Does Medicare Cover Dental Implants in 2024? A Deep Dive into Your Options

Many Medicare beneficiaries wonder if their plans cover the cost of dental implants. Understanding this can be confusing, as coverage varies widely between different plans and providers. We dug deep into Medicare's Evidence of Coverage (EOC) documents to get the answers for you.

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Does Medicare Cover Dental Implants in 2024? A Deep Dive into Your Options
John Ramsey

Key Takeaways: Who Covers Dental Implants?

  • UnitedHealthcare: Nursing home plans cover dental implants.
  • Aetna: A HMO and D-SNP plans cover implants.
  • Anthem Blue Cross and Blue Shield: Every plan covers implants.
  • AvMed Medicare: HMO-POS plans cover implants with a copay.
  • HealthSun Health Plans: Two plans cover implants.
  • Humana: Two plans cover implants at $0 copay.
  • Kaiser Permanente: Cover one dental implant procedure per year.
  • Prominence Health Plan: One HMO plan covers implants.
  • Simply Healthcare Plans: All plans cover implants.
  • Wellcare: One special plan covers implants.

Important Note: Many other providers do not cover dental implants, or they only cover the removal or repair of existing implants.

Table of Content

How We Found the Answers

We combed through the EOC documents for the major Medicare providers.

When the EOC clearly stated coverage, we took a screenshot and highlighted the relevant section. If a benefit wasn't mentioned, we assumed it's not covered.

We also looked at different plan types (HMO, PPO, etc.) and noted variations in coverage between plans.

Aetna Medicare

Aetna Medicare

Plan Type Covered Implants?
HMO Yes
HMO-POS No
PPO No
D-SNP No
C-SNP n/a
I-SNP n/a
PFFS n/a
Aetna Medicare Select (HMO) EOC - Confirmation of Dental Implant Coverage (Page 90)
Screenshot from Aetna Medicare Select (HMO) Evidence of Coverage document showing the section detailing coverage for dental implants.

Aetna Medicare Select (HMO): Covers 1 implant per tooth every 5 years.

  • Aetna Medicare Assure Plus (HMO D-SNP): This enhanced plan does cover dental implants.
  • Other Aetna Medicare Plans: Most other Aetna Medicare plans do not cover dental implants.

Anthem Blue Cross and Blue Shield

Anthem Blue Cross and Blue Shield Medicare

Plan Type Covered Implants?
HMO Yes
HMO-POS n/a
PPO Yes
D-SNP n/a
C-SNP n/a
I-SNP n/a
PFFS n/a
Screenshot from Anthem Medicare Advantage (HMO) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
Anthem Medicare Advantage (HMO) Medicare Plan - Confirmation of Dental Implant Coverage (Page 62)

All Anthem Plans: Cover dental implants, but the coverage amount varies for each plan.

AvMed Medicare

AvMed Medicare

Plan Type Covered Implants?
HMO No
HMO-POS Yes
PPO No
D-SNP n/a
C-SNP n/a
I-SNP n/a
PFFS n/a
AvMed Medicare Access (HMO-POS) Medicare Plan - Confirmation of Dental Implant Coverage (Page 100)
Screenshot from AvMed Medicare Access (HMO-POS) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.

AvMed Medicare Access (HMO-POS): Covers dental implants with a copay.

  • Other AvMed Medicare Plans: Do not cover dental implants.

Blue Cross Blue Shield

Blue Cross Blue Shield

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO No
D-SNP No
C-SNP n/a
I-SNP n/a
PFFS n/a
  • All Blue Cross Blue Shield Plans: Do not cover dental implants.

CarePlus Health Plans, Inc.

CarePlus Health Plans, Inc.

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO No
D-SNP No
C-SNP No
I-SNP n/a
PFFS n/a
  • All CarePlus Plans: Do not cover dental implants, but some plans cover cleaning (prophylaxis) on existing implants.

