We are NOT a dental office.
We can help you with Dental INSURANCE.
#Delta1 Dental No Wait
- Six page summary of no wait plan
- Plan Maximum $2k/person per calendar year
- Get Quotes & Enroll – Quotit
FAQ’s
- I currently have denti cal. I wanted to ask you is there a coverage in order get implants covered partly?
- Try the Delta Dental No Wait Plan above.
- Here’s our FAQ’s on having two dental policies Private Policies pay first
Implant Explanations
- Sorry to say but here is generally No coverage for implants.
- Medi – Cal generally does not cover implants.
- Nor does Medicare.
- Check out alternatives to Implants Like Dentures.
- However, check out Dental for Everyone and Quotit they have plans that will cover implants! Remember though, there is no free lunch. Insurance Companies have to take in more money in premiums than the pay in claims… MLR Medical Loss Ratio and all.
. - Check out Medicare Advantages plans – some may offer $400/quarter that rolls over quarterly, but not annually and may also offer “essential extra’s” like a $500 flex card
- Blue Cross Dual Medi Medi Medicare Advantage Plan offers a $4k allowance for implants See page 82 of the EOC Evidence of Coverage.
- See our webpage on Anthem Blue Cross Medicare Advantage Plans
- Dental Benefits in Medicare [Advantage] and Medi-Cal
- Blue Cross Dual Medi Medi Medicare Advantage Plan offers a $4k allowance for implants See page 82 of the EOC Evidence of Coverage.
Try turning your phone sideways to see the graphs & pdf's?
Dental For #Everyone,
has an excellent website with full brochures, Instant online quoting and enrollment
- One of our colleagues on how Dental for Everyone Works.
- Some of our webpages on dental
- VSP Vision
Medical Loss Ratio 80% Claims - 20% Operating Costs & Profit
Image from BCBS.com
Steve's Explanation of MLR Medical Loss Ratio
More Video's
- Kaiser Health News - Medical Loss Ratio
- Department of Managed Health Care on MLR in Affordable Care Act
- White House – YouTube Channel on Health Care Reform
- Tom Petersen Insurance 101 History of Lloyds to present EXCELLENT!!!
- Our Webpage on MLR & Actuarial Value
#Delta Dental Direct
Delta Dental - Get Quotes & Enroll Affiliate Link
Be sure to put in our AGENT # 2094784
Delta Dental – Covered CA Plans
California
- 2025 plan brochures Brokers ONLY
English
- Direct - Not Covered CA
- Delta Dental Individual & Family™ Delta Dental PPO™ Family Dental PPO 1690 KB
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Delta Dental PPO™ Children's Dental PPO for Small Businesses 1688 KB
Delta Dental PPO™ Family Dental PPO for Small Businesses 1690 KB
Delta Dental PPO™ Family Dental PPO for Small Businesses 949 KB
Delta Dental Individual & Family™ DeltaCare® USA Family Dental HMO 945 KB
DeltaCare® USA Children's Dental HMO for Small Businesses 948 KB - 2024 Brochures
- All about dental implants How these artificial teeth can help your smile
- Delta Dental Individual & Family™ Delta Dental PPO™ Family Dental PPO 421 KB
- Delta Dental PPO™ Children's Dental PPO for Small Businesses 401 KB
- Delta Dental PPO™ Family Dental PPO for Small Businesses 419 KB
- Delta Dental Individual & Family™ DeltaCare® USA Family Dental HMO 435 KB
- DeltaCare® USA Children's Dental HMO for Small Businesses 431 KB
- DeltaCare® USA Family Dental HMO for Small Businesses 432 KB
- California Brochures
- Delta Dental PPO Premium Plan covers implants at 50%, after a 12-month waiting period.
- Delta Dental Individual & FamilyTM Delta Dental PPOTM Family Dental Plan 669 KB
- Delta Dental PPOTM Children’s Dental PPO for Small Businesses 790 KB
- Delta Dental PPOTM Family Dental PPO for Small Businesses 794 KB
- Delta Dental Individual & FamilyTM DeltaCare® USA Family Dental HMO 872 KB
- DeltaCare® USA Children’s Dental HMO for Small Businesses 837 KB
- Members Resource WebPage
- Find a Dentist
- FAQ's
- We are interested in the Delta Dental PPO Premium Plan but have a few questions:
- What do we need to give to Delta Dental to have the 6 month waiting period waived?
- Let's check the EOC Evidence of Coverage and Summary of Benefits
- Attachment A Footnote 3 just says acceptable documentation. I suggest that your ID card and proof of payment for 6 months will suffice.
- Prior coverage In certain cases, a waiting period will be waived if a comparable dental insurance plan was terminated in the 30 to 60 days prior to the effective date of your new plan, but your former dental plan must include very similar coverage. Delta *
- Let's check the EOC Evidence of Coverage and Summary of Benefits
- Our current policy does not include orthodontics. Would this affect the waiting period for just the orthodontic coverages in Delta’s plan.
