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I've been seeing the same dentist for the past 15 years. Today I had an appointment and when I arrived, I was told that they couldn't see me because I have Medicare and they didn't accept Medicare. I've had Medicare for the past 7 years and have always paid cash. They said they could be fined if they saw me. Is this true or were they making that up?


Thanks, Ken

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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.
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rovana Feb 2021
I don't quite understand - if you are paying cash, why not just say you have no applicable insurance coverage and go from there?
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Medicare or MEDICAID? I suspect it is the latter.
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AlvaDeer Feb 2021
Oh, I took it to mean medicare.
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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?
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kennyb2 Feb 2021
No problems at all, I did cancel one appointment because of covid.
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Medicaid does indeed pay for Dental, at least here in NY it does.
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AlvaDeer Feb 2021
But this isn't medicaid, as I understand it?
The OP says medicare. Does medicare do anything other than surgical dental work?
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Many dentists now expect consumers to have dental insurance and refuse cash.
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Isthisrealyreal Feb 2021
I have never experienced such a thing. Considering dental insurance covers almost nothing it sounds like a business plan for failure.
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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.
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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.
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Some Medicare Advantage plans cover dental.
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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$$ed.
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notgoodenough Feb 2021
Wow, I don't blame you, I'd be pi$$ed off, too!
I would seriously have reported this to the AMA, or whatever watchdog agency oversees dentists! Stopping in the middle of a procedure! If that wasn't a classic "bait and switch" tactic, I don't know what is! Shame on them!
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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.
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worriedinCali Feb 2021
“Having Medicare has nothing to do with dentists”

That is false. Some people have dental coverage through their Medicare advantage plans.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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Stacy0122 Feb 2021
Wow, you really needed to get me worked up before bed on that POS legislation that you know started MERP which I personally have a huge problem with.

You know, I read things here which are totally wrong, sometimes sickening...the my tax dollars, etc, etc. Just disgusting, imo.

I have been on a one person mission to destroy that act, for alot of reasons. Jeez, if you could only see my response from my POS Senator, I will never vote for her again, ugh.

Sometimes I wish people did not just come to the site for the support. No one will ever rock the boat, please do not get me into that but just guess. The Wallstreetbets, completely entertains me, but they will change things and I wish that was what this is about but we do not have Daddy Elon, but wish we did.
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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.
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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.
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Geaton777 Feb 2021
They are not a retail outlet. They don't like to have cash because it "disappears"; it sets them up for robbery; but mostly because their bookkeeping and accounting apps can't track it like a check or cc payment. They don't have a way to "make change". My business doesn't take cash either. Most corporations and non-retail businesses don't take it. In medical facilities and clinics everything regarding billing is based around codes. It is more complicated than you can know.
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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.
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Geaton777 Feb 2021
NHWM, I'm prefacing this by saying I'm not laying blame on you for the payment debacle, but as an employer who has provided medical, dental and vision coverage for my employees since 1984, it is the employees' responsibility to know and understand what their benefits are. I know it is complicated (and believe me, it is complicated from the employer's side as well!) I take pains to make clear what our benefits are to a point, but they must read the carrier and provider paperwork provided to them. FYI we provided 100% coverage for medical, dental, vision AND covered their deductibles up until the 2000's when the cost of coverage was going up over 10% every single year. Now we offer 70-30 + full HSA contribution. There are many reasons why it has become the crap show called health insurance. Too many for this forum, but we need to push for pricing transparency.
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