Coverage questionsCoverage depends upon the procedures involved and how your dental plan is set up. We suggest you get a pre-treatment estimate (predetermination) for any oral surgery procedure. We'll let you know if your plan covers the care suggested. Show For more information, call the Member Services number on your ID card. It depends upon your plan. First, find out if your treatment will be covered under your medical or dental benefits or insurance plan. You or your dentist can send a request for a pre-treatment estimate (predetermination). We'll let you know if and how your plan covers the care suggested. You will be reimbursed under the plan in which the oral surgery procedures are considered covered services. It depends on your medical plan. Call Member Services at the number listed on your ID card. Surgical dental extractions are considered dental in nature. They are typically covered under an Aetna dental plan. There are exceptions, however. To verify whether your dental or medical plan may cover surgical extractions, call Member Services. If you’re planning a major oral surgery, then you’re probably wondering whether your medical or dental insurance will cover the cost. Oral surgeries can include the removal of diseased or impacted teeth, dental implants, biopsies, tumor removals, repair of trauma, and other surgical issues involving the bones and soft tissues of the face. These surgeries can be very expensive, so it’s important to know how your insurance can help with the cost. Having dental insurance offers many benefits like lowered dental care costs and the ability to stay on top of your oral health. Also, keep in mind that, within the wide range of procedures and treatments performed in a dental office, your medical insurance provider may consider many of them as medically related. For many oral surgeries and certain dental-related procedures, your medical insurance may cover all or a portion of the healthcare bill. Is oral surgery covered by medical or dental insurance? Your dental health can affect the rest of your body, and your overall health can affect your oral health. When you require a serious dental procedure, like oral surgery, some of the costs may be covered by both your dental insurance plan and your medical insurance plan. Whether or not your medical insurance covers a dental-related procedure will depend on your insurance provider and plan coverage. In most cases, medical insurance plans will cover some major oral surgery procedures. We recommend that you have a conversation with your dentist or dental specialist office staff to see if they have experience filing medical claims. They should be able to give you an idea of the likelihood of receiving coverage and help you obtain a predetermination of benefits. You can also talk directly with your medical insurance provider to see if your procedure is covered, get an estimate of how much they will pay, and gain a better sense of what out-of-pocket costs to expect. Be sure to do the same with your dental insurance provider, as they may provide a higher level of coverage for such a procedure. When will my medical insurance cover oral surgery? 1 Most common oral surgeries are covered, at least in part, by your dental insurance provider. However, this depends on the specific type of surgery you need, your dental plan, and your level of coverage. Your medical insurance may also pick up the cost in full or part for medically related oral surgery procedures depends on your plan, medical health status, and the type and degree of difficulty of the surgery. Costs may be covered for diagnosis, treatment, or prevention of a medically related oral condition or for rehabilitation of lost skills related to the problem. Other frequently asked questions Do I need to get treatment from an oral surgeon, or can a general dentist perform the service I need? Oral surgeons and other dental specialists, as well as general dentists, can bill medical insurance for certain procedures. Look at your specific dental insurance plan information to see if the treatment will be covered by dental insurance or if you should get your medical insurance provider involved. In some cases, both your dental and medical insurance may pay a portion of your treatment. When that’s the case, you or your dental provider can send a request for a pre-treatment estimate to one or both insurers to get a better understanding of the costs you will acquire. Which dental procedures are covered by medical insurers? Depending on the circumstances, your insurance provider may bill different dental procedures as medically related dental procedures. Some examples include:
Final thoughts Many common dental treatments can be billed as medical treatments under certain circumstances. That being said, submitting your oral surgery claims to your medical plan can be a good way to extend your health care dollar. However, the medical claim submission process is different and could be more difficult than the dental insurance claim process. It usually requires more documentation and proper medical coding of procedures from the provider. To help make the submission process easier, you can ask if your dental provider is familiar with submitting claims to medical insurance. Note that oral surgeons will typically have more experience submitting medical claims than general dentists. This claim submission process will require coordination between your dental insurance provider and your medical insurance provider. It’s considered coordination of benefits (COB) similar to the claim submission process when you have two dental insurances. Some types of medical insurance policies require that your provider bill the dental insurance company first, and then once that claim is processed, you can file a claim toward medical insurance. It is important to make sure that coordination takes place even when your medical and dental insurance is covered by the same insurance carrier. Also, keep in mind that medical insurance could carry high deductibles that may need to be satisfied before any payment is made. If you have questions, we recommend talking with your oral surgeon or dentist office staff or contacting your medical insurance provider directly. Sources
How do people afford to remove wisdom teeth?If you don't have insurance to pay for wisdom teeth removal, then you have a variety of low-cost options. Federal programs, dental schools, clinical trials, and financing can all help you to afford a wisdom teeth extraction.
Is wisdom teeth removal painful?You shouldn't feel any pain as your wisdom teeth are removed because the area will be numb. However, if you do feel pain during the procedure, tell your dentist or oral surgeon so they can give you more anaesthetic. How long it takes to remove the tooth will vary.
Is an impacted wisdom teeth an emergency?Wisdom teeth may stop erupting or grow sideways and be unable to erupt further, which causes impaction. This, in turn, can cause symptoms like pain and discomfort, and a higher risk of a gum or tooth infection. If you have one or more impacted wisdom teeth, you need to get emergency tooth extractions from Dr.
Is wisdom teeth removal a surgery?Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.
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Are wisdom teeth covered by health insurance
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