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Insurance
What plans cover,
and what they don't.
Dental insurance was designed around fillings and cleanings, not around reconstruction. Most plans contribute something to implant treatment — rarely all of it, and almost never in the way patients expect.
Why patients come here
- Practice limited to prosthodontics and oral implantology
- Every case CBCT-scanned and fully guided
- IV conscious sedation available in-office
- A written, itemized plan before anything is scheduled
The mechanics
Three limits that decide your number.
The annual maximum
Most dental plans cap what they will pay in a calendar year, and the cap has barely moved in decades. Implant treatment usually exceeds it, which is why staging across two calendar years is sometimes worth planning deliberately.
The missing tooth clause
Many policies exclude replacement of a tooth that was already missing before the policy began. It is worth knowing whether yours has one before you plan around a benefit that will not arrive.
Category and percentage
Extractions and grafting are often covered at a higher percentage than the implant itself, and the restoration may be treated as a major service with a waiting period. The categories matter more than the headline percentage.
How we handle it
Pre-determination, filed before you commit.
We file
Your plan, imaging and procedure codes are submitted to your carrier as a pre-determination before treatment begins.
At planningThey answer
The carrier responds in writing with what they will pay per procedure. Typically two to four weeks.
2–4 weeksYou decide
Your estimate is revised against their answer, so the figure you are planning around is theirs rather than ours.
Before schedulingTypically
Where plans usually land.
Often covered
Extraction of a failing tooth, and frequently the ridge-preservation graft placed at the same visit.
Sometimes covered
A portion of the restoration — the crown or the prosthesis — often at a major-service percentage and subject to the annual maximum.
Less often covered
The implant fixture itself, sinus elevation and larger augmentation, though this varies significantly by plan and by employer group.
Practical
Bring these to the consultation.
- Your insurance card and the group number
- The plan booklet or benefits summary if you have it
- Whether you have used any of this year's maximum already
- Any secondary coverage through a spouse's plan
Coverage detail here is general and varies by carrier, plan and employer group. Nothing on this page should be relied on as a statement of your specific benefits — the pre-determination is what settles that.
Start with a scan and a straight answer.
A consultation includes an examination, a 3D scan and a written, itemized plan. If implants are not the right treatment for you, we will say so and tell you what is.