Is there coverage for  Dental Implants?

 

There is generally No coverage for implants. 

We did find THREE  Individual Plans from Dental for Everyone that will cover implants! 

Click on the button below  or link  above to get quotes and details.

For a quick look at the schedule for what the percentage paid is click on the relevant link.  Delta or Renaissance or just scroll down the page.

Liberty Dental Plan!

 

Liberty Dental DHMO plan features large group type benefits, but is not rated by age or zip code, and you may enroll individuals or groups with no participation requirements!  

 Benefits Include: 

No Annual Maximums, No Claim Forms, Coverage for Pre-Existing Conditions, No Waiting Periods, Orthodontia, Dental Implants and More. Not to mention a generous commission for you!

Brochure and Enrollment Kit

 *When using the online provider link, select the CA-400 plan (not to be confused with the CA-400-R Plus) from the Benefit Plan /Network drop down. You will have to scroll down about half way to find it. Then select Zip Code, Country, State and City and click on the Search button.

Check out and do your due diligence on the Google Ads below about implant and “alleged?” grants.  I don’t know what they are.  Please do your own research.  You may post your findings in the comments below.

 

Dental Implant Picture  

redd road family dental.com

Steve Shorr
Website Introduction

Instant Health Quotes & Enroll

15 Reasons to appoint us as your broker - No extra charge

 

Our Webpage on Insurance Coverage for 

COVID 19 

corona virus

 

 

Dental Max “Pretty” brochures

Renesasse - Coverage for Implaints
Highlights
Full Brochure
implants

Be sure to click on the button below to get a quote and the most current coverage information!

Liberty

 

liberty implant schedule

liberty implant schedule 2

No plan maximum 

 

 

What are Dental Implants?

Dental implants (ADA Codes) may be thought of as artificial tooth roots which allow the fabricated teeth to be firmly attached to the mouth.  One may consider the jaw bone as a piece of wood and a dental implant as a screw

Dr. Dorfman’s DDS Website 

Boston Dental Implants Website (Archive.org)

Smile Implant Center.com

Write implants off your Taxes – using Health Savings Accounts

The average cost of placing a single dental implant ranges from $1,600 to $2,200, not including the cost of a restoration. Redd Road *

Implants may be covered under health insurance, if there is a “medical necessity” like cancer, major accident or skeletal deformity.  View sample Delta policy page 40 #32.

You can include in medical expenses the amounts you pay for dental treatment. This includes fees paid to dentists for X-rays, fillings, braces, extractions, dentures, etc.   including artificial teeth (IRS Publication 502 Page 5 & 7)

Implants are done when one doesn’t want a bridge because it more permanent and look better even in the back of the mouth and in view of this it’s considered cosmetic.

Unfortunately, implants are not generally a covered benefit. However, it is possible that Delta would provide an allowance for the covered benefit. It’s best that the enrollee ask their dentist to submit a pre-determination to Delta so that Delta can determine the covered benefit (if any) and the enrollees responsibility for payment in advance.

Limitations:

The replacement of lost or stolen dentures, crown and bridge work, dental procedures and charges incurred as part of implants (placement or removal) and prosthetic devices placed on implants (fixed or removable, for example: bridges, crowns) are not covered.  Smile Saver Brochure

Implants

Answers.com

Blue Shield Small Group Dental  PlansDental Implant Explanation

Dental For Everyone,
has an excellent  website with full brochures, Instant online quoting and enrollment

Dental for everyone free quote

One of our colleagues on how Dental for Everyone Works..

Google Ad Sense




Why Buy Dental Insurance?

A warm, bright smile can make a big difference in the way you look and feel. Regular dental check ups and cleanings are important to keep your smile healthy and can help you maintain better overall health.

What dental Insurance... should I buy Stephen Hook DDS

When people ask, what dental insurance plan should I buy, I'm tempted to answer, "None of them". But that's not a very helpful answer, so in this video I attempt to give you some guidance about things to consider before buying a dental insurance plan. Keep in mind that there also are finance plans available if you decide to go that route. And, you should not be shy about negotiating with your dentist regarding his or her fee for the services that you need.