- It's not clear in footnote 3. I would say no, as you don't have comparable orthodontic coverage.
- Send me your ID Card and proof of payment and I can ask Delta.
- Delta said Will need a letter from the prior insurance company with the effective and end date, also the type of coverage the client had.
- Do you have a summary of benefits for the plan you have now?
- Can you just get the letter and we can get an authoritative answer.
- I'll research if there is any more detail... Pre Existing Conditions like before ObamaCare
- Send me your ID Card and proof of payment and I can ask Delta.
- It's not clear in footnote 3. I would say no, as you don't have comparable orthodontic coverage.
- What is the process for us to purchase the Delta Dental PPO Premium Plan from you?
- Use the affiliate link above and enroll online.
- Do the 2 cleaning per calendar year have to be spaced out in 6 month intervals?
- Attachment b page 4 states they pay for 2/year. No requirement to space them out.
- What do we need to give to Delta Dental to have the 6 month waiting period waived?
- We are interested in the Delta Dental PPO Premium Plan but have a few questions:
- Broker ONLY
What are Dental #Implants?
Dental implants (ADA Codes) may be thought of as artificial tooth roots which allow the fabricated teeth to be firmly attached to the mouth. One may consider the jaw bone as a piece of wood and a dental implant as a screw
Learn more from REAL Dentists:
- American Academy of Implant Dentistry
- VIDEO – Dr. Kuzma
- southland dental care.com/the-myth-are-dental-implants-really-necessary
- dr palani.com/video-library
- Dental implant surgery is a procedure that replaces tooth roots with metal, screwlike posts and replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Read more Mayo Clinic
- Dental Implants: What You Should Know FDA
Write implants off your Taxes – using Health Savings Accounts
- The average cost of placing a single dental implant ranges from $1,600 to $2,200, not including the cost of a restoration. Redd Road *
- Implants may be covered under health insurance, if there is a “medical necessity” like cancer, major accident or skeletal deformity. View sample Delta policy page 40 #32.
- You can include in medical expenses the amounts you pay for dental treatment. This includes fees paid to dentists for X-rays, fillings, braces, extractions, dentures, etc. including artificial teeth (IRS Publication 502 Page 5 & 7)
- Implants are done when one doesn’t want a bridge because it more permanent and look better even in the back of the mouth and in view of this it’s considered cosmetic.
- Unfortunately, implants are not generally a covered benefit. Check out the Delta Dental No Wait Plan. Alternatives for Implants
Limitations:
The replacement of lost or stolen dentures, crown and bridge work, dental procedures and charges incurred as part of implants (placement or removal) and prosthetic devices placed on implants (fixed or removable, for example: bridges, crowns) are not covered. Smile Saver Brochure
Implants
- Answers.com
- Blue Shield Small Group Dental Plans – Dental Implant Explanation
- Alternatives for Implants
- Some questions that a patient could ask a dentist include:
Gum Disease Treatment
If you have a tooth that is loose and may be “hopeless,” it might still be saved with gum disease treatment . If the gums are receding and there has been bone loss around the tooth, that doesn’t mean that the tooth is guaranteed to be lost.
With gum disease treatment, we can clean out the infection around your tooth, and hopefully the tooth will heal. Sometimes we might splint the loose tooth or teeth to natural teeth that are stable. This can help stabilize the loose teeth and give them time to heal. Then you’ll still have your natural tooth for longer, potentially the rest of your life. This costs significantly less than a dental implant. And Pinhole ® Gum Therapy can be used to restore the natural contour of your gums.
Caveats: For a tooth that is designated “hopeless,” the success rate is lower than that for dental implants. And because we’re preserving your natural tooth, it will continue to look as it had, so if you’re unhappy with the appearance of this threatened tooth, it might not be the best choice. Plus, sometimes the infection is so serious that we want to remove teeth to better control the risk that the infection could spread to other parts of your body.
Root Canal Therapy
If your tooth is threatened by an infection inside the tooth, we can use root canal therapy to clean out the tooth and make it stable again. The tooth will be reinforced and topped with a dental crown . The success rate for root canal therapy is comparable to that for dental implants, and it has the benefit of retaining your natural tooth. Plus the dental crown means that the appearance of the tooth will be improved, too. If you later need to replace the treated tooth, you will usually be able to get a dental implant, and in the meantime, you get to enjoy the benefits of having a natural tooth rather than an implant. Cost is slightly less than for a dental implant.
Caveats: Whether a root canal is appropriate or not depends on the state of your tooth. If the tooth root is damaged, a root canal is not recommended. Sometimes an infected tooth can be a serious risk and needs to be extracted right away. Extraction is best for badly damaged or seriously infected teeth.
Dental Bridge
If you can’t save the tooth with either gum disease treatment or root canal therapy, you can often get a dental bridge that will perform the same function as a dental implant. With a dental bridge, the replacement tooth is supported by dental crowns on teeth next to the missing tooth.
