We are discussing here all about does Medicaid covers dental implants. Loss of teeth or a missing one may be a primary reason why you miss your beautiful smile. Many times we often feel like getting it fixed as quickly as possible. A dental implant is a cosmetic surgery that costs very high charges.
In this article, you will explore in-depth whether Medicaid pays for a dental implant. Stay tuned to explore more about it in this article.
Will Medicaid Cover Dental Implants?
In almost all cases Medicaid does not pay the charges for dental implants. Medicaid is a government program that aims to help families who suffer from financial crunch as they cannot afford the charges of dental treatment.
Dental implants fall under the category of cosmetic procedure which is not essential for good health. This is the primary reason why Medicaid doesn’t provide coverage for these procedures.
However, there are certain exceptions, patients who have a significant requirement for dental implants can be approved for the dental implant by Medicaid.
You have to submit detailed paperwork which is approved by your dentist or physician. You need to provide a letter that explains why dental implants are the only process which can help you overcome your dental problem. You need to provide your dental X-rays by the doctor or dentist to the Medicaid provider.
In multiple cases still, there are high chances that your application gets denied by Medicaid. People who are under the age of 21 can be helped by Medicaid to provide a particular cost of the dental implant with the assistance of a Federal program. Does Medicaid Covers Dental Implants?
Early and Periodic Screening Diagnostic and Treatment (EPSDT) is provided to teens, children and young adults with the help of this program.
If dental implants are genuinely required then Medicaid will bear the cost of the treatment and procedures which are done under EPSDT. Patients over the age of 21 are not eligible for EPSDT coverage.
Does Medicaid Cover Dental Implants For Adults?
In multiple cases, Medicaid doesn’t cover the charges of dental implants for adults. This program provides financial assistance to the families who suffer from the financial crunch and the ones who can’t bear the high charges of dental and medical care.
Does Medicaid Cover Dental Implants For Patients Under 21 Years?
It depends upon the USA state in which you reside whether Medicaid will pay for your dental implant charges or not if you are over 21 years of age.
The Medicaid facilities vary from state to state. The dental implant has multiple stages and processes. Medicaid can pay for certain parts of the dental implant procedure.
They may pay for particular procedures like : –
- Bone Grafting : Bone grafting can occur either due to chronic health conditions or severe accidents.
- Surgical Installation : Surgical installation of an implant frame is done into the bone which is present in the jaw.
- CT scan : With the help of a CT scan you can find structural ambiguity or problems in your bone’s structure.
- Tooth removal : Removing a tooth due to any adverse health condition or accident.
Does Medicaid Cover Dental Implants For Patients Over 21 Years?
Whether dental implant charges will be covered by Medicaid or not depends upon the American state you reside in. It may vary from state to state as there are various things that you need to undergo under the dental implant process.
Medicaid can help you pay for certain parts of the procedure. As per the studies, only 38% of them accept Medicaid.
Medicaid is accepted in the following cases : –
- Bone grafting
- Surgical installation
- Tooth removal
- CT scan
When Does Medicaid Pay For Dental Implants?
As we already know, Medicaid doesn’t pay for dental implants for adult citizens. However, with the help of a taxpayer-funded program, there are two different outcomes. Your mouth is considered to be one of the important parts of the body and good dental health is essential for overall health. The insurance world considered it to be two different aspects.
- The health insurance component will help you pay for vital treatment if the problem occurs anywhere else in your body.
- Dental insurance helps in paying the most affordable element which supports oral care benefits when the problems in your teeth occur.
Dental Insurance :
With the help of dental insurance, Medicaid can help to pay for tooth implant treatments. It will pay for the problems of periodontal disease, and tooth decay. The following three categories which are mentioned below may vary in the country.
Under the dental insurance coverage, Medicaid pays for the crowns and bridges in all the 26 states of The United States of America. It also comes with restorative advantages. In restorative dentistry, the damaged or missing teeth are replaced. The dental insurance may pay for the crowns and bridges but it doesn’t pay for the following aspects
- Crows and bridges: maybe sometimes
- Surgical implant body replacement: not done
- Surgical implant abutment installation: not done
The charges of the oral surgery may be covered by Medicaid under the dental insurance program. The oral surgery is done in all the 26 states of The United States of America by Medicaid. Dental insurance may pay for early-stage tooth implant treatment depending upon the advantages.
