* 4 year HFM Exceptional Specialty Pharmacy Partner

Tony Tezak
Phone: 717-480-8008
tonyt@cottrillspharmacy.com

Evelyn Tezak
Phone: 717-557-6004
Evelyn@cottrillspharmacy.com

Ask your dental provider to coordinate with your HTC to develop a safe & appropriate treatment plan before any invasive procedure

IMPORTANT: Allow ample time (preferably multiple weeks) for the HTC to develop a plan with your provider and for you to obtain prescribed coagulation medications prior to procedure.

To avoid unnecessary costs, contact your insurance company BEFORE a procedure to see if a PRIOR AUTHORIZATION is needed.
NOTE: It can sometimes take a week or two to obtain prior authorization. IV Coagulation Medication.

If you normally infuse factor/medication at home, when planning a procedure that may require a provider to administer IV medication, ask your insurance company if this will impact your out-of-pocket cost.

Oral or Topical Coagulation Medications can be expensive with high co pays. For cost saving options see the Hemophilia Federation of America http://www.hemophiliafed.org/resource-library, ask your pharmacist, or call Amicar eVoucherRx Program 1-844-202-5909.

Dental Coverage for Children is presently an “essential health benefit” under the Affordable Care Act (ACA), which means it must be available for purchase in ACA Marketplaces.

All qualified health plans in Maryland Health Connections cover dental services for children. The ACA does not require insurers to offer adult dental coverage.

Maryland Medical Assistance (MA)/Medicaid/REM Children & Pregnant Women over age 21 with Maryland MA and Adults enrolled in Rare and Expensive Case Management (REM) are provided Dental Services by Maryland Healthy Smiles

Dental Program “Healthy Smiles” is administered by Scion Dental, Inc. Some covered services: exams, cleanings, fillings, braces for children (if medically necessary, with prior authorization). Find more information at https://sciondental.com/ Adults age 21+ with Priority Partners Maryland MA are provided dental services through DentaQuest. For details or to find a dentist visit http://www.dentaquest.com/maryland/ or call 1-800-698-9611

Healthy Smiles & DentaQuest do not cover oral surgery requiring general anesthesia in an operating room With prior authorization, Maryland MA may pay for a needed hospitalization after a dental procedure.

Dental Coverage for Adults age 21 and older with Maryland MA and REM is limited. There are less covered dental services and providers who treat adults with Maryland MA and even fewer specialty providers such as oral surgeons. Cost Saving for Wisdom Tooth Extraction or Oral Surgery with Maryland MA or REM Complete needed oral surgery before age 21, obtain needed prior authorizations, ask your oral surgeon if he/she can use outside films from a general dentist, consider purchasing secondary dental insurance in preparation for a planned oral surgery (check for policy restrictions or exclusions). Medicare Medicare Does NOT Cover Most Dental Care like cleanings, fillings, tooth extractions, dentures, dental plates, or other devices.

For more information visit https://www.medicare.gov/coverage/dental-services.html

Medicare Part A (Hospital Insurance) may pay for certain dental services received when hospitalized and may pay for inpatient hospital care if needing emergency or complicated dental procedures.

Some Private Medicare Health Plans Offer Dental Coverage. Check to see what services your private plan covers.

Consider Purchasing a Medicare Health Plan or Advantage Plan that offers dental coverage. NOTE: Some Advantage Plans do not participate with Johns Hopkins HTC. Call 410-955-3000 to confirm before purchasing.

To Find a Free or Reduced-Cost Dental Clinic in your area visit: www.medicareinteractive.org

Personalized Medicare Insurance Counseling is available from the Maryland Department of Aging – State Health Insurance Assistance Program (SHIP) 1-800-243-3425/410-767-1100 or visit http://aging.maryland.gov/StateHealthInsuranceProgram.html

Find Free or Sliding Scale Dental Clinics at HRSA Information Center 1–888–Ask–HRSA (1–888–275–4772)

http://findahealthcenter.hrsa.gov

​Individuals with HIV may be eligible for a Ryan White Grant to pay for dental needs (not implants) performed at a federally approved center such as Johns Hopkins Hospital or the University of Maryland School of Dentistry.

Buy a Dental Plan to meet your needs directly from insurance companies or online. For help finding dental plan call (855) 642-8572 or Maryland Health Connection 1-877-223-5201 https://www.marylandhealthconnection.gov/buying-dental-plan/

NOTE: ACA tax credits, subsidies, and out of pocket limits do not apply to dental benefits.

TIPS: Check all plan benefits carefully before purchasing. Dental plans can provide coverage at variable rates depending on procedures. For example, a plan may cover procedures at 100% Preventative, 80% Basic, 50% Major. Plans categorize similar procedures differently. For example, one plan may have deep cleaning and/or simple extractions under Basic Procedures, while another plan could list them as Major Procedures. Plans will have an annual maximum of what they will cover and may have a deductible. Some plans may have up to a 1 year wait period before covering major dental work. Beware of a “Missing Tooth Clause” that excludes any procedure related to any missing teeth at the time of enrollment (bridge, denture, crown….). Discount dental plans offer a one-time low cost flat fee for a 1, 2, or 3-year plan that then might charge significantly reduced fees per dental procedure. You May be Eligible for Premium and/or Co Pay Assistance or a Bleeding Disorder Grant. Contact your HTC social worker to find out if you are eligible for financial assistance for dental care.