Will Insurance Cover Treatment For TMJ Disorder?

Will Insurance Cover Treatment For TMJ Disorder?

Surgical treatment can often give patients relief from symptoms of a temporomandibular joint (TMJ) disorder when other, more conservative interventions have been ineffective. Unfortunately, some patients may be reluctant to pursue surgical options out of concerns related to the cost associated with such procedures.

Patients who have medical and/or dental insurance often find that TMJ treatments, including surgical procedures, are covered under those plans. Our practice has a team of insurance experts who will work with you and your insurers to maximize your benefits and coverage and minimize your out-of-pocket costs.

Treatment from an oral surgeon can be covered under medical benefits in some cases, so our staff will request information about both your medical insurance and your dental insurance.

The staff will request pre-authorization for covered services in advance of your scheduled appointment for the procedure. A member of the team will then have a discussion with you about any anticipated or estimated out-of-pocket expenses that remain after your insurance benefits have been applied to your account.  

Keep in mind that an insurance authorization is not necessarily a guarantee of payment, so patients should be prepared for the small possibility that insurance will not cover the service. This is very rare, though, and should an insurance issue a denial for a previously pre-authorized procedure, our staff will work diligently to sort out the issue. We will also prioritize communication with the patient regarding any updates on the coverage.

For any costs not covered by insurance, we accept a wide variety of payments, including cash, check and credit cards. We also can help you connect with a health care financing service, if that option appeals to you.

In addition to TMJ treatments, our staff works to coordinate insurance coverage for other oral surgery treatments, such as wisdom tooth extraction and jaw surgery.

Don’t assume that a surgical procedure that could eliminate your TMJ pain is out of reach financially. Talk to a member of our financial team to learn more about your options and expected out-of-pocket costs.