Is wisdom teeth removal covered by health insurance?

Is wisdom teeth removal covered by health insurance?

Wisdom teeth removal can be painful, but nothing can affect us more than the medical bill after such a complex procedure. Thankfully, there is a way to overcome that tragedy; via insurance policies covering your expenses. 

But it is common knowledge that not all medical issues are covered. So, is wisdom teeth removal covered by health insurance?

Well, read ahead to find out. 

Is Wisdom Teeth Removal Covered By Health Insurance?

The answer entirely depends on the quality of your claim. Is your condition deemed medically necessary? If yes, then worry not, as it is highly likely that you are getting the support you need from your insurance provider. Some may even cover all expenses, including cleanings, check-ups, X-rays, etc. 

The removal of wisdom teeth is covered in some measure by a large number of dental insurance plans. Most insurance plans cover between 50% and 80% of the dentist’s or oral surgeon’s fees for wisdom tooth extractions. They frequently have deductibles and co-pays as well. The insurance company’s annual maximum payment limits also apply to the removal of wisdom teeth.

Talk to your insurance provider and dentist to get a clear picture.

How Much Does It Cost?

The price of removing a single wisdom tooth can range from $200 to $1,000. If the tooth is affected or if you need to have more than one wisdom tooth removed, for example, you can wind up spending extra. Remember, the charges are $200 to $1,000 per tooth.

Prior to covering the expense of wisdom teeth extraction, several policies include a waiting period. Verify that any waiting period has been satisfied if you have recently become covered by your dental insurance policy before arranging your wisdom teeth extraction.

Is Wisdom Teeth Removal A Medical Necessity?

Previously, it was standard to remove wisdom teeth as a preventive measure, even if they were not causing any problems. However, now, dental experts have changed their recommendations and advised against removing wisdom teeth unless they are causing any issues. The main reason for this shift is that research has revealed wisdom teeth don’t always cause problems, and removing them can lead to unnecessary complications.

However, if a patient experiences discomfort, such as pain and swelling due to the wisdom tooth, seeking medical assistance is a must. Also, crowding, cysts, or infection may result in the need to remove wisdom teeth if your mouth is not large enough to accommodate another molar or if your wisdom teeth do not emerge straight into the mouth or have emerged at an odd angle. In cases of it being trapped in your jaw or gum, an extraction is advised.

In the cases above, your insurance company can cover the extraction.

Frequently Asked Questions (FAQs)

1. What happens if you leave wisdom teeth in too long?

If you leave a wisdom tooth that needs to be extracted for too long, there can be some issues. 
It can push against adjacent teeth, causing them to shift out of position, leading to crooked or crowded teeth.
Wisdom teeth can be challenging to tend appropriately, leading to decay and gum disease. These problems can spread to other teeth and cause serious oral health issues.
These teeth can develop cysts and tumors that damage the jawbone, nerves, and nearby teeth. In rare cases, these growths can even become cancerous.
Affected or partially erupted teeth can cause significant pain and discomfort, badly influencing the ability to eat, speak, and perform other daily activities.
Wisdom teeth that develop in the upper jaw can push against the sinuses, causing sinus pain and congestion.

2. What age should wisdom teeth be removed?

Usually, a wisdom tooth extraction takes place before one turns 25. 

3. What is the latest age to get wisdom teeth?

Most of the time, people get wisdom teeth by age 25, but there are exceptions where teeth come out later in life.

Wrapping It Up

Health insurance may cover the cost of wisdom teeth removal if they consider it medically necessary. This may include cases where these teeth cause pain or infection or if they damage surrounding teeth or gums.

However, health insurance may not cover the removal cost in other cases if the procedure is considered elective.

Check out more articles like this: Does Blue Cross Medical Insurance cover oral surgery?

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