How do senior citizens find inexpensive dental implants when Medicare pays a fraction of the retail cost – if at all?
Make mountains out of molehills.
No single strategy will reduce your cost to replace missing teeth down to zero, but a series of modest discounts can add up to significant savings!
First, learn when Medicare covers dental implants. Or, better yet, discover which Parts (B, C, N, etc.) pay for specific treatment steps and how finding a provider accepting your coverage offers hidden discounts.
Then, explore other ways to reduce out-of-pocket costs through other government benefits, grant programs, private insurance, and IRS tax breaks.
Dental Implants Paid by Medicare
Most senior citizens searching for dental implants paid for by Medicare must find additional ways to make treatment affordable. However, it is a good starting point if you can solve a three-part riddle.
- Find other financial help with dental implants
- Get Medicare to pay for some services
- Find a prosthodontist accepting Medicare
Medicare Plans
Getting Medicare to cover dental implants is the first puzzle piece toward lower costs. However, the rules explicitly exclude “services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth.”
Fortunately, every rule has exceptions, and below you will find two: medically necessary services and Advantage Plans with dental benefits.
Medicare Part B
Medicare Part B does not cover dental implants but could pay for medically necessary procedures that occur early in the process.
- Reconstruction of the jaw following an accidental injury
- Tooth extractions in preparation for radiation treatment due to cancer
Free dentures for seniors on Medicare Part B might be a better alternative for those dual-eligible for Medicaid, which covers removable false teeth in thirty-three states.
Medicare Supplements
Medicare supplements (Parts F, G, K, L, M, or N) or Medigap policies do not cover dental implants, as they fill holes left by Part B. They do not pay for any treatment besides medically necessary services.
- Reconstruction of the jaw following an accidental injury
- Tooth extractions in preparation for radiation treatment due to cancer
Supplemental dental insurance for seniors pays for dental implants after a 24-month waiting period, while coverage for other treatments may begin more quickly, making oral care more affordable in the interim. Please note that these plans are unconnected to Medicare.
Medicare Part C
Dental implants for seniors paid by Medicare Part C (Advantage Plans) are a more realistic way to lower costs. This option covers more services and provides in-network discounts but limits benefits.
Many private companies offer Advantage Plans with different features in each state. Therefore, check your coverage outline to verify the details.
Part C Coverage
Medicare Part C rarely pays for dental implants but could cover medically necessary procedures and related services more frequently if your plan includes oral care benefits.
Medicare Advantage Plans that cover dental implants fall into two categories.
- Part C plans often pay for early-stage dental work such as medically necessary procedures, diagnostic imaging, extractions due to decay or gum diseases, prescription drugs, and perhaps Alveoloplasty or bone grafting.
- Part C plans rarely pay for late-stage treatment steps such as implant surgery, abutment placement, and permanent dentures.
Part C Discounts
Medicare Part C discounts make dental implants more affordable for seniors when they choose a prosthodontist that is in-network with their Advantage Plan.
In-network dentists cannot charge more than permitted by insurance. The allowed amount is a pre-negotiated discount price the provider agrees to charge members.
For instance, you might find similar figures in an Explanation of Benefits.
| Service | Provider Charge | Allowed Amount | Discount |
|---|---|---|---|
| X-Ray | $25 | $16 | $9 |
| Simple Extraction | $350 | $200 | $150 |
Part C Limits
Medicare Part C annual benefit maximums limit how much your Advantage Plan will pay towards early-stage dental implant treatment steps each year. The average yearly maximum is about $1,500 of the allowed amount.
Here is what to do when dental insurance is maxed out: spread treatment over two years or more. Many surgical procedures (extractions, bone grafting, implant placement, etc.) require significant healing time between each step, making it easy to overcome this limitation.
Accepting Medicare
The ability to find dental implants near you that accept Medicare is the second puzzle piece for lowering costs. Only local providers in-network with your Advantage Plan agree to the bargain prices negotiated by your insurance company.
Dentists near you who take Medicare participate in-network with your Advantage Plan. Therefore, the best approach is to visit the online provider directory published by the insurance companies United Healthcare, Aetna, BCBS, Humana, and others.
