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Medical insurance for dental care?

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

Someone here, some time ago, posted or responded to a post that they managed to get dental care covered by their medical insurer.

I visited ENT Man (ToothDude was concerned about ulceration in the oral cave but ENT Man proclaimed it non-cancerous and probably long-term radiation effect) and he said that if I could get more information about how to get medical to cover dental, he would be interested in knowing as well.

Because of trismus (mouth doesn't open as wide as it did before cancer) I have to see an oral surgeon, sometimes for xrays (panoramic xrays, they are called) and certainly for tooth extractions, since I need to be sedated.

My dental insurance is great for work done by ToothDude, but not so great for work done by an oral surgeon.

Any ideas greatly appreciated.

Take care,

Joe

Tonsil Dad's picture
Tonsil Dad
Posts: 488
Joined: Dec 2011

Hi Joe,
I am getting my teeth fixed before I go for radiation. I have Solstice 3 dental insurance.
I went in for an evaluation last week and the dentist & oral surgeon gave me a total of
$9750. for the work that needs doing then my insurance kicked in and brought it down
To $3400. which is my portion to pay so I've started the treatment. My medical insurance
Is an HMO and it covers dental and vision ( Coventry which is the old Vista Ins Co). I don't
Know what else to say only treatment on the teeth is damm expensive.

Good luck and God bless.

Tonsil Dad.

albertoderio
Posts: 1
Joined: Mar 2013

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I am interested in becoming your subscriber, so please keep me updated. I find the thoughts and opinions of this blogger, very inspiring and actually worth following. Nice work.

 

Tonsil Dad's picture
Tonsil Dad
Posts: 488
Joined: Dec 2011

Hi Joe,
I am getting my teeth fixed before I go for radiation. I have Solstice 3 dental insurance.
I went in for an evaluation last week and the dentist & oral surgeon gave me a total of
$9750. for the work that needs doing then my insurance kicked in and brought it down
To $3400. which is my portion to pay so I've started the treatment. My medical insurance
Is an HMO and it covers dental and vision ( Coventry which is the old Vista Ins Co). I don't
Know what else to say only treatment on the teeth is damm expensive.

Good luck and God bless.

Tonsil Dad.

jtl's picture
jtl
Posts: 420
Joined: Sep 2011

I looked into this a while back. From what I found it is a real struggle to get Medicare to pay for post radiation issues involving teeth. If I needed a bunch of stuff done I would probably go to Mexico.

denistd's picture
denistd
Posts: 490
Joined: Apr 2009

You may be referring to me Joe,I got my teeth problems covered 100% by my health insurance and Medicare. I have a very simple Medicare supplement with Blue Shield, only costs $39 a month and that includes part D. I started to have teeth problems a few months after radiation, I had 5 teeth removed before radiation, this was covered except for a $100 co-pay. 6 months after rads I had 20 sessions of HBO, 3 teeth pulled and then 10 more sessions. All was well until June of 2011, the remaining teeth had to come out. My rad onc at Hershey Med (Penn State) wrote a letter explaining that the teeth situation was a result of radiation and therefore, to save any problems with my jaw at a later date, it was essential that they be removed immediately and it was medically necessary. He referred me to an oral surgeon who also talked with Blue Shield. They agreed to cover it. I did have to go through HBO again, and then they all came out, total cost was over $20,000, not including the HBO which was also covered at 100%, and I did not have to pay a penny. Denis

longtermsurvivor's picture
longtermsurvivor
Posts: 1780
Joined: Mar 2010

My wife has had surgery done there at a fraction of the cost.

I think what you said is basicallly correct. Don't have much experience with it, but I think it depends largely on whether someone can create a diagnostic code that allows this to be filed on medical insurance. For instance, the various treatments for "osteoradionecrosis" can be justified as medical treatments of a bone problem, not dental treatments. But that takes some creative billing, and obviously won't work for all things dental.

Noellesmom
Posts: 1293
Joined: Aug 2010

Because Jim's dental care (full mouth extractions) was related to cancer, our major medical had no problem covering it.

soccerfreaks's picture
soccerfreaks
Posts: 2801
Joined: Sep 2006

Thanks to all who commented. The information is greatly appreciated and I am particularly interested in the notion of how the service is coded. I will not be going to Costa Rica any time soon, regrettably, but do seek solutions with some of the other ideas mentioned.

Take care,

Joe

D Lewis's picture
D Lewis
Posts: 1523
Joined: Jan 2010

Nice to see you around again.  I hope all is well.  

 

With regard to my dental needs, I believe my dentist was able to code some of my treatments as medical, rather than dental.  I never saw the details, but a lot of the last minute work happened without my ever seeing a dental bill.

Deb

luv4lacrosse's picture
luv4lacrosse
Posts: 1385
Joined: Jul 2010

I agree with Pat. I have Delta Dental and their contract pays for cleanings and routine care on a semi annual basis. Since I had bilateral rads to the neck, my Dentist wanted to see me every 90 days. I had my Rad Onco send a letter to Delta agreeing with my Dentists treatment plan. I have also been very fortunate to have no dental issues to date since completing Rads in Oct of 2010 that would require an Oral Surgeon.

Mike

donna b
Posts: 13
Joined: Mar 2013

Does anyone know if dental insurance is possible to buy after cancer, with radiation? I have no dental insurance since I retired as a teacher(only medical) and not quite old enough for Medicare. Even with Medicare, in 5 months, how will I get help paying?

donna b
Posts: 13
Joined: Mar 2013

Does anyone know if dental insurance is possible to buy after cancer, with radiation? I have no dental insurance since I retired as a teacher(only medical) and not quite old enough for Medicare. Even with Medicare, in 5 months, how will I get help paying?

donna b
Posts: 13
Joined: Mar 2013

Does anyone know if dental insurance is possible to buy after cancer, with radiation? I have no dental insurance since I retired as a teacher(only medical) and not quite old enough for Medicare. Even with Medicare, in 5 months, how will I get help paying?

backachedp
Posts: 124
Joined: Oct 2009

My Husband has had so many Dental issues and we have had the ENT and Radiation Dr and other Dr's send letters to our Inusrance saying it was due to radiation and Chemo...to no avail...Bob is still awaiting the arrival of his Dentures....he seems to think they will help his swallowing issues but it won't.  Swallow Dr say's Feeding Tube and it is very important as he will continue to get Aspiration Phemonia and at some point it will do so much damage...well it is not looking good.  I am excited for him to get his teeth but it is all so unfair when he had perfect teeth before he got Cancer...we have to fight over every bill...we just got new Insurance as of March 1st so we will see if the coverage is any better...

Skiffin16's picture
Skiffin16
Posts: 8062
Joined: Sep 2009

D, and others...

This is actually an old post revived by a newbie I believe...

Joe has been off of the site since around last August September range...

JG

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