Medicare Does Not Cover Costs For Teeth, Even If Problems Result From Physical Disease.

A plaintiff suffers from Sjogren’s Syndrome, which has left her unable to produce saliva.  As a result, she lost teeth, her gums deteriorated, and her bite collapsed. She is a Medicare beneficiary, and she received dental services to correct her problems. But the Secretary of The Department of Health and Human Services denied coverage [HHS].  The trial court upheld HHS’s ruling, and the Ninth Circuit affirmed, citing 42 U.S.C. § 1395y(a)(12) which excludes coverage “for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth.”  Fournier and Berg v. Kathleen Sebelius  (Ninth Cir.; May 31, 2013) (Case No. No. 12-15478).