Medical Card Dental Coverage

andodenis. · 09-11-2012 3:50pm

Originally Posted by Rockin
Current medical card dental coverage as of February 2011

an examination,
2 fillings (emergency)
as many extractions as required

I was wondering about some things
1/ Is this the same level of coverage for Medical card holders now, it hasn't been changed or reduced, has it?
2/ Does the filling have to be an emergency filling? How is this defined? Is it the dentist that defines what an emergency is?
3/ I have broken part of my tooth, the filling in the tooth is still in place, but I will need a new filling to make sure it stays there, is this counted as an emergency?
4/ Does the dentist of the medical card holder have the right to refuse to cover some of the things that are supposed to be covered? Can he pick & choose & decide himself what level of coverage to provide? Or does he have to provide the full level of coverage?
I just want to make sure of a few things before I visit the dentist.

tfjmor · 12-12-2012 9:34pm

Rockin wrote: »

Current medical card dental coverage as of February 2011

an examination,
2 fillings (emergency)
as many extractions as required

Today,4/12/12,:mad: my dentist informed that the current treatments allowed by the HSE under the medical card scheme are:
1 - annual check up & extractions only. Fillings not covered.

Oral Surgeon · 12-12-2012 9:50pm

tfjmor wrote: »

Today,4/12/12,:mad: my dentist informed that the current treatments allowed by the HSE under the medical card scheme are:
1 - annual check up & extractions only. Fillings not covered.

2 fillings per year are covered afaik...

lmahoney79 · 14-02-2013 5:51pm

Need a false tooth, is any of this cost covered by medical card?

andym1 · 05-03-2013 11:45pm

Here is the latest update from the HSE updated 18/2/13

http://www.hse.ie/eng/services/healthpromotion/dental/

yohanlon · 14-03-2013 11:49pm

lmahoney79 wrote: »

Need a false tooth, is any of this cost covered by medical card?

Your dentist can send a form for approval to see if this can be covered, the rule is it has to be for aestethics so if its a front tooth you have a good chance as opposed to a back tooth.

ordinary_girl · 15-07-2013 6:52pm

I know you can't get root canal treatment on the medical card but is there even a reduced rate or something for mc holders? I've already had one tooth removed that I was told probably could've been kept if I got a root canal but I couldn't afford it. I really don't want to have to do that again.

yohanlon · 15-07-2013 7:17pm

You are entitled to have root canal on your first 3 teeth each quadrant.as in front tooth, next one and eye tooth anything back is considered cosmetic, other than that the medical card will pay for an extraction. Maybe put your name on the waiting list at a dental hospital where the price will be way less but is time consuming??

Kanno · 08-10-2013 10:36pm

Are you limited to one dentist with the medical card or can you go to different dentists during the year ,i.e get extraction with dentist A and filling with dentist B ?

yohanlon · 08-10-2013 10:38pm

Your not tied to any dentist with a medical card like you are with a doctor so can get treatment done whereever you like, however the first dentist you visit will more than likely do your examination and claim it on your card so visiting a 2nd dentist you may have to pay privately for an exam before they'll do fillings.
Hope this helps

Kanno · 08-10-2013 10:40pm

yohanlon wrote: »

Your not tied to any dentist with a medical card like you are with a doctor so can get treatment done whereever you like, however the first dentist you visit will more than likely do your examination and claim it on your card so visiting a 2nd dentist you may have to pay privately for an exam before they'll do fillings.
Hope this helps

Thank you ,that is good to know.

Big_G · 08-10-2013 10:41pm

You are not limited to the same dentist but you are limited to the same amount of work regardless as stated above. So no matter the number of dentists you see you still have the same limited treatment available and dentists check it online what you are entitled to. So if you've been to another dentist, it can be checked to see whether you are eligible for any more work in the calendar year.

