Looking for a specialist...

Emily Morales77 said:So, I’m just circling back to a question someone asked a few pages ago because I haven't seen an answer yet: how does it work with dentists who run private practices but also take Medicare? Like, which treatments are covered by Medicare and which ones you have to pay for out of pocket? How does the whole setup actually function?
I'm a little confused here.😢

Any dentist who takes Medicare can see you as both a private patient and a Medicare provider. If you're registered with that dentist under your Medicare coverage, you're entitled to a specific "basket" or package of services covered by your insurance. You really need to check exactly what's included in your specific plan.

If you need a procedure that Medicare doesn't cover, you'll have to pay for that out of your own pocket. That dentist is required to give you a receipt for those services. If you're employed, you can use those receipts at the end of the year to claim a tax deduction on your federal return, just like everyone else in the US.

From what I know, most of the headaches happen because patients don't actually know their rights. Seriously, do your homework and find out exactly what you're covered for and what isn't.

Here's a quick breakdown—Medicare covers some basic prosthetic aids, but they don't cover much else.

http://www.medicare-info.gov/coverage

Found it! A colleague already posted about this earlier.

http://www.american-forum.com/showpost.php?p=1...0&postcount=10

stormyheron4, thanks a million! You were a huge help! 😍

Guys, seriously, I need some recommendations. Looking for a decent Community Health Center.
Ideally one over on Vodnikov.
Right now I'm stuck with this hilarious Dr. Neda Kršek—honestly, the woman has absolutely no clue what she's doing.
Please, have mercy on me. 🙄

And when can I actually switch? Is it possible right now, or am I looking at January or whenever?

stormyheron4 said:Any dentist who takes Medicare can basically work both sides of the fence—treating you as a private patient or under your insurance coverage. If you’re officially registered with that dentist through Medicare, you’re entitled to a specific package of services covered by your plan. I guess you really ought to look into exactly what's included in that package so you know what you're actually entitled to.

If you need a dentist to do a procedure that isn't covered by Medicare, you’re going to have to pay out of pocket. If that happens, just make sure the dentist gives you a formal receipt for the service. At the end of the year, if you're working, you can probably include that receipt on your tax return as a deduction—something all employees in the US can do.

From what I can tell, most of the headaches come from patients just not knowing their rights. You really ought to do some digging and figure out exactly what you're entitled to and where you stand.

There's some basic prosthetic gear covered by Medicare here, but they don't offer much else in terms of services.

Found it—another guy here already posted about this.

I think we should probably just stick to what works. I mean, if you’re already seeing results with the current plan, why mess with it? Maybe there are other ways, but I guess it's safer to stay the course for now. It seems like a lot of extra work for something that isn't broken. Just my two cents, anyway.

Just wanted to jump in here and build on what my colleague said. Basically, Medicare covers manual endodontics. However, machine-assisted endodontics isn't part of the standard Medicare coverage, so you'll have to pay out of pocket based on the minimum rates set by the American Dental Association. I should probably mention that machine-assisted work is way better—it's more successful, though it is definitely a more complex procedure. And honestly, endodontics is one of the most critical parts of dentistry. Also, if you're getting amalgam fillings, they really should only be done with a zinc phosphate cement base.

I can't really say for sure, but I guess it might be worth looking into. Maybe check with a local Community Health Center or something just to be safe. It’s hard to know without more info, honestly.

Regarding that link, I should probably point out that anything Medicare doesn't cover is considered a private service. That means you have to pay based on the minimum fee schedule set by the American Dental Association.
( Check out this PDF from the American Dental Association website: Stone only covers manual scaling—it doesn't cover ultrasonic or sandblasting. Those pins mentioned in the post are metal, which are way worse than the newer composite or fiberglass-reinforced ones, and they're only used for mobile work.
Medicare doesn't actually approve the price lists at dental offices—that's handled by the American Dental Association. It's because those price lists include private services that aren't even under Medicare's jurisdiction. I guess it just works that way.

