What is Medicare?

Medicare is a health insurance that provides benefits for patients over the age of 65 who have a “Medical Necessity.” If you have a condition that, if left untreated, would worsen and impact your well-being then this condition may be covered, in part, by Medicare insurance. This can include major oral surgery services. There are conditions of coverage and exclusions and each patient must be evaluated individually to find out if they have a condition that meets Medical Necessity requirements.

Who can use their Medicare insurance for major dental services?

If you have Medicare insurance and a condition deemed a Medical Necessity, you may be eligible to have part of your oral surgery and dental implant treatment paid through Medicare. We have many patients who take advantage of this. There are multiple Medicare insurance plans in California and not every plan will pay for dental services. The only way to find whether you have an eligible plan and a condition deemed Medical Necessity is to come to the office for a personal consultation.

If I’m covered what may this mean financially?

Many times these benefits have a major value in lowering your out-of-pocket expense. Medicare won’t cover all of the fees needed for treatment but with specific conditions it’s not unusual to have 30-50% of fees paid. For some conditions, this translates to up to $20,000 for whole mouth oral surgery and implant treatment.

How do I find out which Medicare plan I have and whether I have a condition deemed Medical Necessity?

To see if you are qualified for Medical Necessity and if you have oral disease which will affect your long term health and well-being, you must be seen for an in-person consultation in the Santa Cruz office. This consultation cannot be done by phone. To schedule a Consultation call (831)-476-7272.

What if you find that my Medicare plan excludes dental services?

Annually, you have the right to change Medicare plans. We will advise you on which plan to switch to so that we can get coverage for you.

How many dentists are credential as Medicare providers? Only 1% of dentists in the United States are Medicare providers who are credentialed (certified) to treat Medicare patients.

How many dentists in the Bay Area can help me use Medicare insurance for dental implant treatment?

Dr. Matiasevich is one of the few Bay Area dentists credentialed as a provider and who has a proven history of helping patients use their Medicare insurance under Medical Necessity provisions for dental implants.