Are Dental Implants Covered by Insurance? A Comprehensive Guide for Markham Patients

If you're considering dental implants in Markham, one of your first questions might be: Are dental implants covered by insurance? It's a valid concern—implants are a significant investment in your oral health, function, and appearance. At Hwy 7 Family Dentistry, we understand the importance of affordability and transparency when it comes to your dental care.

This guide will walk you through what dental insurance typically covers, what out-of-pocket costs to expect, and how patients in Ontario—especially in the Markham area—can plan for a dental implant procedure.

What Are Dental Implants?

Dental implants are a permanent solution to missing teeth. A titanium post is surgically placed into the jawbone, which serves as a foundation for a crown that mimics a natural tooth. They restore not just aesthetics, but also bite strength, jawbone integrity, and self-confidence.

Unlike dentures or bridges, implants are fixed in place, durable, and can last a lifetime with proper care.

Components of a Dental Implant:

• Implant post (surgically placed in jaw)

• Abutment (connector piece)

• Crown (visible replacement tooth)

Each component may be billed separately, and insurance may only cover specific parts, which is why understanding your policy is essential.

Why Choose Dental Implants?

Here are just a few reasons why Markham patients are choosing dental implants:

• Look and feel like natural teeth

• Prevent bone loss in the jaw

• Maintain facial structure

• Long-term durability (10+ years)

• No need for adhesives or removal

Are Dental Implants Covered by Insurance?

It depends. In Ontario and much of Canada, dental implants are generally not covered by public health insurance like OHIP, as they’re often categorized as cosmetic. However, some private dental insurance plans may offer partial coverage, depending on the policy and whether the procedure is deemed medically necessary.

What Determines Insurance Coverage?

Several factors influence coverage:

• Type of Insurance Plan: Basic plans often exclude implants, while comprehensive ones might include partial reimbursement.

• Medical Necessity: If a tooth was lost due to an accident or health condition, some insurers will cover the implant under major restorative services.

• Yearly Maximums: Many plans have a limit (e.g., $1,500/year), which may not cover the entire cost.

• Waiting Periods: Some policies require a 12-month wait for coverage on major procedures.

What Parts of an Implant Might Be Covered?

Here’s where it gets even more nuanced. Even if your insurance does cover implants, it might only cover certain components.

Component	Typical Coverage
Implant post	Often not covered
Abutment	Sometimes covered
Crown	Frequently covered under major restorative care
Bone graft/sinus lift	Rarely covered
Imaging (X-rays/CBCT)	Often covered as diagnostics

Why Are Implants Not Fully Covered?

Insurers tend to classify implants as cosmetic, even though they restore critical function. This outdated view is slowly changing, but full coverage is still rare.

• Cost factor: Implants are expensive. Full coverage would burden insurance pools.

• Alternative options exist: Bridges and dentures are cheaper and often covered.

• Risk and failure rates: Though rare, insurance companies factor in the surgical risk.

What Do Other Clinics Say?

We analyzed what Ontario dental clinics tell their patients:

• Marketplace Dentistry in Ontario says implants typically cost $3,000 to $6,000, with limited insurance coverage.

• Shin Dentistry confirms OHIP won’t cover implants, and insurance is often hit or miss.

• Sunshine Dentistry in Richmond Hill notes some plans reimburse 50–80%, but usually not for the surgical component.

How to Maximize Your Implant Insurance Coverage

1. Know your policy details

Read the fine print. What’s your annual maximum? Are implants included? Is there a waiting period?

2. Submit a treatment plan in advance

This gives your insurer time to determine what (if anything) they’ll cover.

3. Space out treatment

Need multiple implants? Consider doing one per year to stay within annual limits.

4. Use a Health Spending Account (HSA)

HSAs let you pay for health expenses—including implants—with pre-tax dollars.

5. Consider supplemental or add-on coverage

Some insurers allow you to purchase "major dental" as an upgrade.

Why Choose Hwy 7 Family Dentistry in Markham?

As one of Markham’s top-rated dental clinics, Hwy 7 Family Dentistry combines advanced technology, compassionate care, and expert training. Here’s what sets us apart:

• 10+ years of implant experience

• 3D imaging for precision placement

• Sedation options for anxious patients

• Personalized treatment plans

• Transparent insurance guidance

We are proud to help patients smile again with high-quality, affordable implants backed by expert care.

Frequently Asked Questions

Are dental implants considered medically necessary?

Not usually. Insurers often view them as elective or cosmetic, despite their functional value.

Can I finance the uncovered portion?

Yes! At Hwy 7 Family Dentistry, we offer payment plans and third-party financing options.

Does CDCP cover crowns on implants?

No. As of 2025, the CDCP does not cover crowns placed on implants.

How can I find out what’s covered?

Contact your insurer directly or let us submit a predetermination on your behalf.

Final Thoughts

So, are dental implants covered by insurance?

Sometimes—partially. Rarely—fully.

OHIP and CDCP won’t help, but many private plans may cover the crown or restoration portion of an implant. Navigating dental insurance is confusing, but you're not alone.

At Hwy 7 Family Dentistry, we’re committed to making your dental implant journey as affordable, transparent, and stress-free as possible.