Does BadgerCare Cover Dental Implants? A Wisconsin Guide to Your Dental Benefits and Alternatives
If you’re here, there’s a good chance you or someone you love is trying to piece together a dental puzzle: “Will BadgerCare pay for dental implants if I need one (or more) teeth replaced?” It’s a question filled with hope—and maybe a little anxiety. Missing teeth can shake your confidence, take a bite out of your daily comfort, and have a ripple effect on your health. Let’s sit down together, unpack your options, and help you step forward with answers—not confusion.
In This Article
- Does BadgerCare Plus Cover Dental Implants for Adults?
- Why Are Dental Implants Usually Excluded from Medicaid?
- What Dental Services Are Covered by BadgerCare for Adults?
- Covered Tooth Replacement Alternatives: Dentures, Bridges, and More
- How Much Do Dental Implants Cost in Wisconsin?
- Affordable Ways to Get Dental Implants Without Coverage
- How to Check Your Specific BadgerCare Benefits
- Key Takeaways and Your Next Steps
The Relatable Hook: You’re Not Alone in This Dental Dilemma
You take a bite of an apple—or just try to smile—and right away you remember the empty spot where a tooth used to be. Or maybe your dentist just told you: “You might do best with a dental implant, but insurance probably won’t help.” If you’re on BadgerCare Plus here in Wisconsin, your next question is both practical and urgent: “Does BadgerCare cover dental implants?”
First, it’s totally normal to feel a little lost. Dental benefits can be confusing! Everyone wants to chew, talk, and smile without worry—and if you’ve heard how helpful implants can be, it makes sense to ask if they’re covered. Let’s tackle your core question right away, no fluff.
Does BadgerCare Plus Cover Dental Implants for Adults?
Short Answer: Mostly, No—Implants Aren’t Covered for Adults
BadgerCare Plus, Wisconsin’s Medicaid program, does not usually cover dental implants for adults (that means anyone 21 or older). Most people on BadgerCare who need a tooth replaced will hear a simple “no” if they ask about getting an implant paid for.
Why not? Dental implants are called major tooth replacements—they are fancy, often called cosmetic, and cost a lot. Medicaid, including Wisconsin’s BadgerCare, is set up to pay for basic and needed care, not big or “nice to have” treatments—even if those treatments feel “needed” to you.
Does BadgerCare Ever Make an “Exception”?
To be real: In super rare cases—like if someone’s mouth can’t handle regular dentures due to a special, proven medical problem—there might be a way to get coverage, but only if a dentist can show BadgerCare (with lots of paperwork) that an implant is truly needed and nothing else will work. Even then, approvals are extremely rare. For almost all adults on BadgerCare, dental implants are not offered.
Children and pregnant women sometimes have more dental coverage under BadgerCare, but implants almost always stay off the list.
Why Are Dental Implants Usually Excluded from Medicaid?
You might wonder, “But isn’t chewing food and smiling with confidence important for health?” You are right. The problem is about how Medicaid—BadgerCare too—spends its limited dental dollars.
It’s About Cost, Policy, and Definitions
- Cost: One dental implant in Wisconsin can cost $3,000–$6,000 for each tooth. Full sets can quickly go into tens of thousands. Compare this to the price of a denture or bridge and you see why implants are much more expensive.
- Policy Aim: BadgerCare wants to help as many people as possible. That means focusing on cleanings, fillings, pulling teeth, and dentures. It’s a way to spread the money to help everyone.
- “Medical Need” Rules: Medicaid has strict rules for what counts as “needed for health” and what’s “just nice to have.” Implants almost always get listed as “not needed for health”—unless your dentist can show your whole mouth is at risk without them, and nothing else will work.
You’re Not Alone: Most States Do the Same Thing
Only about 16 states offer “lots of” adult dental benefits with Medicaid; in most, adults only get basic or emergency care. Implants are almost never part of the benefits. BadgerCare’s rules for dental implants are normal compared to the rest of the country.
What Dental Services Are Covered by BadgerCare for Adults?
If implants are not covered, what can BadgerCare help pay for? There are actually quite a few things you can get. Here’s a quick look at what adults can expect from BadgerCare Plus—so you aren’t left wondering.
What BadgerCare Will Cover (for Adults, 21+)
These benefits are for keeping you out of pain and in the dentist’s office, but they don’t pay for most high-tech solutions like implants or work just to make your teeth look better.
Covered Tooth Replacement Alternatives: Dentures, Bridges, and More
If you can’t get an implant with BadgerCare, what can you get to fill the gap in your smile and in your chewing? Here’s what you need to know:
Full and Partial Dentures
BadgerCare will usually cover full dentures if you have lost all your teeth in the upper or lower jaw, or partial dentures when only some teeth are missing.
- Good things: Cheaper, no surgery, easier to get paid for by BadgerCare.
- Not so good things: Can feel bulky, might slip, and takes time to get used to. Adjustments and new sets are covered, but not all the time.
Dental Bridges
A fixed bridge uses the teeth next to the gap to hold a fake tooth in place. BadgerCare’s rules for bridges are strict—you often need to get it approved and show nothing else will work.
- Good things: More solid than a denture; doesn’t come out.
- Not so good things: Doesn’t work for everyone who’s missing teeth, and isn’t always covered. Making a bridge usually means grinding down nearby teeth.
Tooth Extractions
Sometimes, the only thing that is covered is pulling out the bad tooth and leaving the space. Not great, but BadgerCare will always pay for extractions if a tooth is hurting or infected.
Tip: Removable things like dentures might be big and take some getting used to, but they can help you chew and smile—often with no or little cost under BadgerCare.
How Much Do Dental Implants Cost in Wisconsin?
