Can a dentist refuse to see me because I have Medicare?

Some things will never make sense to us regarding health care.

I experienced an extremely high risk pregnancy and had to see a high risk specialist.

I almost died. My baby was in danger too. I was in an out of the hospital.

I ended up on complete bed rest for the duration of the pregnancy. My baby girl was born via an emergency cesarean section.

I went to pay for my first pregnancy visit at my doctor’s office and I was told that I did not have insurance!

Well, you can imagine my shock.

I immediately told the receptionist that she must be mistaken because my husband had good insurance.

So she says, “I will do as you ask and double check.”

When she called to verify she found out that my husband’s company had swapped the maternity insurance for dental insurance! We were screwed!

The inside joke between my husband and I was, “If we can figure out a way for the dentist to deliver our baby, then we are all set!”

So, I say to the receptionist at the doctor’s office, “Isn’t maternity insurance mandatory for employers to carry?”

She answers by saying, “Indeed, it is mandatory in most states. Only a few aren’t required.”

To which I said, “Let me guess, those few are ‘southern’ states.”

She says, “You guessed correctly. I am so very sorry!”

We made it through but our savings took a BIG hit!

High risk specialist without insurance cost a fortune!

Sometimes we have a safety net. Sometimes we don’t.

We either make it or we fall apart. Thankfully, we made it.

There must be something to not accepting cash, because it is happening more and more.

As Geaton says, they view it as complicated.

Seems crazy to me but I am no expert on this topic!

Once I took my brother to get insurance for his motorcycle. He had cash on him. The agency refused his cash.

It seems like cash is not always welcomed these days.

I have no idea how it works, so I am not claiming to be an expert in this matter.

This is only a thought that I am throwing out for the OP!

I have not used their services so I can’t recommend or not recommend them.

In my state there is a dental school run by a large university (LSU) that the public can use at discount rates.

I have no idea what the policies are at dental schools but I do know that the prices are greatly reduced.

Best of luck to you in finding dental care.

The Balanced Budget Act of 1997 prohibits drs from making private contracts with Medicare recipients. It means that’s drs cannot take cash from Medicare recipients for services covered by Medicare unless the dr has opted out of Medicare. There are similar laws regarding Medicaid, drs cannot accept Medicaid recipients as cash clients. It’s possible some of these laws extend to dentists as well, although in the OPs case traditional Medicare doesn’t cover dental cleanings so under the 1997 act I cited, they should be allowed to pay cash. But their dental office is really who they should be asking about this as someone there should be able to explain the policy change.

The same thing happened to my father with seeing our chiropractor we go to. He said he was paying cash and they said sorry if you have Medicare we can be sued. We can’t treat you

My moms insurance did not cover dental. .our dentist offered a plan that covered 2 cleanings and a discount for other proceedures. we never had a problem .but we did buy the private insurance he offered.

Medicare.gov: Medicare Part A (Hospital coverage) may cover if dental work done in hospital (emergency or complicated cases). Some Medicare Advantage plans offer dental (at dental office) coverage.

I don't get the fined part. We don't use our Medicare dental plan. He just wouldn't file with Medicare. They are either confused or making it up.

Our Medicare plan covers some dental work, but you have to see a dentist that is on their list. I looked them up and no way. It seemed like Dollar Store dentistry. We pay for our own dental insurance. It's not cheap but not awful. Ask your dentist what insurance he takes. There are several companies that offer dental insurance. Delta Dental and USAA are two that come to mind.

My husband has dental insurance. He had his teeth cleaned twice, at no cost to him. The last time, they wanted $100 co-payment. I asked what the cash price was. $100.
I called around and found one who accepted $60 cash.

Why the first dentist keeps calling, I do not know. They won't stop. We hang up on them.

Having Medicare has nothing to do with dentists. When I didn't have dental, I just paid cash to my dentist. If the receptionist said Medicare she probably meant Medicaid. Talk to the office manager. I think a mistake has been made. People get the two confused all the time.

Now Medicaid for heath, dental and vision, you need to find doctors who except it. When u are on Medicaid, you are not allowed to pay cash and the doctor who excepts it can be fined.

We had this with my nephews Neurologist when he was on straight Medicaid. His Neurologist did not except Medicaid and was not allowed to except cash. We had to find a Medicaid Neurologist. Once, though he was on Medicare with Medicaid as a supplimental he was allowed to go back to his old Neurologist.

Yes, they can refuse any patient. A few years ago, my tooth abcessed and my entire face was swollen and I had my dentist for years. They started the root canal procedure, like drilled it to drain it. The new office manager came in and said my dental was cancelled, I told her yeah, I have cash no problem. She said they could get me a dental credit plan (they get referral fees), I said no, I have cash. They stopped the procedure, put an anticeptic ball in the tooth and some putty on top and said they couldn't finish it. I was so pi$$ed.

Some Medicare Advantage plans cover dental.

https://www.ada.org/en/member-center/member-benefits/legal-resources/publications-and-articles/reimbursement/medicare-enrollment-decision-tool-introduction-medicare-enrollment/medicare-enrollment-faq

Yes, they can refuse Medicare patients. They don't get reimbursed enough from Medicare so they'd have to see many more patients in the course of every day to make the same amount of money.

My dentist no longer accepts the work-provided dental insurance plan i am on, so yes they can refuse to accept you. I did pay cash for the visit i was attending and in the meantime had to find a new dentist - after 20 years.

The reimbursement model gets too low - they can't afford the patient.

Many dentists now expect consumers to have dental insurance and refuse cash.

Medicaid does indeed pay for Dental, at least here in NY it does.

Medicare doesn't really pay for dental work that I know of; nor does many supplemental insurance policies. I am not certain why a dentist would even ask about medicare or medicaid as they just don't cover dental; I understand their asking if you have dental insurance. Usually a dentist gives you an estimate of the work you need, and asks for some payment up front, the rest after the work is done.
Also, you are paying cash, so what you are a member of or not a member of should not figure in things?
I would speak with your dentist again, ask what you are missing, and telling them you will take your/their story to the American Dental Assn. or the Dental Board of the State of ____________(your state) to ask for details. Tell them that you suspect there may be some patient abandonment here and you would like a letter of explanation as to why they can no longer treat you.
Have there been any problems between you and this dental group in the past?

Medicare or MEDICAID? I suspect it is the latter.

I would say that they are making it up if you are a cash patient.

I would ask the dentist if they know that cash customers are being turned away.

Call and leave a message on the dentist's voicemail or go in and request to see the doc. Be loud if you are brushed off so you can be heard by the person that you want to speak with. The front office workers in medical offices tend to be beyond ignorant towards patients and many times their employer has no clue that they are behaving so out of line.