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Are Dental Implants Considered Major Restorative Care For Insurance?

Jan 4

Prioritizing your dental plan may cause you to encounter the words "basic" or “major”, but what do they signify?


Major dental care includes all services that surpass dental implants,fillings and root canals - think along the lines of crowns, bridges and dentures; treatments designed to replace teeth with either damage or absence.


In terms of insurance coverage, it is critical for understanding this distinction between basic and major treatment.


Common Dental Insurance Tiers


Dental insurance plans typically categorize dental services into three distinct classes of care.


Class 1: Proactive and diagnostic services, like x-rays and cleanings

Class 2: Primary restorative care, comprising of fillings and root canals

Class 3: Advanced restorative treatment, which encompasses dentures, bridges, and crowns


Insurance regularly pays for complete preventative treatments and covers between 75-80% of simple treatments. But, when it comes to major dental restorative care, the absolute most you can expect your insurance plan to contribute is 50%, leaving half of all expenses that accompany this type of treatment in need of being covered out-of-pocket.


Dental Implants and Insurance Coverage 


It is important to note that dental implants are considered major restorative care, meaning they will not be covered in full by your insurance. The best way to determine how much of the costs associated with dental implants your plan will cover is to contact your provider. 


In some cases, providers may offer partial coverage for implant-supported dentures or bridges. It's also possible you'll receive 15%-50% coverage for the crown portion of a single implant, but this varies from provider to provider and plan type.


It is recommended that you discuss all potential payment options with your dentist before starting any procedure, so you understand what percentage of an implant treatment may be covered by insurance, as well as other alternative financing options available.


You can also shop around for a plan that offers more coverage for major restorative care, including dental implants. As with any other health insurance policy, it’s important to read the fine print and be sure you understand what services are covered and to what degree. Doing research into different plans may help you save money in the long run.


How Will I Know If I Need Basic Or Major Restorative Dental Services?


In most cases, you'll be able to determine if a basic or major restorative dental service is needed by talking with your dentist. During an initial consultation, they will assess the condition of your teeth and gums and discuss any existing issues that may need treatment. Depending on the severity of the issue, they will provide recommendations for either preventive or restorative care.


For more serious conditions such as advanced gum disease or extensive decay, a major procedure such as dental implants may be necessary. In these situations, it’s especially important to have a good insurance plan in place so that you can get quality care without breaking the bank. 


By researching different providers and comparing coverage options, you’ll be able to make an informed decision that ensures you get the best possible care available.


Ultimately, having a good insurance plan is key when it comes to getting quality restorative dental care. By researching different providers and comparing coverage options, you’ll be able to make an informed decision that ensures you get the best possible treatment without breaking your budget. 


With proper understanding of basic and major restorative dental services, you can make sure that your teeth and gums stay healthy for years to come.


At Seaglass Dental Care, we are committed to helping you find the best dental care coverage for your needs. Contact us today to learn more about our services and how we can help you get the treatment you need at an affordable price.