Does Private Health Insurance Cover Dental Implants?

Does Private Health Insurance Cover Dental Implants? By Maylands Dental Centre | December 19, 2022

Does Private Health Insurance Cover Dental Implants?

Dental implants are an increasingly popular option for replacing missing teeth, offering several benefits over other replacement teeth. However, one major concern of most patients is the cost of dental implants.

Tooth implants are not cheap. It is one of the most expensive tooth replacement options available. But if you’re considering dental implants and looking for a way to lower the cost, dental implant cover from your health insurance might help. Many people are unsure if their dental insurance cover will help pay for this type of procedure. If you’re one of them, keep reading.

In this blog post, we’ll provide some basic information on dental implant coverage and explain how to find out if your policy will help pay for this type of treatment. We hope this information is helpful!

How Much Do Dental Implants Cost?

Dental implants are very beneficial for many people. These artificial teeth are strong and durable and can last a lifetime with proper care. However, dental implants can be quite expensive, costing anywhere from \$4,000 to \$6,000 for a single tooth or a single implant.

There are a few reasons dental implants cost as much as they do:

  • The dental surgery itself is technique-sensitive and requires the use of special equipment.
  • Dental implants are typically made from materials like titanium, which can be expensive.
  • The dental surgeon must undergo specialized training to learn about placing implants.
  • Dental implants require ongoing care and maintenance for dental health.
  • Additional procedures such as bone grafts, sinus lifts, and gum grafts can add to the cost.

For all these reasons, dental implants can be quite expensive. However, many people feel they are worth the cost. They look and feel like real teeth, providing a more natural and long-lasting solution than other options like conventional dentures or bridges.

the woman came to the dental clinic.

Are Dental Implants Covered by Health Insurance?

The answer to this question depends on your insurance plan, your level of cover, and how it is structured.

Some health plans will cover at least a portion of the cost of dental implants, leaving you with some out-of-pocket costs. Still, some plans consider them to be cosmetic procedures and do not provide any reimbursement. Other insurance companies will cover the entire cost of the dental treatment if they are considered medically necessary.

It’s important to check with your insurance provider before the surgical procedure to determine the type of dental implant cover you will have.

How Does Dental Insurance Coverage Work?

In Australia, private health funds (or insurers) provide two types of dental insurance coverage – General Dental and Major Dental.

General Dental covers the cost of routine dental care, such as regular dental check-ups and cleanings. It also pays for preventative treatment procedures such as mouthguards, x-rays, and tooth extractions. Meanwhile, Major Dental covers the cost of more extensive dental work, such as root canal treatments, tooth fillings, crowns, and dentures. However, it does not include orthodontic treatments because they have a lifetime limit.

Most dental insurance plans will cover a portion of the costs for both General and Major Dental, but there is an annual limit on how much coverage is available for each type of service or item.

For example, a typical plan might cover 80% of the costs for General Dental and 50% of the costs for Major Dental. This means that you would be responsible for paying the remaining 20% of the costs for your routine care and half of the treatment costs for any major dental work.

When it comes to dental implants, your coverage depends on the specifics of your insurance plan. Some plans may offer partial coverage or rebates for dental implants, while others may not cover them at all. In addition, some plans may only cover the cost of the implant itself, while others may also cover the cost of the abutment and crown. Conversely, there are insurance policies with Hospital cover. This means they will cover dental implants as long as you are admitted as an inpatient for hospital treatment.

Since every dental insurance plan is different, it’s important to read your policy documents carefully to understand what dental services are covered and how much you have to pay out-of-pocket.

Also, check with your insurer or contact your dental provider to ask about waiting periods and other rules. By doing so, you can be better prepared to pay for the dental care you need based on your treatment plan.

What Makes Dental Implants Medically Necessary?

There are some instances where dental implants are considered medically necessary. These false teeth maintain oral health and function. As such, dental implant surgery may be covered by a health insurance policy in the following circumstances:

  • When dental implants are used to replace missing teeth that cannot be restored with dental bridges or dentures.
  • When dental implants are used to support a dental prosthesis (e.g., denture or bridge) that would otherwise be unable to stay in place.
  • When dental implants are used to provide stability for a dental prosthesis that is causing pain or discomfort.
  • When dental implants are used to manage periodontal or gum disease or severe tooth decay.
  • When dental implants are used to address a malocclusion or bad bite.

It is important to check with your insurance provider to determine whether dental implants are included in your policy.