Just a few thoughts on the ADA's minimum pricing.

The American Dental Association (ADA) sets official price floors that dentists in the US aren't supposed to dip below. It’s basically the bare minimum needed to keep things profitable for both the dentist and the lab tech. If a dentist decides to undercut those rates, they’re violating ADA regulations, which could land them in front of an ethics committee. From there, they're looking at heavy fines or even losing their license permanently. I guess if you see a price that looks suspiciously low, you have to wonder if the materials you actually paid for are even what was ordered. You can find the rest of the details on their website. www.ADA.org

A lot of patients just don't get this part of the story. It’s actually pretty vital to understand exactly what Medicare does and how little they actually cover.

Note to admins: I think this probably belongs in the dentistry thread instead.

Karen Phillips21 said:I think I'm actually losing my mind!

A few years back, my doctor left to go grab some specialization—nobody really knows when or if she’s ever coming back (my guess? Not anytime soon)—and now she's being replaced by this older doctor who just grinds my gears. Look, the guy is perfectly nice and all, but I feel like I have to negotiate everything with him. If an internist already told me I need certain tests, why on earth should I have to beg him for the referral?

But yeah...

Does anyone have a recommendation for a doctor in Savannah? Honestly, they don't even have to be world-class—I'll settle for average—as long as I'm not sitting in the waiting room for hours and they actually follow through with the recommended testing. Of course, if they happen to be friendly and easy to talk to, I'd be thrilled.
Oh, and one more thing—it would be great if they're actually accepting new patients. Every single person who's been recommended to me so far has a waitlist a mile long...

Just quoting myself here in a moment of total desperation...

🙂

It’s a bit of a specific request, and while I don't have a question for any specialists, I figured I’d post it here rather than starting an entirely new thread: does anyone know which pharmacy in Miami carries Clindamycin gel? I am specifically looking for the GEL, not the lotion version...
Thanks in advance!

Helou!
I really need some urgent help here! For several years now, I’ve been dealing with this undefined dermatitis on both my hands, and it is absolutely killing me. To give you an idea, the skin on my palms regenerates incredibly fast; layers upon layers of thick, hard skin build up and then just crack along the lines. It bleeds, it itches terribly, and I end up scratching myself uncontrollably in my sleep... My experiences with recommended dermatologists—both private ones and those through Medicare—have been a total c a t a s t r o p h e!

1. A friend suggested a private specialist near Pike Place Market (dr. Ceković), but I nearly lost it when this woman charged me $83 just for glancing at my hands for two minutes! Honestly, she didn't do anything besides look at them; she even checked her cell phone twice while I was sitting right there in the exam room(!?). Her reaction was basically, "Oh honey, what's the big deal?" It was such a 🙂
mess. She prescribed some corticosteroids and a few other things for sensitive skin (hand baths and stuff), and told me to sleep in gloves. After a week, things improved for about two weeks, and then everything flared up again... Basically, the diagnosis was just "some form of dermatitis." When I asked which kind specifically and how I could prevent future outbreaks—well, of course, she had no clue since she barely gave me a proper examination.

2. Through Medicare, I saw a dermatologist at the clinic over by the University of Michigan Wolverines. She was actually quite nice and friendly, and she did a decent job examining my hands and chatting with me. She suggested it might be an allergy, but she didn't refer me for testing immediately because she wanted me to try a specific therapy first to see if it helped. I kept insisting on getting some kind of testing done (since there has to be a way to actually define "some kind of dermatitis"), but get this: even though my skin is dry and cracking until it bleeds—which is horrific—she claimed there was no visible inflammation because nothing looked red. Granted, it's true that samples are usually taken from inflamed areas, and my skin isn't red or showing typical signs of inflammation, but it still cracks, leaves open wounds, and itches like crazy... In the end, I got a prescription—again, just more corticosteroid cream, hand washes, cod liver oil, and other sensitive skin products... The effect was instant; I felt better within a week, but as soon as I stopped using the steroids, it all came right back...
When I went back for a follow-up, the doctor had gone on maternity leave, so I had to see someone else entirely...