Enter your zip code and get a quick list of nearby prosthodontists in your Advantage Plan that accept the allowed amount as full payment.
Free Implants
By now, you should realize that free dental implants for seniors on Medicare are unrealistic because government-sponsored insurance never covers the total cost. Plus, the alternatives are limited for two reasons.
- Free dental implants for low-income adults are uncommon because the overwhelming demand outstrips the undersized supply. Pro bono dentists and charitable organizations exist, but their chairs quickly fill up with patients wanting treatment at no cost.
- Free dental implants make little financial sense when a less costly alternative to replace missing teeth exists: removable dentures. Therefore, you might want to adjust your expectations to make treatment more budget-friendly.
Inexpensive Implants for Seniors
Inexpensive dental implants are a more realistic goal for Medicare seniors. You can lower costs by using other strategies that reduce out-of-pocket spending on fixing your smile.
Low-Cost Services
Sometimes, the only way low-income seniors can make dental implants seem economical is to cut unrelated household costs or raise funds from another source.
Free government money for seniors over 60 is waiting for you to come and claim it. Find out where to apply for this help and use the extra cash to pay the prosthodontist out-of-pocket.
Government benefits help older adults reduce everyday expenses such as food, transportation, phone service, home repairs, utility bills, rental housing, and more. Use the savings from these separate services to replace missing teeth and restore your smile.
Grant Programs
Partial grant programs marketed by private companies can sometimes lead to inexpensive dental implants for seniors with something of value to trade. Please verify that the offer is legitimate before signing on.
Government dental implant grants do not exist (outside of the topics discussed above) because no federal agency provides free money to individuals for personal use. Instead, the funding flows to large institutions to foster a public good.
However, other organizations offer grants for cosmetic dentistry as new patient acquisition programs. They promise free services to lure older people with rotten teeth to participating offices. Those with the financial capacity to pay for all treatment receive the most significant awards.
Insurance Plans
Dental insurance for seniors over 65 can make implants less expensive, but not in the way you might think. Remember that issuing companies want to make money, too, and will pay out less in benefits than they take in from premiums.
Dental insurance that covers implants immediately will include graded benefits that limit their value. The claim payments begin small but grow over time, ensuring that premiums exceed benefits for several years.
However, enrolling in senior dental insurance might offer the same in-network discounts as the Advantage Plans but across more treatment steps. The allowed amount applies only to covered services, so a plan covering implants right away ensures that you at least get these cost savings.
Full-Mouth
IRS tax breaks make dental implants inexpensive for seniors on Medicare by increasing the size of their refund. They work better for those needing full-mouth restoration than those replacing a single tooth.
Dental implants are tax deductible, generating savings for pensioners with significant income from Social Security, 401K, IRA distributions, and defined benefit retirement accounts.
Savings begin after meeting two critical thresholds requiring planning and timely action: itemized deductions and unreimbursed medical and dental expenses.
Itemizing Full-Mouth
Full-mouth dental implants for seniors are more cost-effective because they allow you to optimize your itemized deductions, which must exceed the standard deduction before savings begin.
| Standard Deduction | Itemized Deduction |
|---|---|
| Individual: $13,850 | Charitable Donations |
| Head of Household: $20,800 | Mortgage Interest & PMI Premiums |
| Joint: $27,700 | State & Local Property Taxes |
| Casualty & Theft Losses | |
| Unreimbursed Medical & Dental Expenses |
The cost of full-mouth dental implants begins at $35,000 and ranges higher, meaning many seniors surpass the first threshold easily when they consolidate treatment in one calendar year.
Full-Mouth Costs
Full-mouth dental implant costs and Medicare premiums move many seniors over the second threshold: Unreimbursed Medical & Dental Expenses must top 7.5% of Adjusted Gross Income (AGI) before savings begin.
Medicare premiums are deductible medical and dental expenses, making it easier to surpass the second hurdle. For instance, pensioners with a $100,000 AGI would see these results.
| 7.5% of AGI | Unreimbursed Medical & Dental Expenses |
|---|---|
| $7,500 | Annual Medicare Premiums: $1,980 |
| Full Mouth Implants: $35,000 |
