Should My Friend's Dental Implants Be Deemed Medically Necessary under Medicare

Hi guys, my friend messaged me today saying he has to get all of the top row of his teeth extracted along with some of the bottom row. He's in his mid-20s and finally brushing his teeth regularly while no longer drinking a bottle of coke a day.

As is common knowledge, Medicare doesn't really cover dental once you're over 18. Don't want to get in a debate over it but I think that's quite silly.

On some sites, it says "Medicare may cover part of the cost if the procedure is deemed medically necessary." I was struggling to find if his situation would be one of medical necessity, or if people are expected to walk around with no teeth and unable to effectively eat. The fact he's so young makes me feel like it should be, as a result of how the jaw can degrade/change over time when left without teeth.

A larger problem is finding out how much Medicare will co-pay if he does meet their threshold. I called up a couple of dentist offices but no receptionist was able to help me.

From what I've heard, none of his teeth are rotting/infected, just severely corroded and dental implants would cost $15,000. This seemed very cheap compared to the estimates I saw of $2,000 to $6,000 per tooth.

I'd love any help clearing this up as I'm quite sure he doesn't have $15,000 lying around

TL:DR - Brush your teeth and flossing can't hurt either

Comments

  • +2

    Hey mate, I don't believe medicare covers any dental procedures unless its related to cleft lip/palate situations. However if your friend has a healthcare card he might be able to access a public dental clinic which can assess and offer him some treatments (most likely not implants as they aren't considered cost effective with public funding).
    Another option is accessing a public dental teaching hospital. I know quite commonly dental specialist are trained in these hospitals and if your friend is screened and deemed a good care he may be offered implants as a teaching case. That being said the criteria can be quite strict so I wouldn't bank on it.

  • +1

    I would find it hard to believe that if Medicare would ever cover dental for adults that it would cover implants.

    Basic fillings, basic extractions, and basic cleaning; IMO is what Medicare should cover. (I would happily pay more tax for that… wouldn't we all?)

    • Basic fillings, basic extractions, and basic cleaning

      Basically the pre-emptive, cost-effective stuff to prevent problems from occurring.

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