U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > General Forums > Health and Wellness > Health Insurance
 [Register]
Please register to participate in our discussions with 1.5 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Jump to a detailed profile or search
site with Google Custom Search

Search Forums  (Advanced)
Business Search - 14 Million verified businesses
Search for:  near: 
 
Old 08-21-2012, 06:17 PM
 
5,264 posts, read 5,547,209 times
Reputation: 1777

Advertisements

I was seen today by an oral surgeon.
The plan is to surgically remove massive tori between my lower teeth = bone mass.
He asked me, if I had Medicare.
This creates an interesting question. Since Part A is hospitalization, and the oral surgeon was very definitive in asking me if I had Medicare, it sounds like the surgery might be covered.
(while the sedation and teeth extractions are not - that is obvious)
I've called Medicare before, about certaion coverages, and at times their answers don't help out. Instead of a no, or a yes, you get a maybe, or it depends.
Depends on what? How the procedure is "coded" by the doctor, dentist?

Anyone had mouth tori removed and it was covered by Medicare Part B?

Thanks.
Reply With Quote Quick reply to this message

 
Old 08-21-2012, 06:54 PM
 
Location: Wisconsin
14,165 posts, read 18,601,021 times
Reputation: 6733
I think outpatient oral surgery is covered under Part B, which you don't have - unless things have changed?

Does Medicare Cover Oral Surgery | Medicare Oral Surgery Coverage
Reply With Quote Quick reply to this message
 
Old 08-22-2012, 10:00 AM
 
5,264 posts, read 5,547,209 times
Reputation: 1777
Quote:
Originally Posted by Ariadne22 View Post
I think outpatient oral surgery is covered under Part B, which you don't have - unless things have changed?

Does Medicare Cover Oral Surgery | Medicare Oral Surgery Coverage
I'll get the doctor's office to check with Medicare.
They may have better luck at getting a straight answer.
I have Part A, but the enrollment period is not far away for Part B, and the work I need done is not time sensitive. If Part B saves me enough, it may be worth it to sign up.
Reply With Quote Quick reply to this message
 
Old 08-22-2012, 10:45 AM
 
Location: Florida
11,199 posts, read 7,907,706 times
Reputation: 9138
Medicare information is pretty explicit on what is covered.
Best inormation is from a government site.
Medicare Dental Coverage | Centers for Medicare & Medicaid Services
Reply With Quote Quick reply to this message
 
Old 08-22-2012, 10:48 AM
 
5,264 posts, read 5,547,209 times
Reputation: 1777
Quote:
Originally Posted by old_cold View Post
Medicare information is pretty explicit on what is covered.
Best inormation is from a government site.
Medicare Dental Coverage | Centers for Medicare & Medicaid Services
The first link sounded like the surgery for removal of bone was covered.
The second links sounds like it is not covered.
Reply With Quote Quick reply to this message
 
Old 08-22-2012, 10:57 AM
 
Location: Florida
11,199 posts, read 7,907,706 times
Reputation: 9138
Quote:
Originally Posted by howard555 View Post
The first link sounded like the surgery for removal of bone was covered.
The second links sounds like it is not covered.
Please do check with your provider.
He can get a definite answer.
I recall something about removal of tumors being covered and a bone malformation might be considered totally medical and not dental/oral.
I know there have been some new severe restrictions changing what was covered (considered medical)before and is no longer.
Reply With Quote Quick reply to this message
 
Old 08-22-2012, 03:34 PM
 
5,264 posts, read 5,547,209 times
Reputation: 1777
I've got two different provider opinions on the surgery. One says the bone must be removed to proceed with lower dentures.
The other one says to leave the bone there and use a bridge. So, different opinions on the need to remove the bone.
Reply With Quote Quick reply to this message
 
Old 08-22-2012, 04:18 PM
 
Location: Ponte Vedra Beach FL
10,833 posts, read 8,053,617 times
Reputation: 3866
How many teeth/implants will you have left to support a bridge - and where are they? I'd definitely go with a fixed bridge as opposed to a denture if possible (especially if you're talking about a lower). Robyn
Reply With Quote Quick reply to this message
 
Old 08-22-2012, 04:41 PM
 
5,264 posts, read 5,547,209 times
Reputation: 1777
Quote:
Originally Posted by Robyn55 View Post
How many teeth/implants will you have left to support a bridge - and where are they? I'd definitely go with a fixed bridge as opposed to a denture if possible (especially if you're talking about a lower). Robyn
Dentist #1 wanted to pull 5 front top, pull left rear wisdom, pull one left lower, pull one right lower.
Repair 2-3-4. Surgically, done by a oral surgeon, remove the lower torus.
Then an upper front partial, and a lower "side" partial.

However, after seeing the dentist and hearing his plan, and before the consultation with the surgeon, I began to have issues with 2 of the front top. I learned about a free dental clinic and travelled to that and got the front 5 pulled by a periodontist, who happened to own 11 dental offices. He did the impressions, the pulling and the front plate. I asked him his opinion about the torus. He said "if it was him, he'd leave the torus like it is, and find a way to pay for 3-4 minis and a full lower bridge."

The surgeon who says that the torus must be removed for a bridge, is mistaken it seems.
He is going by the instructions from the dentist to remove the torus, so a partial lower side plate can be made.
The periodontist feels that all that surgery just for a side partial is excessive.

Last edited by howard555; 08-22-2012 at 05:05 PM..
Reply With Quote Quick reply to this message
 
Old 08-23-2012, 12:13 AM
 
Location: just wandering around
8,268 posts, read 8,009,632 times
Reputation: 3473
Quote:
Originally Posted by howard555 View Post
Depends on what? How the procedure is "coded" by the doctor, dentist?
The oral surgery has to be medically "reasonable & necessary" to prevent and/or treat serious health problems.
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:

Over $84,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > General Forums > Health and Wellness > Health Insurance
Similar Threads

All times are GMT -6.

2005-2014, Advameg, Inc.

City-Data.com - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 - Top