Dental bridges are fully fixed in your mouth. They’re not loose and won’t slip out, so your diet won’t be impacted, and they can look as good as dental implants. Plus the dental crowns on neighboring teeth can be very helpful if they have been damaged.
Caveats: Dental bridges don’t stimulate your jawbone and gums the way a dental implant does. This may not matter, but it can potentially cause collapse of the gums under the replacement tooth. And if the supporting teeth aren’t fully healthy and strong, they may be put at risk by having a dental bridge placed over them. That’s because two teeth are now being asked to do the work of three. Because of this restriction, we only recommend dental bridges in limited situations where they don’t cause much increased risk to your natural teeth.
The Denture Fountain of Youth®, which replaces all your natural teeth. This type of denture looks natural and encourages better biting and chewing function. While not as good as implant-supported dentures, they are close. Kuzma *
Experts say 90% of patients with complete tooth loss opt for dentures. Ivy Rose *
VIDEOS
- Denture FOY Fountain of Youth VIDEO’s High End Dentures – Better than what your Parents wore
- Interviews – Testimonials VIDEO –
Learn More
Links, FAQ’s & Resources
- American Academy of Implant Dentistry – Implants vs Dentures & Bridges They have nice explanatory pictures too!
- Dental Implant Cost Guide
- Alternatives
- Health Savings Accounts?
- How are Dentures covered by Medi Cal?
- Let’s look at the Denti-Cal Handbook
- Page 8 has a graph that says Dentures are covered. Do a Control F to find more detail…
- See also Smile Care.org and dental.dhcs.ca.gov
- Bottom Line – Ask your dentist
- dental.dhcs.ca.gov/find-a-dentist/home
- Let’s look at the Denti-Cal Handbook
Medi Cal
FAQ’s Medi Cal & Dental #Implantsx
- Do you have an “OFFICIAL” explanation from Medi Cal on how implants are covered or not?
- Hi Steve,
- A Medi-Cal member is eligible for dental services provided by the Medi-Cal Dental Program. Eligibility for benefits is determined by the member’s local county social services office and reported to the State of California. The State, in turn, issues a Medi-Cal Benefits Identification Card (BIC) to members who are eligible for Medi-Cal Benefits. Limitations or restrictions of dental services may apply in certain situations.
- Medi-Cal offers a broad base of dental benefits, please refer to SmileCalifornia.org for information about Medi-Cal’s dental benefits.
- With respect to your specific question regarding full mouth implants, implant services are a benefit only when exceptional medical conditions are documented, and those conditions are reviewed by the Medi-Cal Dental Program for medical necessity (as defined by law) for prior authorization. Some of those exceptional medical conditions are:
- Cancer of the mouth requiring extensive surgery such that a conventional denture can no longer be worn.
- A skeletal deformity that precludes the use of a conventional denture.
- Traumatic destruction of jaw, face or head which makes a conventional denture impossible to wear.
- Furthermore, single tooth implants are not a benefit of the Medi-Cal Dental Program. If the member has an exceptional medical condition, the assigned dental and medical providers will need to get together and fully document the medical and dental needs in writing.
- Providers shall submit a complete case documentation (to include such items as radiographs, scans, operative reports, craniofacial panel reports, diagnostic casts, intraoral/extraoral photographs and tracings) necessary to demonstrate the medical necessity of the requested implant services.
- If the member has existing dentures that do not fit, there are ways to modify them (such as tissue conditioners and relining them) to aid in their retention. This is a conversation the member will need to have with their regular dentist. Modification of existing dentures and even fabrication of new dentures (a benefit once in a five-year period) are benefits of the Medi-Cal Dental Program with prior approval.
- Providers shall submit a complete case documentation (to include such items as radiographs, scans, operative reports, craniofacial panel reports, diagnostic casts, intraoral/extraoral photographs and tracings) necessary to demonstrate the medical necessity of the requested implant services.
-
Thank you,
Monique Garcia
Chief of Provider and Beneficiary Services Section
Medi-Cal Dental Services Division
- Can I get implants from iehp? Medi Cal? Denti-Cal?
-
- I’m In need for dental implants and am low income. Two pair of dentures that don’t fit properly. Can’t chew food without teeth.
- REPLY
- See below or to the right for the Denti Cal – Medi Cal Member Handbook. I’ll grant, that I don’t see on that page anything about implants, so here’s our research.
- The Denti-Cal provider handbook does mention Implants, so I guess it’s covered. I suggest you ask your dentist. Your question is beyond my pay grade! (Zero, as Medi Cal doesn’t pay agents)These are the “codes” in the provider manual that related to implants:
- Here’s why I don’t like to guess or answer questions on the phone. I checked with justice in aging.org/ and said
- “Single tooth implants are not a benefit of the Medi-Cal Dental Program” Some legal advocates have attempted to make compelling medically necessary arguments, and the provider manual allows for that “Implant services are a benefit only when exceptional medical conditions are documented and shall be reviewed for medical necessity.”But generally speaking not a benefit and not one we want to promote as available to Medi-Cal beneficiaries since they are so limited. they pointed out this section in the provider handbook:
- Implant Services General Policies (D6000-D6199)a) Implant services are a benefit only when exceptional medical conditions are documented and shall be reviewed by the Medi-Cal Dental Program for medical necessity for prior authorization. Exceptional medical conditions include, but are not limited to:
- i) cancer of the oral cavity requiring ablative surgery and/or radiation leading to destruction of alveolar bone, where the remaining osseous structures are unable to support conventional dental prostheses.
