Getting a Root Canal Done Under Medicare

My brother is in a care facility and is in need of a root canal. He has SS, Medicaid, and Medicare. How or can he get help with the cost?

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April 9, 20191 found this helpful

If he lives near a dental school, he can get care at a reduced cost. The waiting list is often long, though.

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April 9, 20191 found this helpful

Medicare does not cover dental. Medicaid dental coverage varies widely from state to state. TN, DE, and AL have none. NV, UT, AZ, TX, MS, MD, WV, FL, MN, NH are "emergency only" (you probably will need a doctor to write orders to prove the emergency). The rest of the states have either limited or extensive coverage. It's a crying shame for the richest country in the world. :-(

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April 10, 20190 found this helpful

I Totally agree! "Crying Shame"

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April 12, 20190 found this helpful

Medicare does not cover any dental unless it is an emergency and that usually means "within a hospital setting".

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Almost every state is a little different with their Medicaid coverage so you will have to work within their guide lines.
Here is a statement from Medicare/Medicaid.Gov about dental coverage for adults:

Dental Benefits for Adults in Medicaid
"States have flexibility to determine what dental benefits are provided to adult Medicaid enrollees. While most states provide at least emergency dental services for adults, less than half of the states currently provide comprehensive dental care. There are no minimum requirements for adult dental coverage."

Have you talked with the patient advocate in your brother's care facility? You do not say if you can legally speck for your brother so whoever has that authority will have to be the one asking the questions.
This person should be able to tell you what is available through Medicaid in your area. They should also be able to assist in finding financial help for anything that is not covered or if you have to go to a private dentist.

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There are health reasons he may be able to receive assistance from Medicaid but it would have to be presented by his doctors.
If he has mental problems, disabilities, serious health problems, he may be able to ask for dental coverage so as not to impair his health any further. If this problem is causing him severe pain or keeping him from being able to eat a healthy diet then this may be covered.

Someone will have to do the leg work as this sort of thing does not just happen by itself but I know it can be done.
If you cannot get help through the advocate at the care facility then you should check out other family service centers. Even ask AARP for help as they usually have representatives in cities or call their national help line and they can direct to someone for help.

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