Cigna Healthcare

Cigna Healthcare

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO No
D-SNP No
C-SNP n/a
I-SNP n/a
PFFS n/a
  • All Cigna Healthcare Plans: Do not cover dental implants.

Clear Spring Health

Clear Spring Health

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO No
D-SNP No
C-SNP No
I-SNP n/a
PFFS n/a
  • All Clear Spring Health Plans: Do not cover dental implants.

Clover Health

Clover Health

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO No
D-SNP n/a
C-SNP n/a
I-SNP n/a
PFFS n/a
  • All Clover Health Plans: Do not cover getting new dental implants but do cover removing and repairing existing implants.

Devoted Health

Devoted Health

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO No
D-SNP No
C-SNP n/a
I-SNP n/a
PFFS n/a
  • All Devoted Health Plans: Do not cover dental implants.

Freedom Health, Inc.

Freedom Health, Inc.

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO n/a
D-SNP No
C-SNP No
I-SNP n/a
PFFS n/a
  • All Freedom Health Plans: Do not cover dental implants.

Gold Kidney Health Plan

Gold Kidney Health Plan

Plan Type Covered Implants?
HMO n/a
HMO-POS No
PPO n/a
D-SNP n/a
C-SNP No
I-SNP n/a
PFFS n/a
  • All Gold Kidney Health Plans: Do not cover dental implants.

HealthSun Health Plans, Inc.

HealthSun Health Plans, Inc.

Plan Type Covered Implants?
HMO Yes
HMO-POS n/a
PPO n/a
D-SNP Yes
C-SNP No
I-SNP n/a
PFFS n/a
Screenshot from HealthSun HealthAdvantage Plan (HMO) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
HealthSun HealthAdvantage Plan (HMO) Medicare Plan - Confirmation of Dental Implant Coverage (Page 64)
  • HealthSun HealthAdvantage Plan (HMO): Covers up to two dental implants per year.
  • HealthSun MediSun Plus (HMO D-SNP): Covers up to two dental implants per year.
  • Other HealthSun Health Plans: Do not cover dental implants.

Humana

Humana

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO n/a
D-SNP Yes
C-SNP No
I-SNP n/a
PFFS n/a
Screenshot from Humana Fully Integrated (HMO D-SNP) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
Humana Fully Integrated (HMO D-SNP) Medicare Plan - Confirmation of Dental Implant Coverage (Page 78)
  • Humana Fully Integrated (HMO D-SNP): Covers dental implants with a $5,000 annual maximum.
  • Humana Gold Plus SNP-DE (HMO D-SNP): Covers dental implants with a $2,500 annual maximum.
  • Other Humana Plans: Do not cover dental implants.

Kaiser Permanente

Kaiser Permanente
Plan Type Covered Implants?
HMO Yes
HMO-POS Yes
PPO n/a
D-SNP n/a
C-SNP n/a
I-SNP n/a
PFFS n/a
Screenshot from Kaiser Permanente Senior Advantage Basic 1 (HMO) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
Kaiser Permanente Senior Advantage Basic 1 (HMO) Medicare Plan - Confirmation of Dental Implant Coverage (Page 104)
  • All Kaiser Permanente Plans: Cover one dental implant procedure per year.

Prominence Health Plan

Prominence Health Plan

Plan Type Covered Implants?
HMO Yes
HMO-POS n/a
PPO n/a
D-SNP No
C-SNP n/a
I-SNP n/a
PFFS n/a
Screenshot from Prominence Plus HMO Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
Prominence Plus HMO Medicare Plan - Confirmation of Dental Implant Coverage (Page 52)
  • Prominence Plus HMO: Covers dental implants (limit of 2) as part of a $4,000 combined limit for preventive and comprehensive dental care.
  • Other Prominence Health Plans: Do not cover dental implants.

Simply Healthcare Plans, Inc.

Simply Healthcare Plans, Inc.