3. After being so disappointed by doctors, I turned to homeopathy. I tried five different remedies prepared by a homeopath—four months later and $667 after, nothing. Zero points.

4. Out of pure desperation, I visited that healer Mekki Torabi twice. I drank God knows how many liters of his "treated" water, and still, nothing...

Right now, my hands are in a veeeery bad state... so bad that I can't do anything except wrap them tightly in gauze, almost like how Rocki walks around town🙂... At least that way they itch a little less, and the bandages are too thick for me to scratch my palms even if I wanted to.

Please, can anyone recommend a good dermatologist?🙂

Hey 🙂
Has anyone here actually been to the Vukas clinic over on Fifth Avenue?
I lost my prescription... and I'm in a bit of a bind because I need to get a new one made ASAP... so if anyone’s had any experience there, please let me know what you think...

Hey everyone. I’m currently on the hunt for a decent dentist here in Chicago. Honestly, whether they run a private practice or work for a large group doesn't move the needle for me, and frankly, the price tag isn't my primary concern—it's the quality of care and the level of genuine dedication. When you're talking about something as personal as cosmetic dentistry, it becomes a sacred thing; it’s intimate, and for many, it’s a major life factor. You need reliability, empathy, and a practitioner who actually listens. I don't know about you all, but so far, I haven't encountered anyone who truly embodies those qualities. My profession or my specific motivations aren't relevant here; I just want to fix some aesthetic issues with my teeth that have been bothering me. I actually wore braces previously, which were handled at this same clinic where I’m now trying to get these corrections done. I originally went there based on a recommendation—I can't quite recall who—because it was touted as this premier, highly vetted institution right in the heart of Chicago, boasting extensive experience and international credentials, catering to foreign patients and acting as if they are the undisputed gold standard. Now, look, I understand the gravity of what they do, but this level of self-aggrandizement—turning an entire medical practice into a literal circus—is beyond ridiculous; in some ways, it’s just pathetic. The owner of this clinic carries herself like she’s some sort of countess or a cosmic ruler, dictating every move to her patients and treating her staff like disposable labor; it’s a hierarchy where everyone else is just a mouse scurrying under her feet. At least, that’s how it looks from my vantage point. When she speaks to you, she doesn't even make eye contact; she stares at the wall next to you, using a condescending tone and snapping whenever things don't go her way. Everyone there seems to be walking on eggshells, dancing to whatever tune she decides to play. But I refuse to dance. And that’s where the friction started. I tolerated her behavior until my recent appointment, when I returned to have certain cosmetic details finalized—work that she charges an absolute fortune for, despite the treatment being abysmal. Not to mention her attitude toward clients. In the end, I walked out feeling completely dissatisfied, only to be told that they simply "can't do any better" and that if I wasn't happy, I should just find someone else. This is coming from a woman with a wall full of professors' degrees and certificates—her husband is also supposedly very influential, though I couldn't care less—and she had the audacity to snap at me when I came back for the second time to fix the work. To them, their version of "optimum" is the end-all, be-all, even when it's glaringly obvious to anyone with eyes that something is off. Some might say I'm being nitpicky, but when it involves your teeth and your confidence in your professional life, you'd understand if you stepped into my shoes. I eventually reached the point of telling her that if it was all about the money, I’d happily take a refund just so she would never show her face to me again. I mean, what else can I say? It was harrowing. I didn't even know how to react to 😉 her behavior. Ultimately, I just left. I refused to descend to her level; she can keep her money, because my dignity is worth more than a botched smile.
So, if anyone knows a good, polite dentist—someone with actual patience (since she’s basically an old crank by now) who will actually put in the effort to advise you rather than just mechanically grinding away at you like a machine—please leave a recommendation... Please. 😉
If you're curious, I can tell you the name of that clinic.

