← Return to Teeth removal for HPV cancer: how to get insurance for replacement?
DiscussionTeeth removal for HPV cancer: how to get insurance for replacement?
Head & Neck Cancer | Last Active: May 15, 2023 | Replies (9)Comment receiving replies
Replies to "It's possible you need to appeal the Medicare decision - a brief search shows that Part..."
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.
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