- ii) severe atrophy of the mandible and/or maxilla that cannot be corrected with vestibular extension procedures or osseous augmentation procedures, and the patient is unable to function with conventional prostheses.
- iii) skeletal deformities that preclude the use of conventional prostheses (such as arthrogryposis, ectodermal dysplasia, partial anaodontia and cleidocranial dysplasia).
- iv) traumatic destruction of jaw, face or head where the remaining osseous structures are unable to support conventional dental prostheses.
- b) Providers shall submit complete case documentation (such as radiographs, scans, operative reports, craniofacial panel reports, diagnostic casts, intraoral/extraoral photographs and tracings) necessary to demonstrate the medical necessity of the requested implant services.
- c) Single tooth implants are not a benefit of the Medi-Cal Dental Program.
- d) Implant removal, by report (D6100) is a benefit. Refer to the procedure for specific requirements.They also told me about this guide for dental care for older adults
- Do you have Medicare? We could look into MAPD Medicare Advantage plans that might offer implant coverage or a quartley spending account that could be used for implants?
- See below or to the right for the Denti Cal – Medi Cal Member Handbook. I’ll grant, that I don’t see on that page anything about implants, so here’s our research.
-
- I’m not in CA. Can you help me with questions on Medicaid or Medicare Advantage plans in my state.
- Sorry no. Try the NAHU National Assoc. of Health Underwriters Agent finder, of course try your EOC evidence of coverage or the SHIP State Health Insurance Assistance Program finder
- 1. Searching for a reasonable rate plan for bone grafting…?
2. How does dental cal, provide for patients that need bone grafting before implants…?- See above, doesn’t look like Denti Cal will cover it.
- What about alternatives to Implants?
- What Type of Dentist Should I See for Dental Implants?
- See our FAQ and comments section below for more FAQ’s or to ask a question
SB 980 #Add Crowns & Implants to Medi Cal – Denti Cal
Medi-Cal’s Dental Care Gap: Getting a Tooth Pulled Is Easy — Much Harder To Get an Implant
SB 980 would also add, as a covered Medi-Cal benefit for persons of any age, subject to prior authorization, a dental implant if tooth extraction or removal is medically necessary or if the corresponding tooth is missing.
SB 90 would condition this coverage on there being no other covered functional alternatives for prosthetic replacement to correct the persons dental condition, as specified, on the person being without medical conditions for which dental implant surgery would be contraindicated, on receipt of any necessary federal approvals, and on the availability of federal financial participation.
Under the bill, the above-described provisions would not be construed to exclude Medi-Cal coverage for laboratory-processed crowns on teeth or dental implants if otherwise required under EPSDT services. Visit this page for the links to work and see video of the CA State Senate Hearings.
Find your CA Representative and tell them how you feel!
Our other pages on
Dental Coverage
We don't put a lot of effort into selling dental coverage. Generally it's a wash on paying premiums vs getting back claims payments. Unless it's employer group. Then the premiums are tax deductible under IRS Section 106.
Here's more information on how we feel about dental. Here's our page on implants, where we get lots of inquires, but few sales. Most people only seem to want dental coverage, after they've been told they need a lot of dental work. Not profitable for Insurance Companies. See our other pages for details & explanations. See our page on Medical Loss Ratio. Insurance Companies need to take in $1 to pay 80c in claims.
Medicare Plans
- Anthem Blue Cross
- Blue Shield – Medi-Gap – Any Medicare Provider
- Health Net Medi Gap
- UHC AARP Medi Gap
- Scan
Individual & Family Plans
Dental For Everyone,
has an excellent website with full brochures, Instant online quoting and enrollment
One of our colleagues on how Dental for Everyone Works..
Employer Group Plans
- Medi-Cal
FAQ’s
- Question i just had all teeth removed and need some help or kind of teeth
- i have medical [Medi Cal]
- id like to get snap in dentures but not sure if im covered
- Answer See our section on dentures
. - Question My friend has lost a great deal of teeth. Cause? Don’t know. Stress? Don’t know. Cancer? I pray not.
- Is there an medical institution who could help my friend?
- I don’t know if she has insurance. I don’t think her income is sufficient. She doesn’t need partial implants. She needs implants for the entire mouth.
- I have in mind to see if UC DAVIS (students), to further their learning skills to help her.
- Is it possible?
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- Answer She might qualify for Denti Cal & Medi Cal? See above and ask to to apply.
- I wouldn’t know what dental colleges have to offer. Check with them.
