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Medicare does not cover most basic dental procedures, like cleanings, fillings, tooth extractions, or dentures. However, Medicare Part B has coverage for some dental surgical procedures, and we may be able to help you. Such as removal of infection or cyst along with bone grafting and biopsies if needed.
Such as Accidents or Injuries to the mouth, teeth, or jaw under your medical plan.
With all medical claims, we must do a Pre-Authorization, and your Medical Deductible has to be met before they will pay. If Dr. Gordon is considered OUT OF NETWORK, they will recommend you find a dentist IN-NETWORK. However, most general dentists do not file Medical claims, and there is a Medical GAP Exclusion that can be filed.
“Medically necessary is defined as a treatment or service that is required in order to treat a specific injury, illness, disease or condition.
It is important to keep in mind that Medicare will not cover oral surgery that is solely intended to treat your teeth, such as the installation of bridges, crowns, or dentures.
If you require this type of surgery, you will likely pay the full cost of your treatment unless you have dental insurance or a Medicare Advantage (Medicare Part C) plan that offers dental benefits.”
Often if you have an infection in the jaw, Medicare will pay for the process to remove the infection and have a bone stabilizer placed. The bone stabilizer is the “dental Implant.” A dental Implant is three parts; the next two parts, the abutment and the crown, are covered by the patient or the patient’s supplemental insurance.
To get an idea of cost, you must come in for new patient consultation, including a CBCT scan (x-ray), to see if you qualify and determine your portion. Dr. Gordon will often discount this part of the treatment.
Please note We cannot offer a FREE consultation to Medicare patients. Medicare will be billed for your visit. As long as your $198 yearly deductible has been met, your visit should not cost you anything.