To be honest—implants cost a lot, especially if you’re paying yourself. But if you still want to think about getting one (or more) by paying on your own, it’s smart to check prices first. Here’s the real story:
Cost for Dental Implants
- One Dental Implant: $3,000 to $6,000 per tooth, from start to finish.
- Full Mouth (like “All-on-4” Implants): $20,000–$50,000+ for the top or bottom, or $40,000–$90,000 for everything.
- Why do prices change?: Prices depend on:
- How experienced your dentist is.
- What kind of metal or ceramic they use.
- Where the office is—big cities can be more expensive.
- If you need extra work, like adding bone.
Also: Even if you pay just for the implant (the little post in your jaw), you still have to pay for a connector piece (abutment) and a crown (the “tooth” you see). Each part puts the price up.
If you want to see how a crown and bridge lab makes the crowns or bridges you might get, check out their info.
Affordable Ways to Get Dental Implants Without Coverage
If you really want implants and can’t get them through BadgerCare, there are ways to make it cost less or to pay over time. Here are some real-world choices:
1. Dental Schools in Wisconsin
Both the Marquette University School of Dentistry and the University of Wisconsin’s dental programs have clinics run by students, with supervision. These treatments usually cost 30-50% less than normal dentist offices, and there are teachers watching over the student work. Sometimes they do special projects for certain treatments, or let you pay what you can.
2. Community Health Centers & Free or Low-Cost Clinics
Wisconsin has lots of clinics in the community that help people with little money. Many have sliding scales or payment plans—some even do implants, though spots are limited.
3. Discount Dental Plans
These aren’t insurance, but if you pay for membership you get 10-60% off the price of implants and other work at dentists who take those plans. It’s worth it if you need a lot of work.
4. Payment Plans & Dental Financing
Many dental offices now partner with companies (like CareCredit or LendingClub) to let you make payments. Some have no interest for the first year or more, but you have to read the details.
5. Grants and Charities
Sometimes, private groups or dental charities (like the Wisconsin Dental Association’s Mission of Mercy) offer some money for special cases. There’s a lot of people applying and not much money, so apply early and don’t count on this alone.
6. Clinical Trials
Sometimes dental schools or hospitals need volunteers for new studies. You could get a cheap (or free) implant in exchange for taking part.
Tip: If you want nice dental pieces for a lower price, working through your dentist with a digital dental lab can also help.
How to Check Your Specific BadgerCare Benefits
Even with all the usual rules, your own BadgerCare plan could be different. Here’s how to get clear answers—so you don’t get surprised when it’s time to pay.
- Use the number on the back of your ForwardHealth card, or go to the ForwardHealth website.
- Ask: “Can you tell me exactly which dental services my plan pays for? Is there a way to get implants?”
- If your dental coverage comes from a certain health plan, call their customer service number.
- Check your BadgerCare Member Handbook for the rules.
- Dentists who work with BadgerCare patients know the rules. They can tell you what’s covered and help with forms, if you’re trying for a rare exception.
- Good dentists will also tell you the real cost, payment plans, or where you could go for cheaper care.
Don’t be afraid to keep asking—being the one with all the questions can save you some big bills later.
Key Takeaways and Your Next Steps
Let’s wrap things up so you can walk away sure of where you stand—and what you can do next.
The Basics on BadgerCare & Dental Implants:
- BadgerCare Plus almost never covers dental implants for adults. They cost too much and are seen as “not needed for health.”
- Other things covered include pulling teeth, dentures (full or partial), and sometimes bridges—with lots of rules.
- If you want implants, plan to pay yourself or look for deals at dental schools, clinics, or studies.
- Costs for implants in Wisconsin are $3,000–$6,000 for one tooth, and way more for a full set.
- You’ve got choices! Dental schools, discount plans, and payment help can make things more affordable.
- Always check your own plan—and ask your dentist for help with paperwork or advice.
What to Do Next:
Still have questions about teeth replacements? Want more info about dental implant solutions or how some dental problems can mess with your smile? Our explainer guides on dental problems are a smart place to look next.
Final Thoughts: You Deserve Clear Answers and a Healthy Smile
Figuring out insurance—especially public programs like BadgerCare—can feel like a maze. But remember, you aren’t alone, and it’s OK to want good, strong, and long-lasting ways to replace teeth.
Whether you use the normal coverage or find a creative way to get implants, what matters is taking charge of your dental choices. Take things one step at a time, keep asking lots of questions, and get help from programs, clinics, or dentists who speak plain and clear. Your smile (and your confidence) are worth it.
Quick FAQ
Does BadgerCare Plus cover dental implants for adults?
No, not under normal rules. Only in very rare, clearly proven cases.
What’s the cheapest way to replace a missing tooth on BadgerCare?
Removable dentures or partials are mostly covered and cost least. Dental bridges can be hard to get covered.
If I pay myself, how much should I plan on?
Figure $3,000–$6,000 for one implant (with the crown), and much more if you need several.
Where can I find cheap or discounted implants?
Try dental schools, community health centers, discount plans, and studies.
Can I call someone to check my BadgerCare dental benefits?
Yes! Call ForwardHealth Member Services or your plan’s customer service to find out.
Want to know more about how crowns or removable dentures are made? Visit a removable denture lab page for a look behind the scenes.
Take the next step for a healthier smile today. Knowing a little bit now can save you lots of worry later!
References:
- Wisconsin Department of Health Services, BadgerCare Plus Dental Benefits [official handbooks and policy manuals]
- National Association of Dental Plans, Medicaid Adult Dental Coverage Report, 2019
- American Dental Association (ADA), Medicaid Dental Benefits
(This article is not a replacement for real advice from a medical or dental professional. Always check with your dentist and plan for what is true for you.)
