Does Delta Dental Cover Dental Implants? A Clear, Step-by-Step Guide to Your Coverage (2024)

If you’re staring at a missing tooth in the mirror—or worried about the big cost of dental implants—you’re probably asking yourself: “Will my Delta Dental insurance help pay for implants? How much will they cover? What should I know before starting treatment?” These are good, and very common, questions. If you’re reading this, you’re already making a smart first move: getting the facts!

Dental implants can change your smile, help you feel better about yourself, and let you eat without worrying about that space in your mouth. But let’s be honest, they cost a lot. Knowing just what your insurance will pay for (and what it won’t) can make getting implants much less confusing.

Let’s break it down, step by step—with no confusing words, no tricks, and lots of easy tips for what to do next.

In This Article

• Quick Answer: Does Delta Dental Cover Implants?
• Understanding Delta Dental Plans and Implant Coverage
• Dental Implant Procedure: What’s Covered (and What’s Not)
• Maximizing Your Delta Dental Implant Benefits
• Cost Breakdown: What to Expect Out-of-Pocket
• How to Confirm What Your Plan Really Covers
• Are You a Good Candidate for Dental Implants (With Insurance)?
• Your Healthy Takeaway: Key Points & Next Steps

Quick Answer: Does Delta Dental Cover Implants?

Let’s get right to it:

> Short answer:

> It depends on your Delta Dental plan. Most Delta Dental PPO and Premier plans can help pay for dental implants—usually covering 25-50% of the cost after your deductible and waiting period. DeltaCare USA (DHMO) plans almost never include implants and may suggest cheaper options.

Here’s why you need to be sure about your coverage:

• Implants are a “major service.” Not all plans cover major work, and some limit what “major” includes.
• Waiting periods, yearly maximums, and “missing tooth” rules can get in the way. These details can lower your coverage, make you wait, or say no to implants for teeth you lost before the plan started.
• You may still pay a lot yourself. Even if insurance helps, getting all the info early can stop any surprises.

We’ll help you understand what is written in the small print, see the real costs, and get the most for your money. Ready? Let’s go.

Understanding Delta Dental Plans and Implant Coverage

Choosing dental insurance isn’t just about strange letters—PPO, DHMO, Premier, and so on! Each Delta Dental plan covers implants in its own way. Here’s what you need to know—no confusing talk.

Delta Dental PPO: Best for Implants

• What it is: PPO means Preferred Provider Organization. It lets you pick your dentist (in or out of Delta’s network).
• Implants: Most PPO plans pay for implants as “major service”—about 25-50% after your deductible and any waiting time.
• Fine print: Yearly maximums (usually $1,000-$2,500) and missing tooth rules (which can block parts of your treatment).

Delta Dental Premier: More Dentists, Similar Rules

• What it is: Premier plans work with lots of dentists and pay them a set amount.
• Implant coverage: Similar to PPO—sometimes with a little more allowed, but the same rules for waiting and yearly maximums.

DeltaCare USA (DHMO): Less Flexible

• What it is: DHMO means you choose one main dentist and usually need approvals to see a specialist.
• Implants: Rarely covered. DeltaCare USA mostly says no to implants, but it might pay for other options, like bridges or dentures.
• Special rules: Even if you can get an implant, you have to use their dentist and follow their steps.

Federal, Medicare Advantage, and Medicaid Delta Dental Plans

• Federal employee plans: Some higher-level choices help with implants, but many basic ones do not.
• Medicare Advantage/Medicaid: If these cover dental at all, they mostly do NOT cover implants, or coverage is very limited.

What Really Matters for Your Coverage?

• Is the treatment needed for your health? Insurance covers implants for eating and talking, usually not just to look good.
• Missing tooth rule: If your tooth was gone before the plan started, you may not get coverage.
• Waiting period: Many plans make you wait 12-24 months before helping with implants.
• Annual max: This is the MOST your plan will pay in one year for ALL dental work.
• Deductibles and copays: You often pay a set amount first (deductible) and part of the rest (coinsurance or copay).

