The Centers for Medicare and Medicaid Services (CMS) has updated information on the Medicare program and contact information for professionals in New York.
In summary, dentistry is excluded from the Medicare benefit package with limited exceptions. The most significant change is, beginning in December 2015, when Medicare recipients purchase supplemental Medicare insurance policies (i.e., Part D drug plans), those plans only will provide benefits when the ordering doctor is “known to” Medicare, i.e., “opted-in” or “opted-out”. It is therefore advisable for dentists either to enroll as Medicare providers or submit affidavits indicating that they wish to “opt-out” of the program. If the dentist takes no action, patients with Part D coverage will not receive benefits when their dentist writes a prescription for them. The important things to note are:
- Regardless of their decision (“opt in” or “opt out”), their patients with Medicare Part D plans will have coverage for any covered prescriptions written by their dentists.
- Dentists who elect to “opt out” are not required to provide individual notifications to patients in their practices as, again, dentistry is not included in the Medicare program.
NYSDA has this information on their website and they also provided the Medicare Summary memo below:
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