Teeth removal for HPV cancer: how to get insurance for replacement?

What insurance do you have? Do you have any dental insurance? In my experience ( although different from yours) my medical insurance company(Medicare) balked at the word DENTAL and denied coverage. Although it seems the removal of teeth should be considered medically necessary for successful cancer treatment, they see the word dentist and thus denied coverage. Its also my understanding that teeth removal and false replacement also wasnt covered in my case. Does Mayo have an oral oncology department which may help with the proper coding for reimbursement? Are they providers for your insurance? This may help when your insurance company sees care by oral oncology but i don't know. I fought for over a year for something similar and eventually gave up. I wish you the best.

Insurance also known as legalized gambling is a fickle institution with a lot of rules in their favor, much of it nearsighted. Mine for instance would not pay for teeth but would pay for liquid foods required for lack of teeth.
Some insurance pays for the teeth required for cancer surgery and treatment and many do not. Most US Government insurance such as Medicare often does pay. Many private and company provided insurance does not.
That said, it may cost you as much as the price of a car to have your teeth restored. It comes down to quality of life. So the question is would we rather walk and chew gum?
I have a friend who lives in the UK and on the wonderful National Health Care. He is a pensioner (senior citizen) and he needed a hip replacement. They put him on the list. As time went on he got older and because of his age the list got longer with surgery dates being moved out further. The man still worked when he could, he was in sales and loved what he did. Frustrated, he came to the U.S. and paid cash for a hip, the price of a small home. He can walk again and life is good without regrets. Four years later the NHS scheduled his surgery. He happily declined.
Many folks cannot afford such a thing and I understand that. If we have no choice because of financial reasons then we must figure out how to deal with the situation we have at hand. Insurance claims can be appealed but often without a favorable outcome.
I had my left mandible replaced along with three molars. The mandible surgery of close to a quarter million dollars was paid by insurance. The $18,000 for dental prosthesis came from my pocket. I don’t blame Mayo. They are in the medical business not the insurance business. They made me whole again. Fantastic!
Life is full of choices, some not easy either way.
Do you want teeth? What are your options? Dentures? Implants?

Okay, I had this dental pushback/initial denial from insurance on my original 2007 ameloblastoma (jaw tumor, I ended up minus two teeth) and a repeat pushback with my likely tumor recurrence now.

Yes, when the medical insurance people hear "Dental" the automatic answer is "Deny."

However, at least for my insurance - if the dental need is caused by a covered health condition (in my case, the tumor) - dental reconstruction IS covered. Medical insurance covered my two dental implants, including the crowns (well, the normal 80% coverage, but you get the idea.)

My husband had six compromised teeth removed by dental oncologists in an operating room(heart complications) prior to radiation for back of tongue cancer. Medicare refused to pay because it was “dental” as did his excellent Medicare supplemental insurance, again because Medicare refused it and their decision rules.

It's possible you need to appeal the Medicare decision - a brief search shows that Part A should cover some in-hospital dental work:

Since I still can't post links, I suggest Googling "medicare paying for dental"

medicareinteractive (dot) org has more details than the official Medicare site and specifically calls out dental work related to oral cancer as being covered.

I suspect Medicare is like most insurance - the person reviewing the approval just hears "Dental" and says "Not covered" - even though it's not true in some cases.

Hi Tom, I noticed that you wished to post a URL with your post. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe. Please allow me to post it for you. I'll also insert the intended URLs in your previous posts. 🙂

Very brief overview on the official site:
- Medicare Dental services https://www.medicare.gov/coverage/dental-services

More detail, specifically calling out oral cancer as a reason for Medicare to cover dental: - Medicare and dental care https://www.medicareinteractive.org/get-answers/medicare-covered-services/limited-medicare-coverage-vision-and-dental/medicare-and-dental-care

Thanks, Colleen!

I totally get limiting new posters. I've been a moderator on another forum for over 20 years.

My husband reminded me that he held off paying the hospital’s dental bill while disputing it and the hospital eventually reduced the bill by 50%(this was not Mayo).

Medicare and our supplement plan F ( is Not an Advantage plan) did in fact pay for my In-HOSPITAL oral prosthesis. However the next intermediate prosthesis was NOT covered by Medicare. My surgical oncologist referred me to a general dentist for the next fabrication stage. One problem we incurred was the dentist was NOT a Medicare provider and this may have been the problem. Although they said Medicare should pay for most of it we were not successful. Medicare does not like the word DENTIST. We are not aware at least in our area. of any dentist or prosthodontist that accepts Medicare. If Medicare doesn't accept your claim your secondary wont even consider payment no matter what the claim is for. After spending thousands of dollars for a temporary prosthesis ( covering jaw, palate and teeth), our next step for the permanent replacement we decided to consult with an oral oncologist/ maxillofacial specialist we found out of town. This was for the permanent prosthesis . It was my understanding the “teeth part” of the prosthesis would not be covered but the other parts were. Even so, this saved us thousands of dollars. My bit of advice is to go to a cancer center or a speciality practice / prosthodontist that number one takes Medicare or whatever insurance you have. Number two has an oral oncology department or prosthodontist/ maxillofacial specialist that has experience with a prosthesis, with insurance and with the coding that will work. They should be able to tell you over the phone what insurance they accept. They should file your claims as well.Best of luck and I feel your pain.