Bottom Line:

Not all Delta Dental plans are the same! Always read your own policy (or call Delta Dental) before you start.

Dental Implant Procedure: What’s Covered (and What’s Not)

Getting an implant takes a few steps—not all are paid for by insurance. Here’s how it usually goes.

Step-by-Step: What Delta Dental Might Pay For

• What it is: X-rays, maybe a scan, and a full mouth check.
• Coverage: Usually these are covered as “diagnostic” care.

• What it is: Taking out the problem tooth.
• Coverage: Usually covered as “basic” care.

• What it is: Sometimes the bone needs to be built up to hold an implant.
• Coverage: Sometimes paid for as “major service,” at 25-50%. Other times not, unless really needed.

• What it is: Surgeon puts the metal piece into your jaw.
• Coverage: If implants are included, this is “major service,” usually at 25-50%, up to your yearly max.

• What it is: The piece that connects the implant to your new tooth (crown).
• Coverage: Sometimes paid for with the crown, sometimes as another “major” step.

• What it is: The fake tooth you can see.
• Coverage: If included, this is “major” and covered up to plan limits.

Common Things Not Covered

• Cosmetic-only implants (just for looks, not health)
• Special implant types or new surgeries
• Problems with older dental work
• Implants for teeth lost before you had the plan
• Experimental stuff

> Tip: If you need “All-on-4” (full set of implants at once) or mini implants, check your plan—these are often not covered or handled differently.

Looking for good, natural-looking teeth? Some people go to a dental ceramics lab for realistic crowns or bridges—the important thing is to double-check your plan covers those choices.

Maximizing Your Delta Dental Implant Benefits

Insurance can feel like a puzzle—here’s how to keep as much money in your wallet as you can.

1. Get a Pre-Treatment Estimate (Pre-Authorization)

Ask your dentist’s office to send a pre-treatment estimate to Delta Dental before you start. This takes away the guesswork.

• What you get: What Delta Dental will pay, what you will owe, and if anything is denied—before you begin.
• Why it helps: No surprises!

2. Read Your Plan Carefully

Not fun, but it’s worth it. Know your yearly max, deductible, what percent they pay, and any “gotcha” rules.

• Check your booklet online or call Delta Dental.
• Look for “implant coverage,” “major services,” and “missing tooth rule.”

3. Use Dentists in Delta’s Network

Delta Dental pays more—often a lot more—if you stick with dentists in their network.

• How to find one: Look on Delta Dental’s website or ask your dentist’s front desk.
• Why it matters: Out-of-network dentists can charge more, and you might pay the extra amount.

4. Split Treatment Over Two Years

Implants take months—this helps you!

If you have one part in December (like pulling the tooth and graft) and the other part next year (the implant and crown), your yearly max can help more.

Example:

• Year 1 (October): Extraction + graft ($1,900, maxed at $1,000 paid)
• Year 2 (January): Implant + crown ($3,500, another $1,000 paid)

5. Pick Cheaper Alternatives if Needed

Sometimes a bridge or removable denture lab can be covered more (even if it’s not the best long-term answer).

6. Use FSAs, HSAs, or Payment Plans

You can use Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) for dental implants—saving you on taxes. Some dentist offices also let you pay over time.

Cost Breakdown: What to Expect Out-of-Pocket

Let’s get real. No one likes a surprise bill, especially when dental work costs a lot.

Average Dental Implant Costs (USA, 2024)

• Implant post (the screw part): $1,500 – $3,000
• Abutment and crown: $1,500 – $3,000
• Full cost (one tooth, no big extras): $3,000 – $6,000
• Bone work (if needed): $500 – $2,500 more
• Several teeth or all teeth (“All-on-4”): Over $20,000 for hard cases

What Makes Your Cost Go Up or Down?

Sample Cost Scenarios

Say you have Delta Dental PPO which pays 50% for major work, a $1,000 yearly max, and you haven’t used any yet this year.