Sarah Patel said:I wanted to build on what my colleague mentioned here—Medicare covers MANUAL endodontics. However, MECHANICAL endodontics isn't part of the standard Medicare coverage, so you’d have to pay out of pocket based on the minimum fee schedule set by the American Dental Association. I really want to stress that mechanical endodontics is significantly better, more successful, and just a much more sophisticated way to handle a root canal. And let's be honest, endodontics is easily one of the most critical pillars of dentistry. As for amalgam fillings—they should ONLY be used with a zinc phosphate cement base.

Sorry for posting this in the general thread, but I think it’s important for everyone else's sake that I clarify a few things regarding what my colleague said. To be honest, Medicare covers an incredible amount of services right now, though in my opinion, that level of coverage won't last forever. All the materials currently covered by Medicare have been industry standards for decades—and sure, they are perfectly fine if applied correctly.
Krumpir, Medicare actually covers posts and faceted crowns for children under 18 and adults over 65—limited to a certain number per jaw. Honestly, I’ve seen far too many metal posts being used over the last 20 years to give you an idea of what "standard quality" looks like in practice.
Medicare also covers ultrasonic scaling twice a year.
Regarding those price lists, my mistake—those are approved by the ADA.

Linda Adams8 said:If you're getting jabbed by your own doctor and they don't have shots for young, healthy people—just call ahead first. If they don't have any, you'll have to buy it yourself. But if you hit up a public health clinic, it should be free.

And 😍 you've gotta account for recovery time after... 😬

Thanks 😉

goldenstag6 said:Hey there!
I really need some urgent advice here. I’ve been dealing with this weird, undefined dermatitis on both my hands for years now—it's absolutely draining. Basically, the skin on my palms regenerates incredibly fast, building up thick, heavy layers that eventually crack along the lines. It bleeds, it itches like crazy, and I end up scratching myself raw in my sleep... To make matters worse, my experiences trying to find help through doctors or via Medicare have been an absolute disaster!

At first glance, Dr. Ivana Nola seems like a great option. She’s genuinely kind and—more importantly—highly skilled. She spent a long time working at a major hospital system, but she has her own private practice now.
Here is the link, give her a call.

I really hope things take a turn for the better for you.

Does anyone know a decent Gastroenterology Clinic in Chicago or the surrounding suburbs that actually takes Medicare? I’m trying to avoid the massive wait times at the big hospitals—it's getting ridiculous. Here's the deal: I just finished getting a colonoscopy and a gastroscopy done, and now I really need a specialist to actually look over everything and give me a professional opinion.

Thanks

Has anyone by any chance visited the Eljuga clinic? If you have—what’s your take on her?

I’d suggest seeing Dr. Jozić-Rogić over at the local community health center. I dealt with some terrible issues with my hands myself, but she was a lifesaver. She and her nurse are both incredibly easy to work with and actually listen to you. Plus, they take Medicare, so there isn't a massive wait time. Honestly, I can't recommend them enough.👍👍

Where can I find a decent sports massage in Washington, D.C.?
I absolutely wrecked my lower back. I’m in serious pain here.
I'm an athlete—mostly soccer and heavy lifting—and I've got a pretty big build.
It’s a terrible combination, trust me.

Help!

blueeagle11 said:Sorry for going off-topic, but I feel like I should jump in here just to set the record straight for everyone else. In my opinion, Medicare covers an incredible amount of services right now, and I honestly don't think that can last forever. All the stuff Medicare pays for has been standard practice for decades, and obviously, it’s all good quality if you use it the right way.
I guess Gregory Gomez45 mentioned that Medicare covers dental posts and faceted crowns for kids under 18 and seniors over 65, per jaw. Looking at my own teeth, I've definitely noticed a ton of old metal posts after being around this stuff for 20+ years.That’s all you can say about the quality.
I guess Medicare also covers ultrasonic scale cleaning twice a year.
Regarding the price list, I guess my mistake was thinking the Chamber would approve that.

