620-B Lillington Highway | Spring Lake, NC 28390

Is Wisdom Teeth Removal Covered by Insurance?

dental insurance, wisdom tooth extraction

Are you experiencing wisdom tooth pain or just curious about potential costs? You might have noticed that wisdom tooth extraction can be expensive. And, you’re probably wondering if your insurance covers these extractions!

Generally speaking, the answer depends on your specific situation. However, most insurance policies cover at least a portion of the cost.

When Does Insurance Cover Wisdom Tooth Extractions?

Medical Necessity

If your dentist considers the extraction medically necessary, your insurance will likely cover it. Common reasons for necessary extractions include:

  • Pain
  • Infection
  • Damage to neighboring teeth
  • Cysts and Tumors
  • Periodontitis (Gum Disease)
  • Impaction (when teeth can’t emerge fully)

However, these reasons don’t guarantee coverage. Therefore, to be sure, check with your insurance provider. Unfortunately, each insurance plan has its own criteria for what constitutes ‘medically necessary.’ Understanding these criteria is crucial in determining if your situation qualifies for coverage.

Network Restrictions

Insurance plans usually have preferred in-network service providers. Staying in-network often reduces the cost of your extraction. These networks are part of the agreements between dental care providers and insurance companies, aimed at providing quality care at a negotiated rate.

Meanwhile, choosing an out-of-network provider might mean paying most or all costs. Certainly, in emergencies, you might need out-of-network care. Still, it’s best to use in-network providers whenever possible. However, some plans may cover a portion of out-of-network costs, so it’s always beneficial to understand your plan’s specifics.

Type of Insurance Plan

Different insurance plans offer varying coverage levels. Higher tiers usually provide more coverage. Thus, check your policy for details on service restrictions, preauthorization needs, age limits, and other factors. This tier system allows for a range of options, depending on the premium you’re willing to pay and the extent of coverage you need.

Wisdom Tooth Extraction in Spring Lake, NC!

Wondering if Spring Lake Oral Surgery accepts your insurance? Don’t hesitate to call us! Moreover, our team is ready to answer your questions and schedule your appointment with our Spring Lake dentist! Our team is committed to providing you with the best care and guidance for your dental health, including assistance with understanding and navigating your insurance options.

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