Can dental implants be considered a medical necessity?

Question

Hi, I’m a stage IV esophageal cancer survivor and all of my remaining teeth were extracted in 2015. I’ve lot all of weight and rarely eat. In short, I’m suffering and even lost my self esteem. I was informed that under certain circumstances, Implants can be considered a medical necessity. If there are any doctors that are familiar with this situation, I would love to hear from you. My Physicians are willing to assist.

Hasan Yap, DDS · Answer

Dental Implants are considered a medical necessity when you have lost your dentition or teeth due to cancer and they are also considered a medical necessity when a lack of teeth has impacted your mastication and digestion. Medical insurance considers four or more implants a full mouth reconstruction. Your challenge will be finding oral health care providers whom are positioned to help you file your medical claims in their office as this is fairly new to the dental industry. It is a plus that your medical providers are willing to help you.

Moris Aynechi, DMD, MD · Answer

Some benefit plans have very specific language in terms of dental implants or rehabilitation.  We need to look into the plan and send for pre-authorization and see if they would cover it.  At times a peer review is necessary as well.  Did you have any radiation to your jaws?  If so this changes things and you may not even be a candidate for dental implants.  We'll need full report of your radiation location, dose and lenght of treatment before even proceeding with implants.

Amber Garcia, DDS · Answer

In situations where teeth were lost due to accident of medical issues, sometimes medical insurance will cover a portion of dental implants. You'd have to look at your specific plan and see if it's a covered benefit.

Andy Shieh, DMD · Answer

No dental insurance companies or dentists will see dental implants as “medical necessity” procedure. They will rather see you suffer with a set of dentures than costly dental implants. As matter of fact, Dental implants are viewed and classified as a “luxury item” and NOT a “medical necessity”. It’s like saying you’ve gotten a medical diesease and lost bit of your legs and now you can walk to get around, is a brand new Mercedes car a “medical necessity”? No! Insurnace would look into getting you leg prosthesis or a wheel chair instead of getting you a car.

Can dental implants be considered a medical necessity?

Answers (4)

Answer: No

Answer: No

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Everything you need to know about Dental Implants

Our mission is to create a world where every investment in modern beauty is Worth It.

Can dental implants be considered a medical necessity?

Answers (4)

Answer: No

Answer: No

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Recommended reading

Everything you need to know about Dental Implants

Our mission is to create a world where every investment in modern beauty is Worth It.