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- I wouldn’t know what dental colleges have to offer. Check with them.
- Question I was born without my upper lateral incisors so I guess that would b considered congenital Maxillofacial deformity. It’s the tooth next to my two front teeth on both sides.
- I’m 37 Caucasian female and I currently have medi cal.
- I’ve worn a Hawley retainer for about 20 yrs.
- It has been a real struggle the whole time with it breaking and having to go days and at one point 18 months with missing teeth near the front of my mouth. It has caused me severe self consciousness, distress, trauma, anxiety, depression. I avoid social gatherings where eating in public settings together which is 96% of the time.
- Have u heard of this type of dental issue before?
- And can u point me in the right direction with more information about medically necessary billing coverage for my particular issue.
- And I already know I’d have to pay for bones grafting out of pocket.
- But my mom thinks maybe some type of implant secured denture would be cheaper but I don’t think that would apply to my needs due to I have all my other teeth minus a molar on the bottom of both left and right sides of mouth.
- I appreciate any help as this is the worst thing I’ve struggled with my whole life and had severe trauma in life that has impeded my ability to obtain proper permanent treatment.
- Answer We’ve answered your question on Medically Necessary Orthodonture
. - Question My front teeth several are missing and it’s hard to get a better job because I’m working out in public my career and my occupation holds me up because of my missing teeth .
. - Answer see the module on implant alternatives.
- Question What insurance will cover dental work that med-cal don’t cover?
. - Answer
- First, check what Medi Cal covers
- Then, what they don’t
- Then what you want coverage for
- Don’t forget the Insurance Companies want to collect enough premiums to pay claims and take 20% for administration and profit
- Then get quotes from the above brochures, Delta or Dental for Everyone.
- Question Need some teeth to eat. But only have medi- cal to cover cost?
- A bad choice I made. Went to a “free dental”, but got left with no teeth on top and was schedule for more mis-treatment that following week.
- Went back and the team had left.
- F**k! I’m just looking for a way to enjoy meals. Like, apples, peanuts, corn on the cob, etc. etc. I have suffered for years and hope for a solution.
- If not please just say so.
- Answer Want about dentures? See alternatives to implants.
- Try calling 1 800 322 6384 also see above link to Smile CA
.
- Try calling 1 800 322 6384 also see above link to Smile CA
- Question I have medi-cal.. I have dental implant posts which I paid for on my own . One of my bridge crowns fell out and was lost . will medi-cal cover all or part of that bridge/crown?
- I want the snapped in dentures. I have (medi-cal,medicare a. b. C.)
- And kaiser Medi-cal
- I need urgent APPOINTMENT
- I don’t know.
- I want the snapped in dentures. I have (medi-cal,medicare a. b. C.)
- Answer Check the Denti Cal handbook and FAQ’s above and check with your dentist.
- We are NOT Kaiser not Medi Cal authorized brokers. Please contact them Directly!
- Check with Medi Cal – see their contact information above.
- Check with Kaiser Medi Cal
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- Question I have medical community health I received dental implants which I paid for previously I’ve lost a bridge crown that strings from one implant post to another. Can my medi-cal cover all or part of that bridge / crown?
. - Answer See the answer to the above question
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> - Question Does health net cover implants?
. - Answer What Health Net plan do you have or want to purchase?
- See above to links to our Health Net Individual and Group Plans
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- See above to links to our Health Net Individual and Group Plans
- Question How much is the premium for dental coverage?
. - Answer Check the brochures and quote engines:
- Question I’m exploring supplemental insurance options with Partnership Health in CA for full mouth implants for myself and my husband.
- I have a full upper denture and partial lower, the implant sites were set at the time of tooth removal.
- My husband has extensive tooth decay, broken and missing teeth .
,
.
- Answer ? give Medicare the power to negotiate for lower drug prices, add new benefits to Medicare
- Adding dental, hearing and vision benefits to Medicare.
- Making new investments in home and community-based services to “help seniors, persons with disabilities and home care workers,”
- Extending a boost to ACA income-based subsidies that were included in the American Rescue Plan Act. The boosted subsidies are set to expire after the 2022 coverage year. Read more Fierce Health
.
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- Question What if I need MAJOR, EXPENSIVE Dental work and don’t have coverage.
- Can I buy it now?
- What are best options to open – start a dental plan to reduce this out of pocket cost?
- Any restrictions such as waiting periods to obtain this care after purchasing a plan?
>
- Answer It would be a spreadsheet of the type of work you need done, the limitations on each procedure and the general maximum of $1k to $1,500/year maximum.
- You might look at financing options.
- Here’s a youtube video we did on what metal level plan might you buy if you know you’re going to have a big claim coming up.
- Review the information on this page, the quotes available and our other dental pages.
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- Question would be beneficial to me to switch to the enhanced 94 plan when I’m currently Under full scope of benefits Medi-Cal and denti-cal for about $7,000 worth of dental work that denti-cal won’t cover that needs to be performed?
