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AB 2994, Brulte. Health insurance: benefit coverage. ... upper or lower jawbone, or associated bone joints. ... This bill would provide that any provision of a prescribed health care service plan contract that excludes coverage for these surgical procedures shall have no force or effect if that provision results in any failure to provide medically-necessary services, as specified.
It would also require certain individual and group policies of disability insurance and certain nonprofit hospital service plans to provide coverage for these procedures except with respect to dental services, if each procedure being considered for reimbursement is deemed medically-necessary pursuant to the plan's or policy's definition of medical necessity.
FAQ's
Is there coverage for Dental Implants?
Generally No. See below for additional information and suggestions.
Dental implants may be thought of as artificial tooth roots which allow the fabricated teeth to be firmly attached to the mouth. One may consider the jaw bone as a piece of wood and a dental implant as a screw Dr. Dorfman's DDS Website Photo's Boston Dental Implants Website (Archive.org) Smile Implant Center.com
Taxes You can include in medical expenses the amounts you pay for dental treatment. This includes fees paid to dentists for X-rays, fillings, braces, extractions, dentures, etc. including artificial teeth IRS Publication 502 Page 5 & 7
Implants are done when one doesn't want a bridge because it more permanent and look better even in the back of the mouth and in view of this it's considered cosmetic.
Unfortunately, implants are not a covered benefit. However, it is possible that Delta would provide an allowance for the covered benefit. It's best that the enrollee ask their dentist to submit a pre-determination to Delta so that Delta can determine the covered benefit (if any) and the enrollees responsibility for payment in advance.
Limitations: The replacement of lost or stolen dentures, crown and bridge work, dental procedures and charges incurred as part of implants (placement or removal) and prosthetic devices placed on implants (fixed or removable, for example: bridges, crowns) are not covered. Smile Saver Brochure
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