Frequently Asked Questions – Insurance

Insurance coverage of implant treatment depends on the individual policy. However, it is rare to receive any substantial coverage. Since the benefit coverage is determined strictly by the amount the employer wants to spend on the policy, and the insurance companies want to build in their profit margins, there are major limitations on most dental insurance plans. In reality, the plans are only designed to cover routine maintenance, emergencies, and basic care. The insurance companies use statistical data to determine the most common procedures submitted on claims, and then they set their own usual and customary fee schedule for these procedures. They also determine the specific restrictions and limitations for each plan. Because the plans are only intended to cover the basics, there is an annual maximum allowable benefit of $1,000-$1,500 on most plans. Although most companies exclude implants as a covered benefit, many of them will pay the same benefit they would cover for the lowest cost alternative treatment option (partials and dentures) and some of the diagnostic records, if a specific request is made for alternative benefits. Even if an individual policy includes implants as a covered benefit, the amount of coverage is still limited to the annual maximum allowable.

There are a few cases where medical insurance is available for people who are missing all of their teeth, and as a result, have medical complications. This type of coverage depends solely on the individual policy. Other than these situations, medical coverage is very rare. Work related injuries and other types of accidents are the other cases that are sometimes covered by insurance. Medicare does not cover implant treatment. All in all, it is best to assume that there is no medical insurance coverage available.

Typically, medical insurance will cover implant/tooth replacement procedures related to the following types of conditions: Trauma - say you lose your front teeth after a car accident Loss of teeth due to a medical condition If teeth are lost in the course of tumor treatment A congenitally missing tooth.

At EON Clinics, the oral surgeon administers the anesthesia, which is included in the fee.

We offer financing through LendingClub, CareCredit, Alphaeon, and Proceed Finance. When you come in for your free consultation, we’ll see if you qualify for financing and payment plans. We’ll also check your insurance plan to see if your plan provides coverage for a portion of the procedure. We’ll assist you with the entire process, making it as easy as possible to pay for your implants.

Unfortunately, Medicaid, Medicare, and state/county insurances (such as BadgerCare and CountyCare) do not cover dental implants as it is considered an elective procedure.

Most of our patients use a combination of personal savings and financing to pay for implants. By taking advantage of our financing options, our patients are able to split the total cost of treatment into affordable monthly payments. Read about the creative ways our patients have funded their dental implant procedures to get inspiration for your own dental implant journey.

Dental tourism can be an affordable way to receive treatment that would otherwise be out of budget, but a limited budget is all the more reason not to gamble with your health and savings. EON Clinics doctors have years of experience fixing teeth that were poorly placed elsewhere at a cheap price. Often times, we see patients spending even more to fix the smile they initially thought would save them money. As such, we highly advise against dental tourism. Read our blog post to learn more about the dangers of dental tourism.