Is pulling of wisdom teeth medical or dental insurance?
Posted on Nov 06, 2009 under Insurance Information |My sister’s wisdom teeth, eight years ago, were covered under medical. Today, my dentist is telling me it’s covered under dental. There’s a BIG difference in the copay!!!
November 6th, 2009 at 7:57 am
Dental
November 6th, 2009 at 7:57 am
When it has to do with teeth it is dental. It’s easy to remeber….dentist=dental Medical doctor= medical
November 6th, 2009 at 7:57 am
it could be medical but it is probably dental since it involves the mouth area and teeth.
November 6th, 2009 at 7:57 am
It depends on your personal coverage.
It generally falls under Dental, especially if you are having them removed simply to have them removed. If they are infected or require some type of jawline or other surgery, then it may fall under medical coverage.
The best way to determine this is to contact your insurance provider and give them all the details of the procedure.
November 6th, 2009 at 7:57 am
treated by a surgeon, it’s medical
treated by a dentist, it’s dental
November 6th, 2009 at 7:57 am
I would say medical if they have to be pulled out(like if they causing pain and such)and dental if you just want them removed.
November 6th, 2009 at 7:57 am
i’ve had dental insurance all my life and had my wisdoms pulled 15years ago and back then it was dental. it still is dental-hence teeth. i think if u dont have dental insurance and u need to have ur wisdoms pulled it can fall under medical because its a surgery.
November 6th, 2009 at 7:57 am
well its actually both dentall insurence has its clauses and some surgical procedure such as wisdom teeth may not be covered under the dental part of the insurence sence there is an anestesia used , ie the med that they call tilight sleep and intervanous fluid given , as well as braces this may not be covered either , just like medical insurence dnt cover all of the medical parts hat u may be need thus requiering otherization from the insurence comany beeofr the insurence wqill pay for it , all i could sugest is look at the insurence papers adn carefully go over them reading the fine print and if it does show where this and that is coverd and there is no condition to when they will cover such procedure go to the insurance agancy and bring it up to them showing them whee it says in the contract that its covered or not covered adn if its covered ask for a refund of money already spent on the co payment , sometimes beofre the insurence will cover the procedure thers a co payment that must be mett ans sometimes each indeveduall has that co payment for example your sister had it done but had to pay the co payment now u need it but the insurence wont cover it till u pay your co payment . etc
November 6th, 2009 at 7:57 am
If it is done by a general dentist then it’s paid for by dental insurance. If it is done by an oral surgeon then depending on your policy it can be covered by either medical or dental insurance…. call your insurance company for details.
November 6th, 2009 at 7:57 am
The fact is, it does not matter WHO takes your wisdom teeth out, a general dentist or an oral surgeon. What matters is what TYPE of extraction is needed. Extractions of wisdom teeth are classified in several different catergories depending on how erupted from the bone and gums the teeth are.
There are simple, surgical, soft tissue impaction, partial bony impaction, and full bony impaction extractions. What you need to do is find out what TYPE of extractions yours are. If yours are coming in and part way through the gums it will definitely be dental insurance. If they are more difficult and impacted they are classified as a "surgical PROCEDURE", even if a general dentist performs the extractions, and may be covered by medical insurance.
I’m sure the staff at your dental office checked your insurance benefits with the information the doctor gave them about what type of extractions you need. If you are concerned they are incorrect just stop in and ask what type of extractions you need. Cross check it with your insurance company.
November 6th, 2009 at 7:57 am
it’s under dental insurance…it’s medical if your put out so it’s two claims
November 6th, 2009 at 7:57 am
You asked the question under Dental…, maybe you knew the answer before you actually asked the question.
April 2nd, 2010 at 11:21 pm
There are certainly a lot of details like that to take into consideration. That is a great point to bring up. I offer the thoughts above as general inspiration but clearly there are questions like the one you bring up where the most important thing will be working in honest good faith. I don?t know if best practices have emerged around things like that, but I am sure that your job is clearly identified as a fair game.
April 3rd, 2010 at 2:48 am
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