Wisdom Tooth Removal - Insurance Coverage?

[Newfie2000]

I was just reading a little about this on another thread and did not want to hijack the thread so I thought I would start a new one.

I was told earlier in the Spring that I needed all of my wisdom teeth removed. I am 35 so I guess it is long overdue. Anyway my regular dentist will only do what he calls "easy pulls". He pulled my top two wisdom teeth in June and it only cost $250.00, we have a limited $ amount of dental coverage each year so I wound up paying $ 50.00 out of pocket after the copay. I also had other extensive dental work done that maxed out my dental coverage for the year. My dentist will not touch the bottom two as he says they are not "easy pulls" and referred me to an oral surgeon. I really do not understand this as my dentist pulled out the tooth right in front of the wisdom tooth a couple years ago, I would think it would be the same? Anyway, because the teeth are not causing me any immediate problems I asked the dentist if it could wait until next year, he said no problem.

After reading the other thread I am wondering if because this needs to be done at an oral surgeon's maybe the medical portion of the insurance would kick in and this would not be considered under the dental portion of coverage? Does that make sense? I know what I want to say in my head but can't seem to explain it. Our dental insurance is tied into our medical insurance through our union and the medical is Blue Cross/Blue Shield. I just thought maybe some of you would know how this works and be able to offer some suggestions/ideas/insite. Thanks!

 

[Malificient Tater]

I have not had your problem because my 3 were easy pulls. But I would check with them. And I am saying this because I found out that with Blue Cross/SHeild that if you have say and eye infection they cover that even if you do not have vison with them.

Also some oral surgeons take what is a 6 month's no interest credit card, care credit. That is what we had to do when my dd got a root canal.

 

[jsmla]

We have Blue Cross and DD's oral surgery was covered. She had two wisdom teeth removed. They were impacted and it was covered through our medical.

Jennifer

 

[ladysoleil]

It depends on your insurance and you really have to call and check with both your dental and your medical insurance.

At my job there are a couple of different options for insurance and depending on which set of plans you have, it may or may not be covered. For example, on my insurance, oral surgery is not covered under my dental plan, and is not covered on my medical plan, either. If I got the more expensive medical plan, it would be.

 

[Cristy]

Many, many, many years ago I had all four of my wisdom teeth pulled via oral surgeon as all four teeth were impacted. It was completed in two separate appointments and they put me under anesthesia each time. It was covered by my medical insurance.

I would suggest you call your insurance company and ask them directly. Usually your insurance card has the phone number for customer service on the back. They should be able to inform you of your coverage and what steps you need to take.

 

[ampooh]

definitely check with your insurance company. A coworker's son had his out last summer and our insurance pays 0 on wisdom teeth it says. Coworker was left with a 1K bill she didn't expect.
get preauthorization

 

[rhiansmom]

When I had my wisdom teeth removed it was also oral surgery. My medical insurance didn't pay a cent and it wasn't covered under my dental surgery. I contacted several oral surgery centers and they all wanted payment in full prior to the surgery. I'm $1200 poorer and have four less teeth.

 

[cinderella73]

I was just reading a little about this on another thread and did not want to hijack the thread so I thought I would start a new one.

I was told earlier in the Spring that I needed all of my wisdom teeth removed. I am 35 so I guess it is long overdue. Anyway my regular dentist will only do what he calls "easy pulls". He pulled my top two wisdom teeth in June and it only cost $250.00, we have a limited $ amount of dental coverage each year so I wound up paying $ 50.00 out of pocket after the copay. I also had other extensive dental work done that maxed out my dental coverage for the year. My dentist will not touch the bottom two as he says they are not "easy pulls" and referred me to an oral surgeon. I really do not understand this as my dentist pulled out the tooth right in front of the wisdom tooth a couple years ago, I would think it would be the same? Anyway, because the teeth are not causing me any immediate problems I asked the dentist if it could wait until next year, he said no problem.

