If you’ve been told you need oral surgery, you might ask how much of the bill your dental insurance will cover. Understanding dental insurance can be tricky, especially for more complex procedures like oral surgery. In this post, Spring Lake Oral Surgery in Spring Lake, NC, dives in on dental insurance and how to stretch your coverage.
What Oral Surgeries Does Insurance Typically Cover?
Dental insurance plans vary, but most will pay for a part of needed oral surgeries. However, it depends on the procedure and if it’s medically necessary. Here is how insurance handles some common types of oral surgery:
- Tooth Extractions: Insurance often covers simple and surgical extractions. This includes wisdom teeth removal, especially when needed to fix pain or prevent further dental issues.
- Dental Implants: Some insurance plans cover a part of dental implant costs. Other plans say they’re cosmetic, and only cover some of the cost or none.
- Bone Grafts: A bone graft is sometimes covered when it is needed for dental implants or to repair bone loss caused by gum disease.
- Oral Biopsies: Insurance usually pays for a biopsy if needed to diagnose a suspicious lesion.
- Jaw Surgery: Jaw surgery is usually covered if it helps with issues such as difficulty chewing, speaking, or breathing.
- Treatment for Oral Infections: Surgeries to treat infections, such as abscesses or cysts, are usually covered, especially when the infection risks overall health.
Understanding Your Insurance Coverage
Before oral surgery, make sure you understand the specifics of your dental insurance plan. Here’s what you need to know:
- Deductibles and Co-Payments: You may need to meet a deductible before your insurance covers the cost of oral surgery. You might also need to make co-payments for each visit or procedure.
- Coverage Limits: Some insurance plans have annual maximums—the total amount your insurance will pay in a year. Know these limits to avoid extra expenses.
- Pre-Authorization Requirements: Some oral surgeries require pre-authorization from your insurance company. This means your dentist or oral surgeon will need to request approval from your insurer before the procedure.
- Coordination of Benefits: If you have dental and medical insurance, some parts of your oral surgery could be covered under your medical plan. For example, your medical insurance might pay for part of a surgery that is needed due to a medical condition.
How to Stretch Your Dental Insurance Benefits
Dental insurance can be complicated, but there are ways to get the most out of your coverage:
- Check Your Plan: Read over your dental insurance policy. Understanding your coverage and exclusions will help you plan.
- Talk to Your Insurance Provider: If you’re not sure what your insurance will cover, contact them. They can explain your benefits and any pre-authorization requirements.
- Discuss Options with Your Oral Surgeon: The team at Spring Lake Oral Surgery are experts at working with insurance companies. We can help you navigate the process, submit claims, and explore payment options to make your treatment affordable.
- Financing Options: If your insurance doesn’t fully cover the cost of your oral surgery, Spring Lake Oral Surgery offers financing options to help manage the expense. We accept CareCredit and other payment plans designed that fit your budget.
What to Do Before Your Oral Surgery
Before having oral surgery, take these steps:
- Check Coverage: Check with both your dental insurance and your oral surgeon’s office what will be covered and what you’ll have to pay for out-of-pocket.
- Get Pre-Authorization: If needed, make sure your oral surgeon turns in all needed paperwork for pre-authorization to avoid any delays or denial of coverage.
- Plan for Payment: If your insurance doesn’t cover the full cost of your surgery, we can discuss payment options. We’re here to help you find a solution that works for you.
Ready for Oral Surgery?
At Spring Lake Oral Surgery, we know that the financial side of oral surgery can be stressful. That’s why Dr. J. Patrick Arnold and our team want to help you with your insurance benefits. We can help you explore your options to make it easier to get your oral surgery.
Do you have questions about your dental insurance? Please contact us if you need an oral surgery consultation. We’re here to help you every step of the way!
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