A medical plan may not cover surgical extractions (including removal of impacted teeth and wisdom teeth), and other oral surgical procedures. In addition to local anesthesia, suturing, and post-operative care, major oral surgery provides benefits.
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Is Wisdom Tooth Extraction Covered By Insurance?
Wisdom tooth extraction costs are usually covered by 80 percent of insurance companies. The downside is that most dental insurance plans have annual limits on how much they will pay out for all dental care (typically about $1500). The procedure is usually divided into two years to increase coverage.
How Much Is It To Take Out A Wisdom Tooth With Insurance?
| Wisdom Teeth Treatments | Costs |
| Initial consultation | $60 |
| X-Rays | $35 – $40 |
| Simple Wisdom Tooth Removal | $200 – $250 (per tooth) |
| Surgical Wisdom Tooth Removal Cost | $250 – $400 (per tooth) |
What Does Blue Cross Blue Shield Cover For Dental?
How Much Does Insurance Usually Cover For Wisdom Teeth Removal?
Wisdom teeth extractions can be covered by some dental insurance plans. Wisdom teeth extractions typically cost 50% to 80% of the dentist’s or oral surgeon’s fee. The cost of their health insurance is usually covered by deductibles and co-pays as well.
Is Removal Of Wisdom Teeth Covered By Health Insurance?
In some cases, your health insurance plan may cover the cost of surgery if it is medically necessary – which is often the case if wisdom teeth are impacted or pose a health risk. In addition, dental insurance plans may cover some or all of the costs associated with these procedures.
Is Tooth Extraction Covered By Insurance?
In general, dental policies cover some of the costs associated with preventive care, fillings, crowns, root canals, and oral surgery. In addition to orthodontics, periodontics (the structures that support and surround the teeth) and prosthodontics, such as bridges and dentures, they might also cover orthodontics.
How Much Does It Cost To Get Your Wisdom Teeth Pulled Out?
Wisdom teeth removal at Woonona Dentists costs between $350 and $500, depending on the complexity of the procedure. It is likely that your cost will rise to between $1500 and $3000 per tooth if you need general anesthesia.
Does Blue Cross Blue Shield Cover Any Dental?
A BCN Advantage. We offer a variety of dental exams, cleanings, and X-rays as part of our BCN Advantage HMO and HMO-POS plans. A supplemental plan that includes fillings, root canals, extractions, crowns, and fluoride treatments is available for purchase. In addition to vision and hearing benefits, it provides other benefits.
Watch does blue cross blue shield cover wisdom teeth removal surgery Video
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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:
● Surgical treatments – Difficult wisdom tooth extractions and other complex tooth removals, soft and hard tissue biopsies, frenectomies on newborns, correction of facial deformities, cancer-related treatment, and dental implants
● Dental/facial trauma – injuries resulting from automobile or other accidents, teeth that have been knocked loose or knocked out
● Diagnostic procedures – certain X-rays (non-routine ones), bacterial testing, and testing used to discover the source of oral and myofascial pain
● Non-surgical medical procedures – emergency treatments for inflammation and infection, drainage of abscesses, general anesthesia for surgeries, and appliances for TMJ or sleep apnea
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 2 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.
Additional resources
Looking for more information? Learn more about common dental procedures:
- Individual & family dental insurance
- What is COBRA insurance?
- What’s the value of dental insurance?
Sources
//www.ada.org/~/media/ADA/Public%20Programs/Files/Documenting_to_Support_Medical_Necessity_for_Pediatric_Professional.pdf?la=en [PDF]. (n.d.). American Dental Association.
//www.mass.gov/doc/orthognathic-surgery-0/download. (n.d.). MassHealth.
1 //www.mass.gov/doc/orthognathic-surgery-0/download. (n.d.). MassHealth.