Kanno · 03-12-2013 2:22am

From what I have read the medical card covers emergency treatment and relief of pain .
What does this emergency treatment and relief of pain actually entail ?

btkm8unsl0w5r4 · 03-12-2013 11:30am

Prescriptions, fillings, extractions, possibly root canal on front teeth.

lorweld · 07-01-2014 10:52pm

Would a person over 70 with a medical card be entitled to free dentures? Tia

Mingetoad · 09-01-2014 8:27am

Each case is assessed separately. If you are missing any front teeth, more than four back teeth and haven't had a denture made under the medical card in the last five years you will most likely be approved.

tina4t · 08-02-2014 11:53pm

it has changed over the years

HairMare · 09-02-2014 2:20pm

Is there any grounds by which they will cover a root canal any more?

davo10 · 09-02-2014 5:33pm

HairMare wrote: »

Is there any grounds by which they will cover a root canal any more?

On a front tooth, maybe, not on a back tooth.

Kristopherus · 09-02-2014 5:43pm

HairMare wrote: »

Is there any grounds by which they will cover a root canal any more?

This is from a Handout I got in a Dental Surgery last week:

"Certain below the line treatment i.e. Periodontal Treatment, Root Canal Treatment & Dentures may be covered by the HSE. An application is submitted to HSE (Region) seeking approval prior to any treatment commencement. HSE(Region) will base their decision on certain medical conditions determined by the HSE."

Make of that what you will, but if you go ahead, make sure you or the Dentist have received the appropriate approval.

davo10 · 09-02-2014 5:48pm

Kristopherus wrote: »

This is from a Handout I got in a Dental Surgery last week:

"Certain below the line treatment i.e. Periodontal Treatment, Root Canal Treatment & Dentures may be covered by the HSE. An application is submitted to HSE (Region) seeking approval prior to any treatment commencement. HSE(Region) will base their decision on certain medical conditions determined by the HSE."

Make of that what you will, but if you go ahead, make sure you or the Dentist have received the appropriate approval.

This relates to root canal treatment on front teeth. Note that they approve treatment based on the presence of underlying medical problems etc diabetes, cancer, Hepititis etc

HairMare · 09-02-2014 7:36pm

I take it screaming the house down in pain doesn't count? Im not sure what specification of tooth it is, not at very front but visible all the same. Thanks for replies il ask my dentist first thing

btkm8unsl0w5r4 · 09-02-2014 8:03pm

The dentist would love to do it for you, the problem the Hse won't pay him, Hse would rather you toothless.

davo10 · 09-02-2014 8:06pm

HairMare wrote: »

I take it screaming the house down in pain doesn't count? Im not sure what specification of tooth it is, not at very front but visible all the same. Thanks for replies il ask my dentist first thing

In the HSE's opinion, if it is any further back than the canine (eye) tooth, extraction is the treatment of choice, retention would be for cosmetic reasons.

HairMare · 10-02-2014 9:57am

davo10 wrote: »

In the HSE's opinion, if it is any further back than the canine (eye) tooth, extraction is the treatment of choice, retention would be for cosmetic reasons.

I think it's a canine, or the bottom equivalent of same. Pain has subsided at the min hoping this bliss lasts

Terry Wogans Inner Thigh · 04-04-2014 9:41am

How can I get a check up for my 4 year old on the medical card? Do I make an appointment with the community dentist? She grinds her teeth a lot in her sleep and I'm worried it might cause her damage.

davo10 · 04-04-2014 12:21pm

Terry Wogans Inner Thigh wrote: »

How can I get a check up for my 4 year old on the medical card? Do I make an appointment with the community dentist? She grinds her teeth a lot in her sleep and I'm worried it might cause her damage.

Over 16 years of age, a check is covered by medical card once a year with participating dentists. Under 16 years of age a check is free only with community/health board dentists as HSE has direct responsibility for kids up to 16. Contact your local HSE head quarters for details. Also if child is at school, contact the school for name of HSE dentist assigned to that school.

Terry Wogans Inner Thigh · 04-04-2014 7:56pm

davo10 wrote: »

Over 16 years of age, a check is covered by medical card once a year with participating dentists. Under 16 years of age a check is free only with community/health board dentists as HSE has direct responsibility for kids up to 16. Contact your local HSE head quarters for details. Also if child is at school, contact the school for name of HSE dentist assigned to that school.

Thanks, she's not in school yet, will give them a ring on Monday so ðŸ˜႒

Chavez · 12-04-2014 2:30am

Terry Wogans Inner Thigh wrote: »

How can I get a check up for my 4 year old on the medical card? Do I make an appointment with the community dentist? She grinds her teeth a lot in her sleep and I'm worried it might cause her damage.