One Tooth Implant (Post + Abutment + Crown)

• Total cost: $4,500
• Delta Dental pays: up to $1,000 (maxed out)
• You pay: $3,500 plus your deductible

If You Need Bone Graft ($1,000 more)

• Total: $5,500
• Delta Dental still pays only $1,000 (hits yearly max)
• You pay: $4,500 plus deductible

Using Two Calendar Years (Spreading Care Out)

• You might get $2,000 covered ($1,000 this year, $1,000 after January)
• You pay: $3,500 plus two deductibles

All plans are different! Always ask for a pre-treatment estimate for YOUR numbers.

For the best natural look, ask about teeth made at a zirconia lab or implant dental laboratory. While the material doesn’t always change what’s covered, it does affect how well your teeth look and last.

How to Confirm What Your Plan Really Covers

You don’t need to know everything about insurance—just follow these steps to make the most of your Delta Dental benefits:

1. Read Your Plan Booklet

Find the parts on “dental implants,” “major services,” and “what’s not covered.”

• Usually online in your Delta Dental member area.
• If you have dental from work, check the HR website or ask HR.

2. Log In to Your Delta Dental Online Account

You can:

• Check if you met your deductible
• See your yearly max left
• View covered and non-covered treatments
• Download info you need

3. Call Delta Dental Support

Have your member ID ready. Be clear! Ask:

• “Does my plan pay for D6010 (implant) or D6057 (abutment)?”
• “Is there a waiting time for major work?”
• “Do I have a missing tooth rule?”

Write things down—a lot of people ask these questions every day.

4. Ask Your Dentist’s Team for Help

Dental offices see this stuff all the time. They can send a pre-treatment estimate to Delta Dental, check your plan, and help plan your care around your insurance.

Are You a Good Candidate for Dental Implants (With Insurance)?

Getting a dental implant is kind of like planting a root for a fake tooth! Not everyone should get them, and insurance rules mean you need to check where you stand.

Good Candidates

• Adults missing one or more teeth (don’t wait too long after tooth loss)
• Healthy gums, no gum disease
• Enough jawbone (or can grow the bone with a graft)
• Non-smokers (or trying to quit)
• Healthy overall (some health issues may slow healing)
• Insurance with “major service” coverage, and no missing tooth rule

Who Should Look into It More

• Kids and teens (maybe okay for older teens with grown jaws)
• People on some medicines (like certain bone medicines)
• Heavy smokers or folks with un-managed diabetes (slower healing)
• Anyone whose insurance doesn’t cover implants or already used up their yearly max

Tip: If insurance won’t help with implants, but you still want a comfortable and cheaper replacement, ask about partial dentures or bridges. These are often made at a crown and bridge lab.

Your Healthy Takeaway: Key Points & Next Steps

Here’s a quick summary for using your Delta Dental and getting the best smile:

Key Points (Don’t Forget!)

• Not all Delta Dental plans help with dental implants. PPO or Premier plans are usually best.
• Coverage is about 25-50% of “major work”—but up to your yearly max only.
• Bone grafts, connectors, and crowns might have different rules or not be covered.
• Watch for waiting times (12–24 months is common), missing tooth rules, and deductibles.
• Even with insurance, you may still pay $3,000–$6,000 for each implant.
• Get a pre-treatment estimate. That’s your protection against big surprises.
• Use dentists in Delta’s network and split big treatment over two years if you can.
• Cheaper options like dentures or bridges may be covered more, but may not last as long.

Your Next Steps: Take Control

A great smile starts with good info. Whether you’re missing one tooth or many, now you know the right questions to ask and how to work with your plan—so you can get back to smiling for years to come.

Want more about implants, crowns, or dentures? Check out topics like dental implant basics, dental problems, or how a china dental lab can deliver good dental work, wherever you are.

That’s a lot to think about… but don’t worry! With the right info and team, you can look forward to a healthy, happy smile.