Dental implants are a popular choice for replacing missing teeth due to their durability, natural look and feel, and ability to improve oral health. However, the cost of dental implants can be a significant barrier for many patients. Fortunately, dental insurance can provide coverage for some or all of the cost of dental implants. In this article, we will explore what Delta Dental pays for implants.
Understanding Dental Implants
Before we dive into Delta Dental’s coverage for dental implants, let’s first understand what dental implants are and how they work. Dental implants are artificial tooth roots that are surgically implanted into the jawbone to support a replacement tooth or bridge. The implant is made of titanium, which is biocompatible and integrates with the bone over time through a process called osseointegration. Once the implant has fully integrated with the bone, a crown or bridge can be attached to it.
The Cost of Dental Implants
The cost of dental implants can vary depending on several factors, including the number and location of the implants, the type of implant used, and whether any additional procedures are needed, such as bone grafting. On average, a single dental implant can cost anywhere from $1,000 to $4,000 or more, while a full set of implants can cost upwards of $20,000.
Delta Dental Coverage for Implants
Delta Dental is one of the largest dental insurance providers in the United States, covering over 80 million individuals. Delta Dental offers several different plans, each with its own coverage details and limitations. In general, Delta Dental’s coverage for dental implants varies depending on the plan and the reason for the implant.
In most cases, Delta Dental will cover a portion of the cost of dental implants if they are deemed medically necessary. This means that the implants are required to restore function or improve the patient’s overall health and well-being. Medical necessity may be determined by the patient’s dentist or by Delta Dental’s medical review team.
If the implants are considered cosmetic, meaning they are not medically necessary, Delta Dental will likely not cover the cost. Cosmetic implants are typically used for aesthetic purposes only, such as to improve the appearance of a smile.
In addition to coverage for the implant itself, Delta Dental may also cover other associated costs, such as consultations, X-rays, and other necessary procedures. However, it is important to check with your specific plan to understand what costs are covered and what limitations or exclusions may apply.
Delta Dental Implant Coverage Examples
To better understand what Delta Dental pays for implants, let’s take a look at two examples:
Example 1: Medically Necessary Implant John has been missing a tooth for several years and has experienced difficulty eating and speaking. His dentist recommends a dental implant to restore his ability to chew and speak properly. John’s Delta Dental plan covers medically necessary dental implants at a rate of 50%, up to a maximum annual benefit of $1,500. The cost of John’s implant is $3,000, so Delta Dental will cover $1,500, leaving John responsible for the remaining $1,500.
Example 2: Cosmetic Implant Samantha has always been self-conscious about her smile due to a missing tooth in the front of her mouth. She decides to get a dental implant to improve the appearance of her smile. However, her Delta Dental plan does not cover cosmetic implants. Samantha is responsible for the full cost of the implant, which is $4,000.
Conclusion
Dental implants can be a life-changing investment for those in need of tooth replacement. While the cost of implants can be a barrier, dental insurance can provide coverage to help make them more affordable. Delta Dental offers coverage for dental implants in certain circumstances, but it is important to understand the specifics of your plan and any limitations or exclusions that may apply. Discuss your options with your dentist and Delta Dental representative to determine the best course of action for your oral health needs.
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