Importance of Dental Coverage 
Dental & General Health

Insurance 101?

We suggest that you check out Life Insurance, Disability, Long Term Care and Retirement as these risks may cause much more financial devastating to your budget than dental bills.

I don't quite agree on the individual vs group rates & benefits - also group plans are income tax free - section 106

On the other hand - Sacramento Truck driver sudden dealth from tooth infection Sacramento Bee 1.31.2017

Picture of Oral Health 

Why you need Group Dental Coverage

Guaranteed Issue - No Pre X Clause
Quote & Subsidy Calculation 

Instant complementary quotes & subsidy calculation

Missed Open Enrollment?
See our Special Enrollment page

No charge for our complementary services

Detailed Video Instructions on using our Quote Engine

How to use our FREE Quote Engine, Subsidy Calculator  and get the MOST from the experience.

When you get a FREE quote, you can also see the benefits, view actual brochures, MD and Hospital Lists all ONE easy process with no obligation & it can be anonymous.   Enter your zip code, date of birth, family - household taxation relationships (MAGI - Definition),    Estimated MAGI - Modified Adjusted Gross Income for the upcoming - current year.  Last years tax return only gives an idea so that Covered CA can approve your advance tax credit to help pay premiums.

If you qualify for tax credits - subsidies and want them in advance (Pros-Cons) of filing your taxes click on "Health On Exchange" - Covered CAillustrated below.

This website and are individual consultation are provided to you FREE of Charge!  We are paid by Covered CA and/or the Insurance Companies to help you.  When you fill out the Covered CA ONLINE Application, just appoint us as your agent under Find Help in the Upper Right Hand Corner so that we get paid for helping you.  Click here for screen shots for more detail of how to do it.  If you prefer, you can pay us a consultation fee in lieu of appointing us as your agent, for educational services only.

You can then see all the quotes on the exchange, showing the Cost Share Reduction - Enhanced Silver  if available, subsidy - tax credit amount and your net premium.    If you click "Off Exchange" you will see more plans and companies which  may have larger provider lists.   Scroll down for more screen shots.

Then click on "View Plan Details" - "View Doctor's & Providers" - to compare and get more information.  Please note that the quote engine does not show enhanced silver, but shows silver at 70%.  Check our chart for the better silver coverage.  

Learn more about the right to change plans when Silver Level Enhanced Changes 

To apply, click on apply now or use the links in the right hand column, ON THIS PAGE, but it will have you redo the quote for that specific company.   The price is the SAME, no matter if you use us, go direct to Covered CA or the Insurance Company, as mandated by law!  If applying through Covered CA, be sure to sign the form to appoint us as your agent.  It's not all the easy to figure out how to do it on their website.

If you have any questions email [email protected] or call us 310.519.1335

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Tools to help you figure out how much you should get

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11 comments on “Dental Implants

  1. This is a FAQ from a page we culled from the website

    would be beneficial to me to switch to the enhanced 94 plan when I’m currently Under full scope of benefits Medi-Cal and denti-cal for about $7,000 worth of dental work that denti-cal won’t cover that needs to be performed?

    Are there any available plans Under The Inn at Silver 94 which offer Dental Care better than what is normally offered through denti-cal?

    Reply

    I really don’t know where you can get coverage for $7k worth of dental work. Most all plans I’ve seen limit coverage to $1k or $1.5k – $1,500/year.

    Silver 94 doesn’t have adult dental, other than if they call it medical services. See specimen policy page 72

    Check out Dental for Everyone or Covered CA’s dental program, which I believe you can get, even if you don’t have a health plan.

    What do you mean by “under the inn?”

    • Check out our webpage on Denti Cal.

      I’ll grant, that I don’t see on that page anything about implants, so here’s our research.