Hi,

My daughter also grinds her teeth. Have been back and forth to the dentist over the last couple of years because I'm always worrying about it. She cracked and broke a back tooth from it. Every time they say not to worry as they are just the milk teeth. The only time you should worry is if it continues when she has her adult teeth.

The last time I went [around two months ago], I told her of my concerns that her teeth were really small and almost to the gum at the top front. I asked was there a shield/guard she could wear at night to protect them. I was told it's not recommended! But I could go and buy a sports guard if it bothered me so much. So, I did! I bought one online for kids that moulds to the shape of the kids mouth. And we haven't looked back. She wears it every night [that we remember XD] and I feel better knowing she's not going to grind right into pulp or break her teeth and cause severe pain.

So if you have no joy getting into a dentist, just a thought on buying a guard maybe

davo10 · 12-04-2014 6:15am

Chavez wrote: »

Hi,

My daughter also grinds her teeth. Have been back and forth to the dentist over the last couple of years because I'm always worrying about it. She cracked and broke a back tooth from it. Every time they say not to worry as they are just the milk teeth. The only time you should worry is if it continues when she has her adult teeth.

The last time I went [around two months ago], I told her of my concerns that her teeth were really small and almost to the gum at the top front. I asked was there a shield/guard she could wear at night to protect them. I was told it's not recommended! But I could go and buy a sports guard if it bothered me so much. So, I did! I bought one online for kids that moulds to the shape of the kids mouth. And we haven't looked back. She wears it every night [that we remember XD] and I feel better knowing she's not going to grind right into pulp or break her teeth and cause severe pain.

So if you have no joy getting into a dentist, just a thought on buying a guard maybe

Be aware, this may damage the tissues in your daughters jaw joints. It may also effect the eruption and positions of her adult teeth. Your decision.

btkm8unsl0w5r4 · 12-04-2014 7:23am

All kids grind there teeth, its sounds aweful and the baby teeth often look very very worn by the time they fall out.

A bite guard in a growing child can possibly cause restriction in the growth of her jaws and is not recommended. I know you trying to do the best for your child but this one is counter intuitive.

Chavez · 12-04-2014 1:17pm

I actually didn't know that! I was just going on the advice of her dentist. Kinda lost as to what to do now! She's a bad grinder like, down to breaking teeth

Terry Wogans Inner Thigh · 12-04-2014 1:25pm

Ray Shrilling Stovepipe wrote: »

All kids grind there teeth, its sounds aweful and the baby teeth often look very very worn by the time they fall out.

A bite guard in a growing child can possibly cause restriction in the growth of her jaws and is not recommended. I know you trying to do the best for your child but this one is counter intuitive.

Ok, good to know, never heard of other children doing it, my two year old doesnt but he doesn't have a lot of teeth yet.

I do it and wear a bite guard, I have worn one since my teens.

tooth_doc · 11-05-2014 8:59pm

Biteguard especially a store brought sports guard is very restrictive on a growing child, if at all a biteguard is fitted for whatever reason, the dentist will,have to bring the child back for more frequent monitoring and adjustments to accommodate growth

However you should seek to find out if there are any other reasons that the child is grinding, i have a active interest in adult jaw joint problems and i see quite a few children who grind too, however childrens grinding could be because of many other reasons. One of the most common reasons is stomach or gastro intestinal problems including childrens gastro oesophageal reflux which is a known condition, the child need to be checked by your family GP to rule out other systemic causes

Tabitharose · 20-10-2014 11:22pm

hi, can anyone advise what a medical card covers, in relation to an abscess on a front tooth? does it cover anything for replaacing the tooth (denture or other) if the tooth needs to be removed? thanks in advance

digzy · 22-10-2014 9:26pm

Tabitharose wrote: »

hi, can anyone advise what a medical card covers, in relation to an abscess on a front tooth? does it cover anything for replaacing the tooth (denture or other) if the tooth needs to be removed? thanks in advance

Post#86 on essentially the same thing.

