How to Find Out if Insurance Covers Dental Surgery

You might have seen doctors, consulted surgeons and been convinced you need oral surgery, but there's one more step you need to take before you schedule surgery. If you have insurance, you will have to ask beforehand if the company will cover the surgery. Being prepared means you won't be surprised by a large bill after your surgery.

Instructions

Difficulty: Easy

Things You’ll Need:

• Your insurance provider's phone number
• Your insurance provider's service guide

Find Out if Insurance Covers Dental Surgery

1. Look in your insurance company's service contract or plan guide. Sometimes individual procedures and how the bills are paid are covered in the book. Call your insurance company to make sure it covers the procedure. Learn more about different types of dental coverage on WebMD's website (see Resources box).
2. Ask your surgeon for the cost of your surgery before you call the insurance company. Some health insurance companies have a "schedule of benefits" that indicate how much the company will pay toward your surgery.
3. Ask your insurance company how they need to receive your surgery request. Some companies require a letter, your medical records or other documents to process your request. Be sure to ask how long it will take to get an answer.
4. Determine if your health insurance will cover dental surgery. If it does not, consider purchasing dental insurance temporarily to cover the cost. This may not work if you need surgery immediately.
5. Find out if you need a referral to a different doctor to have your insurance cover the procedure. HMO patients with legitimate medical problems actually need their doctor, not their dentist, to refer them to a dental surgeon. Find out the specifics of what procedures are covered by the HMO at the Liquid Diet website (see Resources below).

Tips & Warnings

• Write down relevant phone numbers and documents you need to provide. If you have trouble getting your request filled, you will have a detailed log of the steps you have taken to get your insurance carrier to cover your oral surgery.
• Some insurance companies don't cover surgery they consider unnecessary, such as plastic surgery. If your surgery is more than cosmetic but not covered, you may need extra time and tests to prove its legitamacy to your insurance company.