- Sinus lift
- Bone grafting
- Tooth extractions
- Cone-beam computed tomography (CT)
Under the category of dental insurance, Medicaid covers the charges of dentures in around 33 states of The United States of America.
The adults who have lost their particular tooth or teeth due to accident surgery can get back their teeth and a beautiful smile. Your state will support dentures or dental implants as the least costly treatment.
Medicaid will help you in covering all the dental implant charges when it behaves as Health Insurance. The rules are the same for the entire country for medically essential oral treatment like injury, disease, disability or treatment of an illness.
You can cover the charges of dental implants with the help of health insurance by showing it as your medical requirement. All that you need is a letter from your physician or dentist which explains the diagnosed illness or injury.
The letter of the physician or dentist must state that a permanent implant is required instead of removable dentures. The health insurance will cover the charges of the Medicaid in two cases-
- To strengthen the jaw bone after surgery or remove cancer lesions or accidental fractures.
- To prevent a trophy which occurs due to the occurrence of different diseases like osteoporosis digestive disorders or Diabetes.
State That Covers Dental Implants Through Medicaid?
Understanding which state covers dental implants through Medicare depends upon your disorder and whether its treatment falls under dental insurance or Health Insurance.
- The dental work for adults under the Medicaid coverage may be for every state for the patients who lost their teeth due to gum disease or decay.
- The office accepts the entire payment and the dental implants taken by Medicaid once the entire amount is paid for the treatment.
- All the states pay for the dental implants for adult people if the person has properly scripted medical necessity from a dentist or physician.
Why Doesn’t Medicaid Routinely Pay For Dental Implants?
As all of us know dental implants help us to overcome problems related to teeth. However, what could be the reason that Medicaid refuses to cover dental implant procedures? A dental implant is considered to be a cosmetic process.
As it is considered to be a cosmetic process they do not consider it to provide assistance to prevent the movement in the teeth so that it remains healthy. The charges of dental implants are very high in comparison to any other kind of dental correction process.
The charges for dental implants may range between 4000 to 6000 USD and this is the primary reason why dental implants are not covered under the Medicaid procedure.
Can You Get Special Consideration For Medicaid To Cover Your Dental Implants?
If a dental implant is the only way to overcome your problem with the teeth then you can obtain special consideration from Medicaid. You have to prove that the procedure is medically essential and it is not just for cosmetic purposes.
You have to provide all the essential documents from your dentist or physician to your Medicaid provider. Let’s understand what are the essential documents that you need to provide to your Medicaid provider.
- Explain how dental implants will help you in improving your medical condition.
- All about the dental implant procedure program.
- An explanation from your dentist or physician about why other tooth procedures such as Bridgework and denture fitting won’t help you and why dental implants are essential to improve your medical health condition.
- A radiograph or analytical panorex of the entire mouth x-ray is used in dental procedures to show the condition of the upper and lower teeth. It also needs to represent the condition of the jaws.
Frequently Asked Questions
What makes dental implants medically necessary?
Dental implants won’t lead to further tooth loss and you can get your beautiful and pearl-like smile back. The benefit of dental implants is that you can restore your teeth without worrying about any kind of side effects.
It doesn’t result in tooth decay as it is attached to the jawbone and it doesn’t impose any kind of stress on the teeth beside it.
Does Medicaid cover dental implants for seniors?
Medicaid doesn’t cover dental implants for senior citizens and low-income individuals. Due to its high charges and certain other reasons Medicaid doesn’t cover the charges of dental implants for seniors.
Conclusion : –
Medicaid helps us to afford multiple medical costs and treatments. A dental implant is considered to be a cosmetic surgery which becomes inevitable to be performed in certain cases. In this article, we have mentioned whether Medicaid pays for the charges of dental implants or not. We thank you for being a part of an article and are awaiting your worthy reviews. Hope you now understand all about does Medicaid covers dental implants.