Is Oral Surgery Covered by Insurance?
We’d love to be able to say that every oral surgery is covered by insurance, but unfortunately, that isn’t always the case.
The specific procedures covered by health insurance vary from plan to plan, and some only pay a portion of the costs for oral surgery. To complicate matters, some insurance companies have separate reimbursement rates for medical and dental procedures.
Generally speaking, oral or maxillofacial surgery to correct a medical condition has a good chance at being covered by most insurance plans. For dental enhancements and services, most patients have to pay out of pocket.
Oral Surgery Procedures that May Be Covered
Oral and maxillofacial surgery that is medically necessary and designed to correct a problem that threatens a patient’s health is usually covered by insurance. Procedures that many plans cover include:
- Treatment to correct a facial deformity or congenital birth defect
- Removal of cysts or tumors in the jaws, cheeks and oral cavities
- Procedures to repair injury from physical trauma to the face
- Surgical treatment for a structural abnormality in the jawbone
Keep in mind that insurance companies might not cover all the costs associated with oral and maxillofacial surgery — you may still be responsible for a portion.
Oral Surgery Procedures that Aren’t Usually Covered
Cosmetic oral and maxillofacial surgery procedures aren’t usually covered by insurance — these surgeries are often considered elective. Patients may have to shoulder the cost of certain surgeries like:
- Tooth removal, including wisdom tooth extraction
- Dental implant surgery
- Surgical preparation of the mouth for tooth restoration, such as bone grafting
- Treatment for temporomandibular joint disorder (TMJ)
- Procedures to treat obstructive sleep apnea (OSA)
Insurance plans may cover some of the oral and maxillofacial surgery procedures listed above after nonsurgical measures have failed. For instance, sleep apnea patients may not have to pay for surgical treatment if a CPAP machine isn’t an effective solution.
What if Insurance Won’t Pay for Your Oral Surgery?
Let’s say your insurance company won’t cover your oral surgery. What are your options to make the procedure affordable?
First, speak to your oral surgeon’s office. Many offer cash discounts for certain procedures, and some provide structured payment plans to patients without insurance coverage.
You can also look for a dental discount plan. In exchange for a monthly or annual fee, you may be able to get a significant discount on your surgical procedure. Depending upon the type of surgery you need, the savings could be in the thousands.
Working with insurance companies is rarely straightforward, but the professional team at Oral & Maxillofacial Surgery of Utah can help you through the process. Our financial staff is trained to make reimbursement for insurance claims as simple and quick as possible. And if insurance won’t cover your procedure, we can help you find a dental discount plan, or you can ask us about our affordable monthly payment plan.
Here at Oral & Maxillofacial Surgery of Utah, we’re happy to work with you to find a payment option that meets your needs. To discuss ways to make your oral surgery more affordable, contact one of our three convenient Salt Lake City area offices today.
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