Does Delta Dental Cover Implants? What You Need to Know Before You Book

By Dr. Mason Haddow

Yes, Delta Dental may cover dental implants, but it depends entirely on your specific plan, provider network, and whether the treatment is considered medically necessary.

Dental implants are one of the most effective, durable, and natural-looking solutions for replacing missing teeth. But they’re also one of the most expensive. So if you’re covered by Delta Dental, the big question becomes: Will they help cover the cost?

In this article, we break down Delta Dental’s implant coverage across PPO and DeltaCare USA plans, outline what’s included (and what’s not), and give you practical tips for making treatment more affordable, even if you’re facing limitations.

Key Takeaways

✔ Delta Dental PPO plans may cover 50% of implant costs, subject to max limits
✔ DeltaCare USA plans typically don’t cover implants, but may offer fee discounts
✔ Pre-authorization, in-network care, and medical necessity are key to approval
✔ Related services (grafts, crowns, scans) may require separate billing
✔ Use FSA/HSA funds, staged treatment, or financing to ease uncovered costs

What Are Dental Implants and Why Are They Popular?

Dental implants are artificial tooth roots, usually made from titanium, that are surgically placed into the jawbone. Once healed, they’re topped with an abutment and a crown, bridge, or denture to restore function and aesthetics.

Why they’re preferred:

Long-lasting (15–25+ years)
Natural look and feel
Prevent bone loss in the jaw
Improve speech, chewing, and confidence

Compared to bridges or dentures, implants are more stable and preserve oral health better over time.

Does Delta Dental Cover Implants? The Short Answer

Sometimes yes—but coverage varies by plan.

Delta Dental PPO plans may offer partial reimbursement (typically 50%) under major restorative services
DeltaCare USA (HMO-style) plans usually exclude implants or offer discounted fees only
Approval depends on factors like medical necessity, pre-authorization, and in-network provider usage

In short: Don’t assume, check your benefits first.

Delta Dental PPO Plans: What’s Covered?

If you’re enrolled in a Delta Dental PPO plan, you’re in a better position to receive coverage for implants. Here’s what these plans typically offer:

Coverage Percentage: Around 50% after deductible
Annual Maximum: $1,000–$2,500 per person per year
Pre-treatment Estimate: Strongly recommended before treatment
Covered Services May Include:
- Implant post (surgical placement)
- Abutment (the connector between post and crown)
- Implant crown
- Bone graft (if medically necessary)
- Imaging or CT scans (depending on plan)

Not all PPO plans include implant coverage automatically. Group or employer-sponsored PPO plans are more likely to cover implants than individual ones.

DeltaCare USA (HMO Plans): What to Expect

DeltaCare USA plans are structured differently. They emphasize cost predictability but come with stricter limitations.

Implants usually not covered outright
Some plans may offer discounted fees through select in-network specialists
Must use assigned primary care dentist for referrals
Alternatives like bridges or dentures are often covered instead

DeltaCare USA is great for preventive and basic care, but may fall short for advanced procedures like implants.

Do All PPO Plans Cover Implants?

Not necessarily. Some basic or budget PPO plans don’t include implant benefits. To find out, review:

Your Summary of Benefits
Plan handbook or benefit booklet
Ask your dentist to submit a pre-treatment estimate to Delta Dental

This step ensures you’ll know what portion (if any) will be reimbursed before you commit to the procedure.

What Implant-Related Procedures Might Be Covered Separately?

Implant treatment is usually multi-phased, and not all components may be included under the same claim.

Delta Dental may separately cover:

Tooth extractions (basic services)
Bone grafting (oral surgery, with documentation)
CT scans or diagnostics
Crown placement (major restorative)

Check each step with your provider to understand what will be billed separately.

What Might Cause a Claim Denial?

Even with a PPO plan, Delta Dental may deny implant-related claims for the following reasons:

The procedure is considered cosmetic, not medically necessary
You’ve exceeded your annual maximum
Pre-authorization wasn’t submitted beforehand
Treatment was performed by an out-of-network provider
Incorrect or incomplete claim coding

A good provider (like Premier Image Dentistry ) will ensure all paperwork is properly handled to avoid delays.

How Much Do Dental Implants Cost With and Without Delta Dental?

Without Insurance:

Single implant: $3,000–$5,000
Full arch (All-on-4 or All-on-6): $25,000–$50,000+

With Delta Dental PPO (If Covered):

Coverage: 50%, capped by annual benefit
Out-of-pocket: $1,500–$4,000 per implant on average

With DeltaCare USA:

No direct coverage
May offer discounted fee (e.g., $2,500–$3,500 per implant)

Are Dental Implants Covered for Seniors or Medicare Users?

Delta Dental Medicare Advantage plans often exclude implants
Preventive and basic restorative care may be included, but not surgical implants
Seniors seeking implants may benefit from a standalone PPO plan with implant coverage
Supplemental insurance or dental discount plans may also help

How to Maximize Implant Coverage with Delta Dental

Confirm your benefits before treatment
Ask your dentist to submit a pre-treatment estimate
Use in-network providers to reduce out-of-pocket costs
Time treatment across two benefit years if near your max
Use FSA or HSA funds to cover what insurance doesn’t
Ask about staged billing: post this year, crown next year

What to Do If Implants Aren’t Covered

1. Explore Alternatives

Bridges, partial dentures, or overdentures may be covered more easily.

2. Look Into Financing

At Premier Image Dentistry , we offer monthly plans and work with CareCredit to help you spread payments.

3. Upgrade During Open Enrollment

If your plan lacks implant benefits, consider switching to a better PPO option at renewal time.

4. Appeal with Documentation

Medical necessity documents, bone loss evidence, and detailed notes from your dentist may sway a denied claim.

Looking for Dental Implants in Lathrup Village, MI?

At Premier Image Dentistry , we specialize in full-service implant dentistry. Whether you’re missing one tooth or several, we provide:

Digital scans and implant planning
In-house surgical placement and restoration
Implant-supported bridges and dentures
Help navigating Delta Dental PPO and DeltaCare USA coverage
Transparent quotes and flexible payment options

Book your consultation today, let’s get you one step closer to a healthier, confident smile.

Conclusion

Delta Dental can cover dental implants, but it’s not guaranteed. Your benefits depend on plan type, treatment complexity, and how your provider submits the claim. While PPO plans offer partial coverage, DeltaCare USA often excludes implants completely.

Don’t let insurance confusion delay your care. With a little planning, some smart paperwork, and the right dental team, dental implants can be within reach.