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Benefits
Most plans help.
Few plans
cover it all.
Dental insurance was designed around fillings and cleanings, and the annual maximums have barely moved in forty years. Here is how implant benefits usually work in practice — and what happens if you have no plan at all.
Why people come here
- Surgery and the finished teeth done by one dentist, under one roof
- Diplomate of the International Congress of Oral Implantologists
- Fellow of the Misch Institute — and faculty at its successor
- A written, itemized plan before anything is scheduled
The mechanics
Four things that decide what you get.
- The annual maximum. Most plans cap total benefits per year, often between one and two thousand dollars. Implant treatment routinely exceeds that.
- The missing-tooth clause. Some plans exclude replacing a tooth that was already missing before the policy started. It is worth checking early.
- Waiting periods. Major restorative benefits often become available six to twelve months after enrollment.
- Alternate benefit. A plan may pay toward what it considers the least expensive adequate treatment — sometimes a bridge or denture rather than an implant — and you make up the difference.
What the office does
The practice works with a wide range of plans, verifies your benefits before treatment and files a pre-determination for larger cases so you see the insurer’s answer in writing rather than finding out afterwards.
Worth knowing
Four ways to get more out of it.
Stage across benefit years
Splitting a larger case across a December and a January can access two annual maximums instead of one.
Use FSA or HSA funds
Implant treatment is generally an eligible expense. Money set aside pre-tax goes further than the same money afterwards.
File the pre-determination
It takes a few weeks and removes the guesswork entirely. For anything substantial it is worth the wait.
Ask about the savings plan
If you have no insurance, the practice’s dental savings plan may cost less over a year than a low-cap policy would.
Questions
Insurance, answered.
Do you take my plan?
Directory listings show the practice working with Aetna, Delta Dental, Ameritas, MetLife, Guardian, United Concordia, Sun Life and Principal among others. Call the office with your card and the front desk will verify your specific benefits rather than guess from the insurer’s name.
What if implants are excluded entirely?
Some plans still contribute toward the extraction, the graft or the crown even when they will not pay for the implant fixture itself. It is worth filing rather than assuming.
How does the dental savings plan work?
It is a membership rather than insurance: you pay an annual fee and treatment is discounted, with no annual maximum and no waiting period. Ask the front desk for the current fee and what it covers.
Start with an exam and a straight answer.
A consultation includes an examination, 3D imaging and a written, itemized plan. If implants are not the right treatment for you, Dr. Patellis will say so and tell you what is.