Legal

Ask a Lawyer and Get Answers to Your Legal Questions

Ask a Lawyer,
Get an Answer ASAP!

Legal
This answer was rated:

My wife has a condition that is covered by Medicare---GVHD,

Graft Versus Host Disease, which...
My wife has a condition that is covered by Medicare---GVHD, Graft Versus Host Disease, which she fought for 4 years with Prednisone. Prednisone kept GVHD in check and now her system is able to keep GHVD in check, for the past 14 months---she has been prednisone free. However, prednisone has side effects--it decreases the blood supply to the ends of the bones. Hence, she has had two joint replacements and needs two more! However, GVHD did do in her sliva glands before it was held in check, as I mentioned before. One of the spin offs of no sliva is very dry mouth. Hence, her medical condition has caused an increase in caries in her mouth. She brushes, flosses and swabs several times a day, but the bad germs are able to atttack the base of her teeth causing a deepening replacement of her crowns. How can I submit a claim for dental work caused by a medical situation that is covered by a Medicare?
Show More
Show Less
Ask Your Own Legal Question
Answered in 1 day by:
11/10/2011
LADYLAWYER
LADYLAWYER, Lawyer
Category: Legal
Satisfied Customers: 6,536
Experience: Civil; Family; HOA; Landlord/Tenant; Real Estate; Probate; Insurance; Immigration; Wills & Trusts
Verified
LADYLAWYER :

Hello, Thanks for choosing Justanswer.com! I look forward to helping you with legal information today.

LADYLAWYER :

It sounds like your wife may have Sjogren's Syndrome, which is an autoimmune condition that attacks the saliva glands and makes the mouth very dry. I would recommend she see a rheumatologist and be tested for all the Sjogren's antibodies. If she is diagnosed with Sjogren's Syndrome, Medicare will probably cover her dental work. You will need to find a dentist that bills Medicare.

LADYLAWYER :

Another option is to ask if Medicare has assigned your wife a Case Manager. They will tell you no, but ask for the Supervisor, etc. You can also ask for the phone number for the Case Management department and talk to them directly.

LADYLAWYER :

Medicare Does Cover These Types of Dental Services:

LADYLAWYER :

Dental services that are an integral part of a covered procedure (e.g., reconstruction of the jaw following accidental injury).

Extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw.

Oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances. Such examination would be covered under Part A if performed by a dentist on the hospital's staff or under Part B if performed by a physician. This is because the purpose of the examination is not for the care of the teeth or structures directly supporting the teeth. Rather, the examination is for the identification, prior to a complex surgical procedure, of existing medical problems where the increased possibility of infection would not only reduce the chances for successful surgery but would also expose the patient to additional risks in undergoing such surgery.

Hospital stays if needed for emergency or complicated dental procedures, even when the dental care itself is not covered. In these cases you should call your Part A contractor for more information.

Inpatient hospital services in connection with the provision of such dental services if the individual, because of his underlying medical condition and clinical status or because of the severity of the dental procedure, requires hospitalization in connection with the provision of such services.

Surgical procedures for the reconstruction of a ridge as the result of and at the same time as a tumor removal (for other than dental purposes).

Payment for the wiring of teeth when it is done in connection with the reduction of a jaw fracture.

Dental splints are covered if used in conjunction with the treatment of a covered medical condition (i.e., dislocated upper and/or lower joints).

Medicare makes payment for a covered dental procedure no matter where the service is performed. The hospitalization or non-hospitalization of a patient has no direct bearing on the coverage or exclusion of a given dental procedure.

LADYLAWYER :

The Medicare chronic disease dental scheme was introduced in November 2007. The scheme allows chronically ill people who are being managed by their GP under an Enhanced Primary Care (EPC) plan access to Medicare rebates for Dental services. So as long as your wife's need for the dental work is required because of a chronic condition (which it sounds like she already has), then she should be covered.

Customer:

Thanks for the info. It looks like I can submit bills for current work to Medicare. Is there a form to use or her dentist to use? Also, it looks like I should find the Medicare number and talk to a case worker or a supervisor for further clarity.

Customer:

Sorry I wasn't on the compurter earlier this morning as I was busy helping my wife in the home.

LADYLAWYER :

No problem! There is often a form that the dentists who ork with Medicare will have for to submit. Otherwise, you can ask the Case Manager to send you a form. Blessings to yoand your wife. I also have Sjogren's so I am in the same boat with the oral care.

LADYLAWYER :

If you have any more questions, I am happy to answer them! If this answer is responsive to your question, please accept it. That is how we are compensated and it will cost you nothing further to do. It would also be appreciated if you provided feed back on your view of the answer. Finally, if the answer was especially helpful you can provide a bonus. If I can be of further assistance or you have other questions in the future you can ask for me and reach me at this site.


