You and your dentist have concluded that oral surgery is your best option. Congratulations! However, you may wonder if any of the costs will be covered by dental insurance. To be sure, every dental insurance provider and plan is unique. However, many do cover all or part of the cost for oral surgery procedures.

After you make an appointment, with Dr. Chris Tye in Grapevine, TX, we can help you estimate your out-of-pocket costs for all treatments involving oral surgery.

How can you determine if your treatment is covered by dental insurance?

The easiest way to know if your treatment is covered by dental insurance is to ask your dentist or oral surgeon, and we are happy to answer any questions you have to help with your decision. 

All coverage policies are dependent on your dental insurance providers’ list of exclusions and limitations, which your doctor navigates daily. Most dental insurers factor in several common aspects of oral surgery treatment. This helps them determine if a situation fits within coverage guidelines. 

For instance, your dental insurance carrier may ask the following:

  • Is the dentist in or out of network? Insurance providers may consider a dentist “in” or “out” of their network. Often, the providers will cover more of the cost of an applicable procedure if it is performed by a dentist “in” network.
  • Should treatment be covered under medical insurance instead? In some instances, oral surgery procedures may be covered by your medical insurance instead of your dental insurance. These are situations where treatment is deemed medical rather than dental. This happens frequently in cases of abscessed teeth. What occurs if your dental insurance provider feels that a treatment is medical? They will likely suggest you put a claim through your medical insurance provider for all or some of your treatment costs.
  • Is the procedure necessary? If your insurance carrier believes that your oral surgery is elective, you may not receive coverage. However, this depends on the provider’s definition of elective services. Sometimes, the provider will ask for proof from the dentist that the oral surgery is necessary.
  • Do you need a referral? Some dental plans require a referral for any type of oral surgery procedure. What happens if you self-refer to us, though? If this is the case, we will help get the referral you need for Dr. Tye to perform your oral surgery.

Should I Get a Pre-Estimate for Oral Surgery in Gravevine, TX?

Why undergo oral surgery procedures without first understanding your expected co-pay or other anticipated out-of-pocket expenses? Work with us to obtain a pre-treatment estimate from your dental or medical insurance carrier. The pre-treatment estimate will outline expected reimbursement amounts for oral surgery services. It is a smart way for you to make the best choices for your needs. It also helps you budget for future treatments.

Where Do Dental Implants Fall in Terms of Oral Surgery Insurance Coverage?

Dental implants offer plenty of benefits for wearers. Despite this fact, their surgical placement costs may not be covered. For this reason, our office makes it easier to pay as you go. We offer personalized financing plans, as well as work with third party financing carriers including CareCreditⓇ.

Is TMJ considered a dental or medical concern?

Temporomandibular joint (TMJ) disorders are characterized by a range of factors such as genetics, arthritis, and jaw injuries. While these issues primarily impact the jaw joint and surrounding muscles, they can manifest in diverse symptoms like headaches, ear pain, and difficulty with chewing. Due to the complexity of TMJ disorders, comprehensive diagnosis and treatment often involve a collaborative effort among dental professionals, oral surgeons, physical therapists, and other healthcare specialists.

Accordingly, TMJ problems are viewed as both dental and medical issues, recognizing that the approach to treatment may vary based on individual causes and symptoms.

Benefiting From Oral Surgery in Grapevine, TX

Whether some, most, or all of the costs of your oral surgery are covered, feel free to call us at (817) 552-3223.  That way, you can arrange for an initial, no-obligation consultation with Dr. Tye. Let us help you understand your financial responsibilities as a patient of Texas Oral Surgery Specialists. Contact our office today and start your journey to the smile you have always wanted.