Are dental implants covered by insurance?

Are dental implants covered by insurance?

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Dental implants are an expensive procedure. While many people will have to fund these themselves, there might be another way. If you have health insurance or you lost your teeth due to an accident, you may be covered.

There are two ways you potentially can get your brand new tooth paid for, ACC and insurance. However, there are strict conditions around these, and you must follow the correct processes.

ACC for tooth loss due to accident

The Accident Compensation Corporation was started in 1974 and has covered Kiwis for a range of medical processes ever since. It’s designed to cover your medical care in case of an accident. They provide no-fault cover for everyone in New Zealand, including children, beneficiaries, students, elderly, visitors and everyone in between.

If you had an accident in New Zealand and it resulted in a broken tooth that requires replacement, then it will be covered by ACC. They don’t cover anything that’s caused by aging or neglect. If you are injured, it’s important that you fill out a claim form and your healthcare provider lodges a claim with ACC as soon as possible, but claims can be made up to 12 months later.

ACC will also cover NZ citizens for accidents that occurred overseas. Make sure you lodge a claim with ACC as soon as possible after the event.

They may also cover some conditions that you were born with. If you are unsure, call them and ask.

Insurance may cover some dental implant costs

Dental insurance can be very expensive and for very little outcome, so many people do not have specialised dental insurance. Some regular health insurance plans do have dental cover, but they are very specific to the provider. It all depends on your cover and the policy.

Some may pay out for dental visits up to a certain amount, or others may cover the whole cost of the procedure, less the excess fee. Other policies may not cover dental surgeon or specialised care at all. Check the fine print for your insurance policy.

There are also the usual exclusions for pre-existing conditions, so if you were aware of the need for dental implants at the time you took out the policy, then your claim will be void.

Government assistance

Basic dental services are free for all under-18’s. While dental implants are not recommended for young children, this could be an option worth asking your dentist about.

Some dentists may offer discounts for over 65’s or those with a community services card. You may also be able to apply for a special needs grant to pay for some dental processes, contact Work and Income to find out more.

Does private health cover dental implants?

As long as it’s not a known pre-existing condition, then it may be covered under your insurance policy, depending on the comprehensiveness of the cover. You need to find out what is covered on your insurance plan. Check:

  • If dental implants are covered
  • If there is a maximum spend that’s covered
  • What the excess is, if any

Speak to your dentist

If you are not covered by ACC or insurance, speak to your dentist. They may be able to provide a payment plan for your dental implants or do the work in stages as you can afford it. Dental treatment is too important to your overall health and wellbeing to ignore.