I (39F) visited the dentist for a regular appointment the other day and, after years of visiting various dentists and having many x-rays and being told I never grew wisdom teeth, they discovered that I do in fact have a horizontally impacted wisdom tooth in my top jaw. Since I never in a million years thought I had wisdom teeth, I never considered that my jaw pain and ear aches on that side were being caused by it. I assumed it was my typical sinus pressure issues.
I have Delta Dental, but it only covers 75% of removal surgery. Needless to say, this still requires a chunk of change out of pocket. I have BCBS for medical and can’t find anything in my plan documents mentioning oral surgery. I know it doesn’t cover dental care, but is it possible to have it considered medically necessary and falling under outpatient surgery? What documentation might I need to get from my medical doctor to make a case for coverage? I haven’t seen my doctor for the ear aches or jaw aches, because I assumed there was nothing to be done but get through a sinus infection or a cold or allergies. I am no stranger to sinus issues.
Is this even worth trying for or will it not be worth the effort? I have a consultation with an oral surgeon in July and will obviously ask what they recommend. I also have some time before the surgery will be scheduled, so I have the opportunity to try to fight the good fight. Willing to put in the work if it’s going to save me some serious cash.
submitted by /u/likeistoleyourbike
[link] [comments]I (39F) visited the dentist for a regular appointment the other day and, after years of visiting various dentists and having many x-rays and being told I never grew wisdom teeth, they discovered that I do in fact have a horizontally impacted wisdom tooth in my top jaw. Since I never in a million years thought I had wisdom teeth, I never considered that my jaw pain and ear aches on that side were being caused by it. I assumed it was my typical sinus pressure issues. I have Delta Dental, but it only covers 75% of removal surgery. Needless to say, this still requires a chunk of change out of pocket. I have BCBS for medical and can’t find anything in my plan documents mentioning oral surgery. I know it doesn’t cover dental care, but is it possible to have it considered medically necessary and falling under outpatient surgery? What documentation might I need to get from my medical doctor to make a case for coverage? I haven’t seen my doctor for the ear aches or jaw aches, because I assumed there was nothing to be done but get through a sinus infection or a cold or allergies. I am no stranger to sinus issues. Is this even worth trying for or will it not be worth the effort? I have a consultation with an oral surgeon in July and will obviously ask what they recommend. I also have some time before the surgery will be scheduled, so I have the opportunity to try to fight the good fight. Willing to put in the work if it’s going to save me some serious cash. submitted by /u/likeistoleyourbike [link] [comments]Read Morer/HealthInsurance