Medicare
The key of our success – Our People
Who we are
We are comprised of a group of true dental enthusiasts! Dr. Ramon Padilla is our “mastermind”. Dental Designs is dedicated to give you a different dental experience.
We not only see patients from Naples or Fort Myers. We are proud to say that we see people different backgrounds and countries which makes us unique. Furthermore, we provide a great amount of services all within the office to fit your family’s needs therefore giving yo and your family great care in one place.
If you are looking to return to the dentist or maybe it’s time to finally take care of that tooth that has been bothering you, look no more! Perhaps you want a brighter smile or straight teeth, don’t worry, you are in the right place, we can help!
What is Medicare?
Medicare is a health insurance that provides benefits for patients over the age of 65 and 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. These medical conditions may include major oral surgery services.
Medicare has conditions of coverage and exclusions, so 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 treatment paid through Medicare. While Medicare is not going to cover your teeth, the oral surgery related payments can make a big difference in your final out of pocket cost for your total treatment. There are multiple Medicare insurance plans in Florida and not every plan will pay for services. The only way to find whether you have an eligible plan and a condition deemed Medical Necessity is to have an oral and physical examination.
If I’m covered what may this mean financially?
Medicare doesn’t cover most dental care, like cleanings, fillings, tooth extractions, etc. However, it may cover some surgeries associated with your treatment if Medicare deems it necessary. Many times these benefits have a major value in lowering your out-of-pocket expense for the total dental reconstruction.
How do I find out which Medicare plan I have and whether I have a condition deemed Medical Necessity?
In order for you to know if you have a condition that may be covered under Medicare, just like in any doctor’s office, you would need to have a complete dental and physical examination to check if you have an oral disease which will affect your long term health and well-being.
In our offices this is a complimentary consultation and cannot be done by phone.
What if I find out that my Medicare plan is not accepted and excludes oral surgery services?
HMO or PPO Medicare plan, do not have oral surgery benefits on their plan even if you have a medical necessity. Usually this may be covered under “traditional Medicare”.
Annually however, Medicare has open enrollment when you have the right to change your plan to Original Medicare (or so called Medicare Part B). Always refer to Medicare and make the decision that fits your needs.
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 Southwest Florida Area can help me use Medicare insurance for major dental treatment?
Dr. Ramon Padilla and his Associates are the first SWFL Area Clinic credentialed as a provider and who has a proven history of helping patients use their Medicare insurance under Medical Necessity provisions for oral surgery.
Medical Necessity?
Oral disease is well documented in the medical literature to worsen many other organ diseases. This includes heart disease where mouth infection can contribute to heart attack, thrombosis (blood clots) leading to stroke, and vascular and valvular disease.
Mouth disease adds to the risk of pulmonary (lung) infection and can contribute to serious pneumonia. Patients with COPD are at great risk of pulmonary infections from mouth disease.
Patients with diabetes are at great risk of infections in other parts of their body as a result of bacteria from gum disease (pyorrhea). The mouth is a main 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 good nutrition.
A recent study by the cancer society links colon cancer to periodontal (gum) disease and chronic infections in the mouth.
If you have any of these conditions and major dental disease, you may qualify for Medical Necessity and have a portion of major dental services covered.
Do teeth play a role in general health?
Teeth are essential for nutrition. Denture patients often become disabled from poor nutrition. Teeth firmly attached to dental implants give patients a better quality of life even in the late stages of life. Many patients have shared stories of a loved one who would have had a much better quality of life if they had only had better teeth to chew with to contribute to better health. Due to all these issues, many patients with significant mouth disease may qualify for medically needed procedures that we can perform to move them towards a disease free and functional oral health.