Read th thread. I'd say your query would be answered on at least 15 different occasions

ordinary_girl · 08-01-2015 6:53pm

Does the medical card cover surgical wisdom tooth extractions?

Ageyev · 02-06-2015 5:54pm

Has anyone got more information on the "some additional treaments" which might be available on medical card with "HSE approval"?

Additional treatments for example, teeth cleaning are available to those persons with specific medical conditions and again, your dentist will be able to advise you of your entitlement if this is the case.

http://www.hse.ie/eng/services/list/2/dental/

Are the medical conditions list on the link above guaranteed to meet HSE approval for necessary treatment or does a decision rest on the whims of a HSE deciding officer? Have the HSE been any more generous with these "pre-approval needed" treatments since the recent 2011 guidelines? Has the economic recovery trickled down into medical card dental services or is it really strict?

Big_G · 12-06-2015 4:21pm

Ageyev wrote: »

Has anyone got more information on the "some additional treaments" which might be available on medical card with "HSE approval"?

http://www.hse.ie/eng/services/list/2/dental/

Are the medical conditions list on the link above guaranteed to meet HSE approval for necessary treatment or does a decision rest on the whims of a HSE deciding officer? Have the HSE been any more generous with these "pre-approval needed" treatments since the recent 2011 guidelines? Has the economic recovery trickled down into medical card dental services or is it really strict?

It depends on what area you are in, I believe it is at the discretion of the local principal surgeon.

Bosley1421 · 11-03-2016 1:00pm

Big_G wrote: »

It depends on what area you are in, I believe it is at the discretion of the local principal surgeon.

Would anyone have any experience of approval cases where a medication for chronic condition had a side effect of dry mouth etc. making cavities and poor gum health more likely?
I actually can't believe how much a year on meds has changed my teeth and mouth. The medical card was approved recently and is connected to my health condition, but this is not on any approved list. I have a check up and clean booked, any advice on etiquette in asking dentist about extra treatment on card is appreciated.

Slunk · 28-04-2016 11:49am

This is not medical card related but PRSI. I went for an examination the other day on my once yearly prsi. They done and xray which cost me 50 euro. I have since been told that the xray should have been included on prsi. I have queried this with the dentist and they said it wasn't an xray I got rather an opg I think they said. A whole mouth scan. Are they fobbing me off? I placed my mouth on the rest and the scanner went around my head. Is this an xray or a more advanced test which would incur payment?

Big_G · 28-04-2016 4:50pm

An OPG is not included in the examination fee for the PRSI scheme. Small inside the mouth xrays are included - otherwise known as bitewings.

Ageyev · 28-04-2016 7:31pm

Bosley1421 wrote: »

Would anyone have any experience of approval cases where a medication for chronic condition had a side effect of dry mouth etc. making cavities and poor gum health more likely?
I actually can't believe how much a year on meds has changed my teeth and mouth. The medical card was approved recently and is connected to my health condition, but this is not on any approved list. I have a check up and clean booked, any advice on etiquette in asking dentist about extra treatment on card is appreciated.

I'd say just straight up tell the dentist that you can't afford whatevr treatment they recommend and ask how you go about applying to the HSE to get it covered.

Good luck!

I haven't heard of anyone getting dental treatment being approved with a medical card. There was a piece on RTE drivetime last week on this issue - the two dental people they had on more or less said that the HSE aren't approving treatment.

Bosley1421 · 03-06-2016 10:26am

Thank you! They were actually really complimentary about my teeth and how I'm managing so treatment is more affordable than I thought it would be. It's not covered by HSE but I had it built up in my head that I'd need x fillings, extractions, etc. Not the case and I'm thrilled!

Dair76 · 17-08-2016 1:55pm

Hi folks,

Does a medical card cover surgical extractions, or just "regular" ones?

Ageyev · 17-08-2016 3:54pm

Dair76 wrote: »

Hi folks,

Does a medical card cover surgical extractions, or just "regular" ones?

Afaik it covers as many teeth pulled as you want. Wisdom teeth I'm not sure. I thinkmit requires a referral to the dental hospital... which is in Dublin (I got a referral once, then missed the appt).

It all has to be pre-approved by the HSE it seems. Which is sh*tty