LADYLAWYER
LADYLAWYER, Lawyer
Category: Legal
Satisfied Customers: 6,536
Experience: Civil; Family; HOA; Landlord/Tenant; Real Estate; Probate; Insurance; Immigration; Wills & Trusts
Verified
LADYLAWYER and 87 other Legal Specialists are ready to help you
Ask your own question now
Ask LADYLAWYER Your Own Question
LADYLAWYER
LADYLAWYER
LADYLAWYER, Lawyer
Category: Legal
Satisfied Customers: 6,536
6,536 Satisfied Customers
Experience: Civil; Family; HOA; Landlord/Tenant; Real Estate; Probate; Insurance; Immigration; Wills & Trusts

LADYLAWYER is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

Mr. Kaplun clearly had an exceptional understanding of the issue and was able to explain it concisely. I would recommend JustAnswer to anyone. Great service that lives up to its promises!

Gary B.Edmond, OK

My Expert was fast and seemed to have the answer to my taser question at the tips of her fingers. Communication was excellent. I left feeling confident in her answer.

EricRedwood City, CA

I am very pleased with JustAnswer as a place to go for divorce or criminal law knowledge and insight.

MichaelWichita, KS

PaulMJD helped me with questions I had regarding an urgent legal matter. His answers were excellent.

Three H.Houston, TX

Anne was extremely helpful. Her information put me in the right direction for action that kept me legal, possible saving me a ton of money in the future. Thank you again, Anne!!

ElaineAtlanta, GA

It worked great. I had the facts and I presented them to my ex-landlord and she folded and returned my deposit. The 50 bucks I spent with you solved my problem.

TonyApopka, FL

Not only did he answer my Michigan divorce question but was also able to help me out with it, too. I have since won my legal case on this matter and thank you so much for it.

LeeMichigan

< Previous | Next >

Meet the Experts:

Tina

Tina

Lawyer

8,775 satisfied customers

JD, BBA Over 25 years legal and business experience.

Ely

Ely

Counselor at Law

24,325 satisfied customers

Private practice with focus on family, criminal, PI, consumer protection, and business consultation.

INFOLAWYER

INFOLAWYER

Attorney

20,642 satisfied customers

Licensed attorney helping individuals and businesses

JPEsq

JPEsq

Attorney

2,132 satisfied customers

Experience as general attorney, in house counsel, SSDI, Family Law attorney, and law professor

Law Educator, Esq.

Law Educator, Esq.

Attorney

42,245 satisfied customers

JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law

Ellen

Ellen

Lawyer, Consultant

8,238 satisfied customers

25 years of experience helping people like you.

Guillermo J. Senmartin, Esq.

Guillermo J. Senmartin, Esq.

Attorney

290 satisfied customers

7+ years of experience handling various legal matters.

