If you’re in this growing group it’s a good idea to know your options for what may be a significant expense. Below, we’ll discuss:
- How much you may pay for dentures without insurance.
- Whether or not dental insurance covers dentures and what to be aware of.
- Whether or not Medicare covers dentures.
- Other options you may have to curb the cost of dentures.
How Much Do Dentures Cost Without Insurance?
There are several factors that can impact the cost of dentures, including:
- Whether you get full or partial dentures.[1]
- The quality of the material the dentures are made of: typically either acrylic resin or porcelain.[2]
- The process for making the dentures, typically either cold-cured or heat-cured.[3]
- Where you live since the cost of care varies by location.[4]
- The amount of care required to fit and maintain the dentures, including removing teeth to fit dentures and replacing dentures if they break.[5]
Below is a list of some sample costs associated with dentures and their related care. Remember, costs vary depending on your location and how much and what type of dental care your specific situation requires.
- Routine tooth removal: $112-$294+ per tooth.[6]
- Surgical tooth removal (including bone): $183-$479+ per tooth.[7]
- Complete set of dentures (upper or lower jaw): $1,072-$2,814+.[8]
- Partial dentures with resin base: $740-$1,943+[9]
- Partial dentures with cast metal framework: $1,140-$2,993+.[10]
- Denture repair: $126- $330+.[11]
When it comes to the estimated cost of your dentures and related care make sure to get that information from your provider. And check with your dental insurance before-hand to find out what portion of your costs will be covered.
Does Dental Insurance Cover Dentures?
Most dental policies include some level of coverage for dentures.[12]
However, there are some important things to keep in mind that may limit the value of dental insurance if you’re facing the cost of dentures:
- Classification of care and coverage levels
- Annual benefits limit
- Waiting period
- Missing tooth exclusion
50% Coverage: Because of the way that dental insurance is structured, some procedures (like dentures) are covered at a lower rate than other procedures (like routine exams). Dentures are typically only covered at 50% or less.[13]
Annual Benefits Limit: Remember, your dental policy has an annual benefits limit that is typically around $2,000 or less.[14] Between the lower coverage level and benefit limit, there’s a good chance you’ll be paying for the majority of the cost of your dentures out of pocket.[15]
Waiting Period: Make sure to find out about any waiting periods associated with your current policy or any policy you’ve considered as many policies have a waiting period of 6-12 months for major procedures (including dentures).[16]
Missing Tooth Clause: You may find that some dental policies have a “missing tooth exclusion.” Essentially, it means the policy won’t cover the costs of care related to care or replacement of a preexisting missing tooth.
Most applicants for dental policies are accepted regardless of health history. Rates are usually based on age and where you live, and exceptions or waiting periods may be instituted.
Compare dental insurance costs and coverage.
Does Medicare Cover Dentures?
Traditional Medicare won’t pay for dentures, but Medicare Part A (hospital insurance) might cover some of the medical prep work if the dentures are needed for a health reason, such as the reconstruction of the jaw following an injury. There are some Medicare Part C (Medicare Advantage) plans that will cover some dental procedures.[18]
Other Options to Curb Out-of-Pocket Costs for Dentures
Even with coverage, dentures usually come with significant costs. If your dental insurance plan does not cover dentures completely (or at all), there may be ways to cut your out-of-pocket costs:
Discount plans: While discount plans are not insurance, they may offer savings of up to 40 to 50%. Discount plans represent a group of dentists who have negotiated discounts and fixed prices for specific dental procedures. After you make sure the plan covers dentures, it’s a good idea to check that the participating dentists in your area don’t have long waiting lists for new patients.[19]
HSA or FSA funds: If you have a flexible spending account (FSA) or health savings account (HSA) through your employer, you may be able to use it.[20]
Medicaid: More than 30 states cover dentures, usually with some limits.[21] PACE (Program All-Inclusive Care for the Elderly) is part of Medicaid and may provide some coverage.[22]
Ask for a discount: Find out if your dentist offers a discount for paying cash up front. Ask if they offer an option to pay in installments.
Dental schools: Some dental school clinics take patients. Students perform supervised treatments that usually come at a reduced cost.[23]
Some nonprofits may offer assistance to low-income seniors needing dentures. Churches and senior centers may be good sources of information.[24]
Summary + Next Steps
Dentures or implants can cost several thousand dollars. And while many dental plans provide some level of coverage, it’s usually only after a waiting period, at a coverage rate of just 50% or less, and won’t cover anything beyond your annual benefits limit.
You can pursue alternatives to dental insurance to try to reduce your costs or obtain discounted services. Still interested in dental insurance?
Get a dental insurance quote today. It just takes a couple of minutes to compare a few different plans. You can also call (888) 855-6837 to speak with an insurance agent to discuss your options for coverage.
