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Most of the time Original Medicare does not provide coverage for dental services, especially if it is routine dental care. Original Medicare will only provide coverage for medically necessary dental services. We are here to find out if that includes bone grafts, which are a key part of getting dental implants.
If you’re wondering, “does Medicare cover bone grafts?” you’re in the right place! In this article, we answer that question in clear, plain English. You will also find the average costs of bone grafts and other helpful info.
Does Medicare Cover Bone Grafts?
The short answer is no. In most cases, Medicare will not cover the cost of bone grafts. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your bone grafts.
Original Medicare (Medicare Part A and Part B) does not provide coverage for bone grafts. So that means you will have to pay 100 percent for your bone grafts. Most of the time, Original Medicare does not provide coverage for routine dental services such as bone grafts.
However, in rare cases, Original Medicare may provide coverage for some dental services which may include bone grafts. As it is with other routine dental procedures, Original Medicare may only cover bone grafts if it is considered medically necessary to treat your condition.
In some cases, Original Medicare may provide coverage for your dental implants. For example, if you need to stay in a hospital overnight after your dental implant procedure, Original Medicare may provide coverage for your hospital stay. However, Original Medicare will still not provide coverage for your dental implants, only your hospital stay is covered.
Original Medicare also does not provide coverage for prescription medications that you need for your bone grafts or any routine dental service and care.
Medicare Part A may also provide coverage for certain dental services if you require emergency dental care while you are admitted as an inpatient in a hospital.
Part C Coverage for Bone Grafts
However, some Medicare Advantage plans (Medicare Part C) provide coverage for bone grafts. Medicare Advantage plans cover everything Original Medicare covers – they have to! But they will also provide coverage for some things that Original Medicare does not. Exactly what the coverage is and what the costs associated with that coverage is will vary depending on the specifics of your plan.
Many Medicare Part C plans provide coverage for dental care. If your Medicare Part C plan has dental care coverage, you will need to visit a dentist that is within the plan’s network for your Medicare Part C plan to provide coverage for your dental implants or other dental services.
How Much Do Dental Implants Cost?
A simple dental implant that uses synthetic bone or sterilized bone from cadavers or cows may cost $200 to $1,200 per implant. A more complex bone graft that uses the patient’s bone may cost $2,000 to $3,000 or more.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover eye refraction?