- Are there any available plans Under The Inn at Silver 94 which offer Dental Care better than what is normally offered through denti-cal?
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- Are there any available plans Under The Inn at Silver 94 which offer Dental Care better than what is normally offered through denti-cal?
- Answer I really don’t know where you can get coverage for $7k worth of dental work. Most all plans I’ve seen limit coverage to $1k or $1.5k – $1,500/year.
- Silver 94 doesn’t have adult dental, other than if they call it medical services. See specimen policy page 72
- Check out Dental for Everyone or Covered CA’s dental program, which I believe you can get, even if you don’t have a health plan.
- What do you mean by “under the inn?”
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- Question Does iehp or Medi Cal insurance get me or cover implants?
- IEHP covered my cancer, my liver and copd
- can I get implants from IEHP? Medi Cal? Denti-Cal?
- Answer – No, but double check. I’m not an authorized IEHP representative.
.
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. - Question I’m In need for dental implants and am low income. Two pair of dentures that don’t fit properly. Can’t chew food without teeth.
- Answer See our reply in the Medi Cal Implant FAQ
. - Question I AM 44YO ON SSDI I AM HIV HEP C
- I HAVE 10 MISSING / CRACKED TEETH AND
- THIS DETRAMENTAL TO MY MEDICAL HEALTH WITH ALL RISKS INVOLVED BY NOT HAVING MEDICALLY NECESSARY IMPALNTS TO REPLACE MISSING OR CRACKED TEETH
- IT ALSO MAKES IT DIFFICULT TO EAT THUS I EAT LESS OR UNABLE TO EAT MEATS MAKING NUTRITION A HEALTH CONCERN ..
- I RECEIVE DISABILITY INCOME AND CAN NOT AFFORD THE 15,000-20,000 BILL FOR IMPLANTS
- I HAVE AETNA MEDICARE ADVANTAGE DENTAL AND HEALTH BUT ITS A JOKE ON HOW LITTLE THEY WILL COVER
- WHICH LEAVES ME WITH A MOUTH FULL OF BROKEN / CRACKED/ MISSING TEETH AND
- I DONT KNOW WHO TO ASK FOR HELP OR
- WHAT INDIVIDUAL DENTAL POLICY I CAN BUY TO HELP MYSELF SO I CAN BE ABLE TO EAT, LIVE A HEALTHY LIFE BECAUSE STATISTICS SHOW IF I DONT DO SOMETHING ABOUT THIS NOW OR SOON IT WILL DECREASE MY LIFE EXPECTANCY AND IVE ALMOST DIED SEVERAL TIMES SO FAR IN MY LIFE SO I VALUE A LONG LIFE EXPECTANCY
- SO IF YOU COULD HELP ME PLEASE OR DIRECT ME ON WHAT TO DO OR WHO TO TALK TO BECAUSE I FEEL SOO LOST NO ONE OFFERS SOLUTIONS OR OPTIONS
- ONLY THAT THE MAX COVERAGE ANNAULLY IS 1500 AND NO SOLUTION ON HOW TO COME UP WITH THE REST.
- I MISS EATING STEAK, PISTACHIOS, ETC..
- I HATE THAT I EAT VANILLA YOGART A LOT BECAUSE ITS WHAT I CAN EAT NOT THAT I LIKE IT OR ITS A FAVORITE BECAUSE ITS NOT.
- I JUST FEEL LIKE I CANT DO ANYTHING WITH IN REACH TO HELP ME
- SO THIS IS WHY I AM CONTACTING YOU WITH HOPES YOU HAVE A SOLUTION.
- PLEASE HELP ME. SO FAR NO ONE HAS BEEN ABLE TO AND I BEEN ASKING FOR 2 YEARS AND THE LONGER TIME GOES BY THE WORSE THINGS WILL GET AND IMPLANT OPTION BECOMES LESS OF AN OPTION WITH EVENTUAL MORE TEETH LOSS WICH MEANS THE GAW BONE MIGHT NOT EVENTUALLY BE ABLE TO ALLOW IMPLANT OPTION AND
- I DONT WANT TO WAIT THAT LONG
- WERE NOT THERE YET BUT EVENTUALLY IF NOT SOON IF SOMETHING ISNT DONE
- I DONT KNOW WHAT TO DO SO AGAIN
- I ASK OF YOU STEVE I AM A 44YO MALE ON SSDI MEDICARE ADVANTAGE PPO WITH DENTAL OPTION INCLUDED
- WHAT DO I DO? I LIVE IN SAN DIEGO xxxx3 IS MY NUMBER IT WORKS WHEN I CAN CONNECT TO FREE WIFI SO PHONE CONVERSATIONS HAVE TO BE SCHEDULED..
- I LOOK FOWARD TO YOUR HELP. KIND REGARDS, JOSEPH R
- Answer What about alternatives, like dentures?
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. - Question do you accept Medi-Cal and Medicare for dental implant work
. - Answer? See above, neither Medi Cal nor Medicare really give you ANY coverage for implants.