      The Denti-Cal provider handbook does mention Implants, so I guess it’s covered. I suggest you ask your dentist. Your question is beyond my pay grade! (Zero, as Medi Cal doesn’t pay agents)

      These are the “codes” in the provider manual that related to implants:

      Implant Services

      D6010, D6040, D6050, D6053, D6054, D6055, D6056,D6057, D6058, D6059, D6060, D6061, D6062, D6063,D6064, D6065, D6066, D6067, D6068, D6069, D6070,D6071, D6072, D6073, D6074, D6075, D6076, D6077,D6078, D6079, D6080, D6090, D6091, D6094, D6095,D6194, D6199

      See also Dental Economics.com

      • Here’s why I don’t like to guess or answer questions on the phone. I checked with justice in aging.org/ and said

        “Single tooth implants are not a benefit of the Medi-Cal Dental Program”

        Some legal advocates have attempted to make compelling medically necessary arguments, and the provider manual allows for that “Implant services are a benefit only when exceptional medical conditions are documented and shall be reviewed for medical necessity.”

        But generally speaking not a benefit and not one we want to promote as available to Medi-Cal beneficiaries since they are so limited.

        they pointed out this section in the provider handbook:

        Implant Services General Policies (D6000-D6199)

        a) Implant services are a benefit only when exceptional medical conditions are documented and shall be reviewed by the Medi-Cal Dental Program for medical necessity for prior authorization. Exceptional medical conditions include, but are not limited to:

        i) cancer of the oral cavity requiring ablative surgery and/or radiation leading to destruction of alveolar bone, where the remaining osseous structures are unable to support conventional dental prostheses.
        ii) severe atrophy of the mandible and/or maxilla that cannot be corrected with vestibular extension procedures or osseous augmentation procedures, and the patient is unable to function with conventional prostheses.
        iii) skeletal deformities that preclude the use of conventional prostheses (such as arthrogryposis, ectodermal dysplasia, partial anaodontia and cleidocranial dysplasia).
        iv) traumatic destruction of jaw, face or head where the remaining osseous structures are unable to support conventional dental prostheses.

        b) Providers shall submit complete case documentation (such as radiographs, scans, operative reports, craniofacial panel reports, diagnostic casts, intraoral/extraoral photographs and tracings) necessary to demonstrate the medical necessity of the requested implant services.
        c) Single tooth implants are not a benefit of the Medi-Cal Dental Program.
        d) Implant removal, by report (D6100) is a benefit. Refer to the procedure for specific requirements.

        They also told me about this guide for dental care for older adults

        Four page summary of dental benefits

  2. I reviewed the options above about the dental plans that offer some coverage for implants, however, that coverage seems very limited for implants and may not cover as much of the cost of non-implant dental work as my current dental plan.

    What other options are there?

    When and how to we set a meeting to discuss-consult on them them?

    • Please, when stating facts, show them. Our commenting section allows you to upload images and URL’s Internet addresses.

      One might look at HSA’s, see above or if you own a business Section 105.

      Click here to set a meeting time with us. Please give us a better idea of what you are looking for in other options, so that we can do the research. Everything we know about implants is on this webpage.

      Use the search feature in the upper right, to find everything about dental on our websites.

  3. Do you know anything about the Careington PPO Dentist plan mentioned on this page as providing some coverage/discounts for implants?

    For example, what those coverage/discount is provided for implants and if there is any pre-existing condition exclusion or waiting period?

  4. I want to set a educational meeting with you to discuss if my husband’s employer group great PPO coverage with Blue Shield will pay for treatment for my:

    arthritis

    loss of one tooth due to an accident

    grinding – loss of 8 teeth – which is causing grave and serious problems.

    can implants be covered for that?

    coverage for depression?

    I’d like to set a meeting so that you can educate me on what my coverage is and how it works.

    • For your depression – check this page. If you have further questions, please post there.

      Arthritis shouldn’t have any issues with coverage. Check out your Evidence of Coverage or Summary of Benefits.

      For us to be of any meaningful help, we need a copy of your ID card, which will be kept confidential. If at all possible, send us a copy of your evidence of coverage. If your husband’s employer is less than 100 employees, we have access to those documents. If it’s large group, we need you to get the EOC.

      After we’ve reviewed the EOC, we can schedule an educational meeting for a fee, click here for more information. We answer questions on the website at no charge, private time is different. It’s educational, we do not tell you what to do or give advise.

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