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Does Medical Insurance Cover Oral Surgery?

By Gregory Hamel

Medical insurance is designed to help you cover the cost of necessary health procedures as well as preventative care like doctor's visits and screenings to keep you in good health. The specific procedures and amount of costs covered by health insurance vary greatly from one plan to another. Oral surgery may be covered by medical insurance in some specific cases, but generally it doesn’t cover non-medically necessary procedures.

Medical Insurance Coverage

Normal medical insurance coverage is focused on providing benefits to keep you in good health and correct problems that threaten your health. Medical insurance typically covers oral surgery that is considered medically necessary to keep you in good health. Examples of oral procedures that may be covered by medical insurance include surgery that involves diseases to the facial bones, physical trauma to the tissue and structures of the face, treatment of jaw disorders and correcting facial deformities.

Dental Insurance

Surgery and other procedures that deal specifically with teeth are considered dental in nature and are typically not covered by medical insurance, though it depends on your specific policy; some plans may cover a small portion of dental costs. For instance, root canals, fillings, crowns, bridges and the installation of other dental structures to support the teeth are usually covered by dental insurance instead of medical insurance. Dental insurance plans typically pay for 100 percent of routine cleanings and preventative care, but may only cover 80 percent the cost of fillings and root canals and 50 percent of major procedures.

Wisdom Tooth Extraction

The extraction of wisdom teeth is among the most common oral operations, especially for young people. Normal medical insurance can provide coverage for impacted teeth, those teeth that fail to emerge from the gums. Wisdom teeth are commonly impacted, so removal is often covered by normal medical insurance. Dental insurance may also provide coverage for wisdom tooth removal, although as a major operation, you could end up paying for a large portion of the cost of the operation yourself.

Cosmetic Procedures

Oral surgery and other procedures that are cosmetic in nature are usually not covered by insurance. Cosmetic procedures describe operations designed to change the way you look, not to improve your health. Some insurance plans provide coverage for braces, although many plans do not provide any coverage for braces and the ones that do may only cover a fraction of the total cost.

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