- Question I have Epilepsy and have been advised not to get dentures but recommend to only receive dental implants. I only have dental through Medi-Cal.
- I’ve received a quote of $50,000 to receive the implants that are needed.
- Will Medi-Cal pay for some or all the cost of my fee’s to receive the implants?
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- Answer Since you have a medical condition that might prevent you from getting dentures, maybe you could get Denti Cal to pay for implants. It’s a tough struggle.
- Here’s information on the appeals process. Have your dentist help you.
- See our webpage on Medi Cal appeals
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Importance of Dental Coverage
#Importance of Dental Coverage
Dental & General Health
Insurance 101?
We suggest that you check out Life Insurance, Disability, Long Term Care and Retirement as these risks may cause much more financial devastating to your budget than dental bills.
Picture of Oral Health
- Dental For #Everyone, Instant Quotes - Online Enrollment
-
Delta Dental - Get Quotes & Enroll
- Dental care reduces likelihood of hospitalization for people with diabetes or coronary artery disease Medical Press 5.6.2022
- The 2022 State of America’s Oral Health and Wellness Report Commissioned by Delta Dental Plans Association
- What drives buyers of individual Delta Dental plans?
- 77 Million Adults Do Not Have Dental Insurance
- CDA-sponsored bills seek more protections, increased oversight of dental insurance Bills would prohibit plans from imposing arbitrary waiting periods, denying coverage for preexisting conditions; require rate review and ERISA notice Learn More >> CDA * CA Legislature * California Benefits Review Program *
Steve on buying, shopping and best use of premium dollars
Dental Insurance VIDEO
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- VIDEO the dentist attempts to give you some guidance about things to consider before buying a dental insurance plan, finance plans available, negotiating with your dentist
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- Health Savings Accounts?
- Video - how bad sugary drinks are for you
Medical Tourism
We are not advising or recommending. We just have an expansive website.
- medical tourismco.com/dental-implants-in-mexico
- algodones dental implants.com/dental-implants
- beyond borders dental.com/50-things-you-should-know-about-getting-dental-work-in-mexico
- infomedd news.com/dental-implants-in-mexico-a-practical-guide-for-medical-tourists
- npr.org/a-reason-to-smile-mexican-town-is-a-destination-for-dental-tourism
- Go Fund Me??? Cheyenne’s Journey to Dental Implants $28,685 raised of $38,000 goal • 1.2K donations
All our plans are Guaranteed Issue with No Pre X Clause
Quote & Subsidy #Calculation
There is No charge for our complementary services
Watch our 10 minute VIDEO
that explains everything about getting a quote
- Our Quote Engine Takes all the complexity out of using pencil and paper to figure out the premiums per the Obamacare/ACA rules under CFR §1.36B-3 *
- Get more detail on the Individual & Family Carriers available in CA
Oral Health for #Seniors
Justice in Aging - Advocates Guide
- Denti-Cal under Medi Cal
- National Institute for Dental Research - Caregiver information
- Health.Gov tips for older adults
- nia.nih.gov/taking-care-your-teeth-and-mouth
- Dental Care - Medicare
FAQ’s
Medical Necessity #Orthodonture
- QUESTION I was born without my upper lateral incisors so I guess that would b considered congenital Maxillofacial deformity. It’s the tooth next to my two front teeth on both sides.
- I’m 37 Caucasian female and I currently have medi cal.
- I’ve worn a Hawley retainer for about 20 yrs.
- It has been a real struggle the whole time with it breaking and having to go days and at one point 18 months with missing teeth near the front of my mouth. It has caused me severe self consciousness, distress, trauma, anxiety, depression. I avoid social gatherings where eating in public settings together which is 96% of the time.
- Have u heard of this type of dental issue before?
- And can u point me in the right direction with more information about medically necessary billing coverage for my particular issue.
- And I already know I’d have to pay for bones grafting out of pocket.
- But my mom thinks maybe some type of implant secured denture would be cheaper but I don’t think that would apply to my needs due to I have all my other teeth minus a molar on the bottom of both left and right sides of mouth.
- I appreciate any help as this is the worst thing I’ve struggled with my whole life and had severe trauma in life that has impeded my ability to obtain proper permanent treatment.
- Answer Here’s the research, but it’s way beyond my pay grade to give you any real direction. Check with your dentist and here’s the phone # for Denti Cal – Smile CA 1-800-322-6384 Here’s the Medi Cal Ombudsmans website No, I’ve never had this type of question before.
- Our main webpage on Medical Necessity
- Medically necessary orthodontic treatment is orthodontic treatment that is rendered by an orthodontist or pediatric dentist to satisfy a demonstrated need for significant functional improvement of the teeth, jaws or related anatomy and is not rendered primarily for esthetic improvement.
- In order to demonstrate need for significant functional improvement, a patient must present with one or more of the following general conditions that can be definitively diagnosed (using generally accepted clinical standards) to be directly related to their malocclusion or jaw relationship:
- Severe impairment of oral function
- Chronic moderate pain or chronic severe pain that cannot be adequately managed through alternative treatments.
