Medicare Credentialed Provider
Hello Dental Arts of Irvine Family!
Dr. Calilung is now a Medicare credentialed provider.
If you are on Medicare, please send us a copy of your current Medicare card so we may check your eligibility in 2022.
Eligibility to Qualify
Member ID
You must have a member ID that is not your Social Security number.
Medical Part B
You must have Medical Part B
HMO Ineligible
Your Plan must not be associated with an HMO Plan.
DISCLAIMER:
Medical and Dental necessity are required to receive Medicare reimbursement.
It’s true, Medicare Parts A and B (also called Original Medicare) don’t provide a lot of dental benefits. Routine dental care like cleanings and checkups are not covered, and neither are crowns or bridges. Any dentistry procedure that’s considered cosmetic will not be covered either, and according to Medicare’s rules, that includes implants. However, there are a couple of exceptions.
Medicare may cover treatments that typically are not covered under Medicare A and B if the procedure is used to correct damage caused by an injury. So if, for example, you fall and knock a tooth out, you may have some of the implant costs covered.
If missing teeth are causing another major medical problem and replacing those teeth can help treat that problem, there may be a case for at least partial coverage under Medicare.
If you have a serious oral health problem that’s medical rather than cosmetic, such as an infection, inflammation in your jaw, or loss of bone tissue (called resorption) that interferes with your ability to chew food, implants may be categorized as a medically-necessary intervention, in which case the cost may be covered by Medicare.
WHAT IS CONSIDERED "MEDICALLY NECESSARY"
It is well documented in the medical field that oral disease worsens many other organ diseases including heart disease. Some mouth infections can lead to heart attacks, blood clots (thrombosis) leading to stroke, valvular, and vascular infection. Oral disease also adds to the risk of pulmonary (lung) infection and can contribute to pneumonia. Patients with COPD are at high risk of pulmonary infections from mouth disease. Patients who have diabetes are at considerable risk of infections in other parts of their bodies as a result of bacteria from gum disease (pyorrhea). The mouth is a primary target of diabetic infection and poor healing. Patients with GERD and other GI issues have many of these problems due to poor diet and not being able to choose healthy food groups for proper nutrition. A recent study by the cancer society links colon cancer to periodontal (gum) disease and chronic infections in the mouth.
If you experience any of these conditions and you have significant dental disease, you may qualify for medical necessity. You may be eligible to have a portion of primary dental services covered.
FIND ADDITIONAL INFORMATION WITH THESE IMPORTANT LINKS BELOW
NOT A MEDICARE PATIENT, BUT KNOW SOMEONE WHO IS?
Please reach out to us at 949 551 5600 and we can begin a patient profile for your MEDICARE patient at the DENTAL ARTS OF IRVINE.