Plan Type Covered Implants?
HMO Yes
HMO-POS n/a
PPO Yes
D-SNP Yes
C-SNP Yes
I-SNP n/a
PFFS n/a
Screenshot from Simply Extra Platinum (HMO) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
Simply Extra Platinum (HMO) Medicare Plan - Confirmation of Dental Implant Coverage (Page 100)
  • All Simply Healthcare Plans: Cover dental implants, but some may require prior authorization.

Solis Health Plans

Solis Health Plans

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO n/a
D-SNP No
C-SNP No
I-SNP n/a
PFFS n/a
  • All Solis Health Plans: Do not cover dental implants.

Sonder Health Plans, Inc.

Sonder Health Plans, Inc.

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO n/a
D-SNP No
C-SNP No
I-SNP n/a
PFFS n/a
  • All Sonder Health Plans: Do not cover dental implants.

United Healthcare/AARP

United Healthcare/AARP

Plan Type Covered Implants?
HMO No
HMO-POS No
PPO No
D-SNP No
C-SNP n/a
I-SNP Yes
PFFS n/a
Screenshot from UHC Care Advantage FL-E001 (PPO I-SNP) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
UHC Care Advantage FL-E001 (PPO I-SNP) Medicare Plan - Confirmation of Dental Implant Coverage (Page 111)
  • UnitedHealthcare Nursing Home Plans: Covers dental implants with annual maximums
  • Other United Healthcare Plans: Do not cover dental implants

Wellcare

Wellcare

Plan Type Covered Implants?
HMO No
HMO-POS n/a
PPO No
D-SNP Yes
C-SNP n/a
I-SNP n/a
PFFS n/a
Screenshot from 2024 Wellcare Dual Liberty (HMO D-SNP) Medicare Evidence of Coverage document showing the section detailing coverage for dental implants.
2024 Wellcare Dual Liberty (HMO D-SNP) Medicare Plan - Confirmation of Dental Implant Coverage (Page 70)
  • 2024 Wellcare Dual Liberty (HMO D-SNP): Covers 2 dental implants (and related services) every 12 to 84 months, depending on the type of service.
  • Other Wellcare Plans: Do not cover dental implants.

Conclusion

While Original Medicare (Parts A and B) generally doesn't cover dental implants, many Medicare Advantage plans do offer some coverage. If you're considering dental implants, it's crucial to carefully review your plan's EOC or contact your provider directly to confirm coverage details.

If you have further questions or need help from a licensed professional, you may contact us.

Need More Information? For a deeper dive into Medicare Advantage plans and their benefits, check out our comprehensive guide on Medicare Advantage Plans.

Disclaimer: This post is for informational purposes only and should not be considered financial or medical advice. Always consult with a qualified professional for personalized guidance.

Important Note: Benefits may vary depending on your location and carrier. Please check your service area for the specific benefits offered by your plan.

Frequently Asked Questions

Are dental implants covered by Medicare Advantage plans?

Dental implant coverage varies significantly among Medicare Advantage plans. Some plans offer coverage for implants, while others do not cover them at all or only cover certain related procedures like removal or repair. It's essential to check the details of your specific plan.

What is the average cost of dental implants without insurance?

The average cost of a single dental implant can range from $1,500 to $6,000 or more. This cost typically includes the implant itself, the abutment, and the crown. Additional procedures like bone grafting can increase the total cost.

Are there any alternatives to dental implants for Medicare beneficiaries?

Yes, there are alternatives to dental implants, such as dentures and bridges. Dentures are removable appliances that replace missing teeth, while bridges are fixed appliances that are anchored to adjacent teeth. These options are often more affordable than dental implants but may not be suitable for everyone.

Can I get dental insurance to cover dental implants if I have Medicare?

Yes, you can purchase a stand-alone dental insurance plan to help cover the cost of dental implants if your Medicare Advantage plan doesn't offer sufficient coverage. Some dental insurance plans offer coverage for implants, but waiting periods and annual maximums may apply.

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