- Traumatic injury to the orofacial structures that requires reparative treatment with orthodontic appliances.
- Craniofacial anomaly or systemic disorder involving the dentition (see list).
- A malocclusion which, if left untreated, substantiates a prognosis of:
- o Premature loss and/or severe debilitation of an essential tooth or teeth
- o Severe debilitation of the dentition, periodontium, and/or temporomandibular joint(s).
- o A sustained or deteriorating condition that in an advanced state will no longer be treatable through orthodontic means alone and that, in an advanced state, will require more invasive or complicated treatment such as orthognathic surgery.
- Furthermore, medically necessary orthodontic treatment should be prescribed within generally accepted standards of orthodontic practice (evidence-based when possible). Read More Medically Necessary Orthodontic Treatment Med Mutual
- Missing lateral incisors in Lexington & Replacement with Wing Bridges
- Hypodontia (Missing Teeth)
- Para Regs – Medi-Cal – Scope of Benefits – General and Dental
- CLINICAL DENTISTRY GUIDELINES Liberty Dental
- Medically Necessary Orthodontic Care AAO
- https://www.dental.dhcs.ca.gov/MCD_documents/providers/ortho_packet.pdf
- Medically Necessary Orthodontic Treatment Med Mutual
- Clinical Guidelines for Implant Treatment in Patients with Down Syndrome nih.gov
- Immediate Implants: Clinical Guidelines for Esthetic Outcomes
- THE MEDI-CAL DENTAL PROGRAM ORTHODONTIC SEMINAR PACKET
- Hawley Retainer Picture from Diamond Braces.com
- Maxillofacial Surgery Cleveland Clinic
- Denti Cal Beneficiary Handbook
Liberty Dental Plan!
Liberty Dental DHMO (Dental HMO) plan features large group type benefits, for individuals and families.
Benefits Include:
No Annual Maximums, No Claim Forms, Coverage for Pre-Existing Conditions, No Waiting Periods, Orthodontia, Dental Implants and More.
More information
- Schedule of Benefits Copayment
- Liberty Online Provider Directory *
- Resources
- Frequently Asked Questions
- Eligibility for Benefits
- Evidence of Coverage
- Shows Exclusions & Limitations
- Terms and Conditions
- Survey of Cost Without Insurance
- Email us [email protected] to enroll
- BROKER ONLY
https://californiahealthline.org/news/article/dental-implants-investigation-failures-unnecessary-healthy-teeth/
https://www.cbsnews.com/news/dental-implants-increasing-profit-experts/
Hey trying to get my in implants
because I have been to the dental in a long time and my insurance do not Cover everything
but I really need my teeth done because I’m trying to get my life back to Together
and I can’t start no job look like this
can please help with me and think so much Because my insurance is HMO
Because I want to the dental try get me a dental but they keep saying they do not take my Insurance
im try to see what is wrong in san francisco treatment
Did you check out the Delta Dental No Wait plan?
How about alternatives like dentures?
I would like to have a an Implant – One tooth – I have Medi cal
Ask your dentist. See above, Medi Cal doesn’t cover implants. Check out SB 980 above to add implants!
Hello,
My name is Deborah W and I’m in a nursing facility and they have not taken me to a dentist thus I only have a few teeth on the bottom and one just fell out yesterday .
I did have great dentures but the staff steals everything you own.
I need to get a Dentist appointment and to have what is left of my teeth. The rest are either so decayed so it makes it impossible for me to eat. I have Medi cal and Medicare also United Healthcare
I’m hoping to find a Dentist that takes my insurance so I can get the remaining teeth pulled out and make me forms so you can make me dentures.
The nursing home is Windsor Gardens refuses to take me to a Dentist so all of the patients here have the same problem.
This Facility needs to be shut down for many reasons.
Sorry I know you didn’t need all the other things I wrote about.
Sorry, your inquiry is beyond my paygrade.
Here’s the Denti Cal Beneficiary Handbook.
Denti Cal doesn’t generally cover implants – here’s FAQ’s and explanation from Denti Cal.
I’m sorry, you asked about dentures. See your dentist.
Here’s our webpage on nursing homes
CA Department of Aging Consumer Guide to Long Term Care
See their resource guide on page 83 for agencies that might be able to help you get better care from your nursing home.
I’m in California in San Bernardino county
I have medical Denti Cal the dentist had told me I have an extra bone in my inner jaw on both ends.
However instead of grinding my extra jaw bone off for dentures to fit is there any way medical Denti Cal can cover two implant on bottom denture instead of grinding off my jaw bone due to the jaw bone loss over time the right way of doing things and not remove from my jaw bone.
Your question is beyond our pay grade. You really need to talk to your dentist and read everything on this page. Namely, the
Denti Cal Handbook
FAQ’s on Implants from Medi Cal
Our webpage on Medi Cal Appeals