Yeah, but you gotta remember that only really matters when we're talking about mobile ultrasound work. I get where you're coming from regarding the ultrasound tech, though I heard rumors that they might be changing everything up next year. As for those metal pins—I've seen plenty of them, but I've also seen plenty of fractures caused by them, too.
When you really step back and look at the big picture, between all the new materials and advanced techniques coming out, Medicare just doesn't cover much anymore. And honestly, like my colleague mentioned, they’ll probably start covering even less pretty soon. Has anyone else noticed that the healthcare budget for 2010 was actually slashed?

Could anyone please recommend a high-quality dentist in Washington, D.C.? Ideally, I’m looking for someone who runs their own private practice—but it would be incredibly helpful if they also accept Medicare!

Thanks in advance

goldenstag6 said:Hey!
I need help, fast. I’ve been dealing with this undefined dermatitis on both hands for years now, and it’s killing me. Basically, my palms constantly regenerate, building up thick layers of skin that eventually crack along the lines. It bleeds, it itches like crazy, and I end up scratching myself raw in my sleep... My experiences with recommended dermatologists—both private and through Medicare—have been an absolute disaster!

1. A friend suggested a private specialist near Pike Place Market (Dr. Ceković), but I nearly lost it when she charged me $83 just for looking at my hands for two minutes. She didn't actually do anything besides glance at them, and she even answered her cell phone twice during my appointment(!?). Her only reaction was, "Oh honey, what's the big deal?" Such a joke 🙂
She gave me some corticosteroids and various products for sensitive skin (hand washes and such) and told me to sleep with gloves on. After a week, things improved for about two weeks before everything flared up again... Anyway, the diagnosis was just "some form of dermatitis." When I asked which kind or how to prevent it from coming back—well, of course, she had no idea since she barely even examined me.

2. Then I went to a dermatologist at the University of Michigan community health center using Medicare. She was nice enough, and we actually talked, and she suggested it might be an allergy. She didn't send me for testing immediately because she wanted me to try her prescribed therapy first. I insisted on getting tested (there has to be a way to define "some kind of dermatitis," right?), but here's the paradox: my skin is bone-dry and cracking until it bleeds, yet she claims there's no visible inflammation because nothing is red. To be fair, samples are usually taken from inflamed areas, and while my skin isn't red or showing typical signs of inflammation, it is cracking and causing painful wounds, not to mention the itching... In the end, I got more treatment—again, corticosteroid creams, hand washes, fish oil, and other stuff for sensitive skin... It worked instantly; I felt better within a week, but as soon as I stopped the steroids, it all came right back...
By the time I went back for a follow-up, she was out on maternity leave, so I had to see someone else entirely...

3. After being let down by doctors, I turned to homeopathy. I tried five different remedies prepared by a homeopath—four months later, and $667 nothing. Zero.

4. Out of pure desperation, I saw that healer Mekki Torabi twice. I drank God knows how many liters of his "treated" water, and still nothing...

Right now, my hands are in terrible shape... so bad that I can't do anything except wrap them in gauze, almost like how Rocki walks around the city🙂... At least that way they itch less, and the bandage is too thick for me to scratch my palms if I really wanted to.

Can anyone please recommend a real dermatologist?🙂

I don't know about NYC, but in a town like Karlovac, there's a great dermatologist, Dr. Ilko Kuljanac. He's excellent; my kids have seen him before...

Neven Tučkar is an OB-GYN over at the local hospital, and honestly, I can’t say enough good things about him! He is such an incredible human being who actually takes the time to walk you through everything, chats with you, and really knows how to calm your nerves when you have questions—which was exactly what I needed. If you ever get the chance to see him, just go, because you absolutely won't regret it! 🙂