lower quality applicants we will get into the dental schools. We all stand to loose.

• Jeffrey Hoos DMD November 24th, 2006

  
  

  Interesting point of maximum benefits. Does not even cover the implant but I will say to a patient if we can get any money it will be a nice bonus. Do not count on it and the total fee is….
  Patient understand that implant dentistry is expensive but another to put it is……it has gotten cheaper when you think of what the fees were 10 years ago and now. Inflation has reduced the cost of implants.

• Ted December 2nd, 2006

  
  

  Anyone know if the U.S. federal gov’t has any health insurance plans for 2007 that will be offering coverage (or partial coverage) for dental implants?

  If so, what is the name of the insurance plan?

• sandy May 22nd, 2009

  
  

  I think insurance companies should cover denture stabilization, we pay for this insurance through out the years we should be able to get something out of it besides a new pair of denture every 5 years. They are getting paid for doing nothing for us. Lets hope if they reform health care they put this into the mix and it comes out in the plans. Without taking more out of our paychecks for it.

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