< Previous | Next >

Related Legal Questions
The owners of my complex are getting a new HUD loan and have
The owners of my complex are getting a new HUD loan and have known for several months. This week they inspected my apartment and told me many changes must be made before December 28. They plan to repl… read more
INFOLAWYER
INFOLAWYER
Attorney
Doctoral Degree
20,642 satisfied customers
We just received an "Injunction against Harassment" that was
We just received an "Injunction against Harassment" that was petitioned for by our next door neighbor. The statements made to obtain the injection are lies. I am fine without talking to them or going … read more
LegalGems
LegalGems
Juris Doctorate
10,377 satisfied customers
Under what circumstances would one party's counsel threaten
under what circumstances would one party's counsel threaten rule 130-1.1 to the other party counsel and how often is it done? thank you… read more
LegalPro54
LegalPro54
Doctoral Degree
1,258 satisfied customers
CAN A MUNICIPALITY FORCE A CITIZEBN TO SIGN AN ILLEGAL
CAN A MUNICIPALITY FORCE A CITIZEBN TO SIGN AN ILLEGAL CONTRACT IN ORDER FOR THE CITIZEN TO USE PUBLIC RECREATIONAL FACILITIES. IE AN EXCULPATORY AGREEMENT TITLED RENTAL AGREEMENT THAT IS REALLY AN WA… read more
HPlawyer
HPlawyer
Attorney at Law
Doctoral Degree
854 satisfied customers
I live in California and have letter from my bank stating
Hi I live in California and have letter from my bank stating they received a subpoena/summons in connection with a case. It says they will comply with the summons unless I provide a copy of a court fi… read more
Bill Attorney
Bill Attorney
law
1,479 satisfied customers
I was in a car accident and was hit but the other driver no
I was in a car accident and was hit but the other driver no one was cited no witness and one was hurt says conflicting story on report but I didn't have insurance am I responsible for fixing his car … read more
Gerald, Esq
Gerald, Esq
Juris Doctor
3,093 satisfied customers
I need to write a cancellation letter to diamond resorts
i need to write a cancellation letter to diamond resorts international to terminate a "sampler package" contract i have now realized is not a good thing. i entered into the agreement on December 8, 20… read more
Ray
Ray
Lawyer
Doctoral Degree
30,492 satisfied customers
If I had a tenant under a 1 year lease with 1 month deposit
Good evening,If I had a tenant under a 1 year lease with 1 month deposit and at the end of that lease they asked to move to another apt of mine which is more expensive, can I keep their existing depos… read more
Barrister
Barrister
Attorney/Landlord/Realtor
Doctoral Degree
34,894 satisfied customers
I am in a nursing home and I had a special package delivered
I am in a nursing home and I had a special package delivered that had some cash as well as special paperwork in it it was tracked by the post office and the post office let me know it was delivered I … read more
Phillips Esq.
Phillips Esq.
Attorney
Juris Doctor
18,110 satisfied customers
Transfer real estate from PA LLC to sole member. Did you
transfer real estate from PA LLC to sole member JA: Can you tell me what state the LLC is registered in? Customer: did you read my question? JA: Has anything been filed or reported? Customer: not rega… read more
DrakeLAW
DrakeLAW
Juris Doctorate
893 satisfied customers
My son was recently found guilty of evading a officer and
My son was recently found guilty of evading a officer and was given 2 years. He pulled over on his own, did not resist arrest was cooperative. However, we feel the Attorney did not represent my son to… read more
Irwin Law
Irwin Law
Juris Doctor JD
7,059 satisfied customers
I have a question about social security. Are you familiar
I have a question about social security. Are you familiar with not claiming social security benefits as a divorced spouse married for 32 years. The mother didn't know she was entitled to claim half of… read more
Edward Young
Edward Young
Juris Doctor
83 satisfied customers
My husband was buried in the wrong plot and the cemetery
My husband was buried in the wrong plot and the cemetery will relocate his body to the correct one. Does the cemetery owe me, as his wife, any compensation other than an apology (i.e. money towards a … read more
LegalGems
LegalGems
Juris Doctorate
10,377 satisfied customers
I own a house and have tenants who have a lease until the
hello I own a house and have tenants who have a lease until the end of January 2018 … read more
Barrister
Barrister
Attorney/Landlord/Realtor
Doctoral Degree
34,894 satisfied customers
I'm an international student and I dropped out of school a
I'm an international student and I dropped out of school a year ago. Is it okay for me to travel by plane in the U.S if I have a valid driver license? … read more
Barrister
Barrister
Attorney/Landlord/Realtor
Doctoral Degree
34,894 satisfied customers
Have employee threatening we promised full time and now only
Have employee threatening we promised full time and now only offering part time. In addition left voluntarily for 3 months and filed for unemployment in CA telling them we laid her off. Reported to Ca… read more
Legal Eagle
Legal Eagle
Attorney
Doctoral Degree
6,353 satisfied customers
I just received a call from" Freeman" 646Said I had just. I
I just received a call from "Michael Freeman" (###) ###-####Said I had just … read more
LegalGems
LegalGems
Juris Doctorate
10,377 satisfied customers
Can I write a letter to the judge asking him to release me
Can I write a letter to the judge asking him to release me early from probation so I can get out to another state with my family?… read more
Law Educator, Esq.
Law Educator, Esq.
Attorney
Doctoral Degree
42,245 satisfied customers

DISCLAIMER: Answers from Experts on JustAnswer are not substitutes for the advice of an attorney. JustAnswer is a public forum and questions and responses are not private or confidential or protected by the attorney-client privilege. The Expert above is not your attorney, and the response above is not legal advice. You should not read this response to propose specific action or address specific circumstances, but only to give you a sense of general principles of law that might affect the situation you describe. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction to which your question pertains.

The responses above are from individual Experts, not JustAnswer. The site and services are provided “as is”. To view the verified credential of an Expert, click on the “Verified” symbol in the Expert’s profile. This site is not for emergency questions which should be directed immediately by telephone or in-person to qualified professionals. Please carefully read the Terms of Service (last updated February 8, 2012).

DISCLAIMER: Answers from Experts on JustAnswer are not substitutes for the advice of an attorney. JustAnswer is a public forum and questions and responses are not private or confidential or protected by the attorney-client privilege. The Expert above is not your attorney, and the response above is not legal advice. You should not read this response to propose specific action or address specific circumstances, but only to give you a sense of general principles of law that might affect the situation you describe. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction to which your question pertains.

The responses above are from individual Experts, not JustAnswer. The site and services are provided “as is”. To view the verified credential of an Expert, click on the “Verified” symbol in the Expert’s profile. This site is not for emergency questions which should be directed immediately by telephone or in-person to qualified professionals. Please carefully read the Terms of Service (last updated February 8, 2012).

Show MoreShow Less

Ask Your Question

x