Are There Other Payment Options for Patients Without Dental Insurance?

Even if your dental insurance cover does not include dental implants, options are still available to help you finance your procedure. These include:

Financing through a Dental Office

Many dental offices offer in-house financing payment plans that can make dental implants more affordable. Patients can make monthly payments directly to the dental office, and they may be able to take advantage of special financing offers with low or no interest.

Credit Cards

A number of credit cards offer 0% interest on purchases for a set period of time. This can effectively finance dental implants if the balance is paid off within the 0% interest period. Be sure to compare different credit card offers to find the best deal.

Dental Savings Plan

A dental savings plan is an annual membership plan that provides discounts on dental procedures, including dental implants. Dental savings plans usually cost around $100 per year, and they can save patients 20-60% on dental implant treatment.

Personal Loan

Another option is to take a personal loan from a bank or online lender. Personal loans usually have lower interest rates than credit cards, making them an attractive option for financing dental implants. Just be sure to compare loan offers from multiple lenders to get the best rate.

Healthcare Flexible Spending Account (FSA)

If you have a healthcare flexible spending account through your employer, you can use it to pay for dental implant treatment. This is an especially good option if you know you will need dental implants in the near future, as you can set aside money in your FSA ahead of time and then use it when you’re ready to pay for your procedure.

With a little research, you should be able to find a way to get the dental implants you need regardless of your insurance coverage.

Are Dental Implants Worth It Despite Their Steep Cost?

Dental implants offer a long-term solution for people who have lost one or more teeth. While dental implants are not covered by dental insurance, they are considered to be a worthy investment due to their many benefits.

One of the main advantages of dental implants is that they help preserve the natural shape of your face. Unlike dentures, which can cause the jaw bone to shrink over time, dental implants stimulate bone growth. This means you can avoid the sunken look that often accompanies tooth loss. In addition, titanium implants are very strong and durable and function like natural teeth. With proper implant placement and care, dental implants can last a lifetime.

While the cost of dental implants is steep, many people feel they are worth it due to their numerous benefits.

Final Thoughts

f you’re considering getting dental implants and want to know what your insurance will cover, check with your provider. Most insurers consider dental implants an elective procedure, so a deductible or copayment may be associated with the cost. However, many implant procedures may be fully reimbursed if you have comprehensive coverage.

At Maylands Dental Centre, we offer various payment options to make dental implants affordable. We also have a team of experienced professionals who will work with you every step of the way to ensure that you are happy with your results. If you have any questions, please don’t hesitate to contact us. We would be happy to help!

Frequently Asked questions

Most patients are not put to sleep for a dental implant procedure. The procedure is done while the patient is awake and conscious. Local anesthesia is usually all that is required to numb the area where the implant post or the titanium screw will be placed, so you should expect minimal discomfort during the procedure. However, in some cases, patients who experience severe dental anxiety or those with medical conditions may be considered for sedation to reduce the likelihood of complications during the procedure.

It depends on your situation. In general, dental implant costs are higher. They are more expensive and require a longer healing process than bridges, but they also last much longer. If you have enough jawbone density to accommodate an implant, it may be the better option for you in terms of durability and cost-effectiveness.

Bridges can also be a good choice if you have insufficient bone density to accommodate an implant or if the patient is unwilling to undergo bone grafting. Ultimately, it’s important to consult your dentist to determine which option suits you.

Dental implants have a high success rate. Most people who get tooth implants can expect them to last for 25 years or more. However, several factors can affect how long an implant will last.

For example, if the implant is not placed properly, it may not fuse correctly with the bone and could eventually become loose. Additionally, if the implant site is not cared for properly, it may become infected, which can also cause the implant to fail.

With proper placement and care, most implants will last for many years, providing a long-term solution to tooth loss.

There are a few reasons why someone might not be a good candidate for dental implants, including:

  • Poor oral hygiene
  • Diabetes or conditions that affect healing
  • Smoking
  • Medications that may interfere with healing
  • Weakened immune system

If any of these apply to you, you should talk to your dentist before getting a dental implant. They can discuss other potential solutions that may be the right fit for you.

Maylands Dental Centre
Maylands Dental Centre
Content published on is intended to be used and must be used for informational purposes only. It is very important to do your own analysis before making any decision based on your own personal circumstances. You should take independent medical advice from a professional or independently research and verify any information that you find on our Website and wish to rely upon.

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