Does my case qualify?
A medical plan looks at the medical cause behind your tooth loss, not at the missing teeth themselves. Tooth loss from ordinary decay or gum disease is a dental matter, and medical plans generally do not pay for routine dental work. Tooth and bone loss caused by an injury or a disease of the jaw can be a medical matter.
Situations that may qualify
- Tooth loss from an accident or injury
- A cyst, tumor, or bone disease of the jaw
- Infection or abscess of the jaw
- Severe jaw bone loss that makes eating or swallowing difficult
- Bone loss after cancer treatment or radiation
Which plans this applies to
- Medicare: the red, white and blue card, or a Medicare Advantage plan from a private company.
- A PPO medical plan, through work or bought directly.
- Another plan, or not sure? Tell us what you have and we will look into it.
Dental insurance is a separate thing and does not count for this path. If you have only dental insurance, you can still come in for a regular consultation, and we will help you understand what that plan offers.
Who decides? Dr. Charles determines the medical diagnosis at your evaluation, and your plan decides what it will pay when it receives the claim. The three questions on our website only tell our team how to prepare for your call. They are not a diagnosis or an application.