After reading the other thread I am wondering if because this needs to be done at an oral surgeon's maybe the medical portion of the insurance would kick in and this would not be considered under the dental portion of coverage? Does that make sense? I know what I want to say in my head but can't seem to explain it. Our dental insurance is tied into our medical insurance through our union and the medical is Blue Cross/Blue Shield. I just thought maybe some of you would know how this works and be able to offer some suggestions/ideas/insite. Thanks!

Okay well I just had my bottom wisdom tooth pulled and I was also reffered to a oral surgeon. I am 33 by the way so close in age. Its a lot more complicated to remove them on the bottom. And be glad that a oral surgeon does it because they can cut around everything well and get it out without as much pulling. Those suckers grow deep!

Now with mine I was told that my regular medical would have to primary to cover the extraction. But I didnt have medical so my dental would have to pay it. They did after I faxed them proof that I didnt have medical and I only had a 100 copay. If you are hoping to get medical to cover it they should as long as its impacted. Which I am sure it is.

I waited and mine became really infected. Not fun. If you can get medical to cover it I would just get it done soon. Mine was getting down to the jaw. And honestly it felt so good after he pulled it I never had to take anything for pain. Because once it gets infected you seriously consider pulling it yourself. Mine got really bad on a day my doctor was away. What a nightmare.

I dont know if the copay you would have would be affected by what type of anestesia ( I know thats spelled wrong lol !) you would choose. I convinced my surgeon to let me do local and it wasnt so bad. Well I ended up with 9 shots of novacaine but no yucky groggy affects and no pain. Just hated the shots themselves. But if you have a good oral surgeon dont be afraid to ask for a local if they let you.

I still have one more that as to get pulled on the bottom on the other side but they refused to let me be awake for those. So I am hoping it will raise up to the surface more and I can do local again. I hate that twilight stuff.

Good luck. Get it done soon . And make your apointment with the surgeon and he can check your insurance. You shouldnt have to pay anything with full medical coverage.

 

[rflorek]

I dont know if the copay you would have would be affected by what type of anestesia ( I know thats spelled wrong lol !) you would choose. I convinced my surgeon to let me do local and it wasnt so bad. Well I ended up with 9 shots of novacaine but no yucky groggy affects and no pain. Just hated the shots themselves. But if you have a good oral surgeon dont be afraid to ask for a local if they let you.

I had all 4 pulled at one time under a local - no problems, and only alittle swelling. They were done at an oral surgeon's and we covered by my dental insurance except for a co-pay (which I think was $150)

 

[jsmla]

When DD went in for her consultation with the oral surgeon I had one with the office manager. She got all of our insurance information and filed for pre-authorization. I recieved a notice from Blue Cross that it was approved a few days later. We had to pay our deductible and then BC covered 80% of the balance. Since her teeth were impacted it was approved for medical.

DD has a serious problem with gagging and panic attacks in the dentist's office so she was given something to knock her out a bit. BC covered it at the same rate as the surgery. She still had a panic attack during the surgery, poor baby.

Jennifer

 

[girli565]

I had mine done with an oral surgeon because all four were impacted and my Dental insurance wanted to only pay for two to be pulled at a time but I was NOT going to go back twice when I knew that I'd be in pain. So we waited forever to get all four approved. because they were impacted they were $60 a piece instead of $25 a piece for non-impacted. I did not have to be knocked out, I got gas and a local and was talking and functioning fine 10 minutes after the surgery. I had swelling that made me look like a chipmunk, lol.

Check with your insurance because we fought and they changed their policy for us and helped us out. And the oral surgeon was great too, we got to pay in two payments.

 

[Snowysmom]

My DS just had his wisdom teeth out. Our medical insurance, HMO Blue, paid for it minus a $25 co pay. I called HMO Blue before scheduling the procedure and got the info right from them.

 

[mom2my3kids]

Our dental does not cover surgical extractions either..

 

[Green Tea]

Our medical covers impacted extractions in full, just like any other outpatient surgery. If they are through the gum though, no coverage for pulling.

 

[bigbabyblues]

I had mine done a couple of years ago, and I had one that was through the gum, and two that were completely impacted. The dental insurance paid only for the one that was through the gum, and my medical insurance would have paid for the two impacted ones, but I didn't know that, and the surgeon was out of network with them. I ended up paying for those two myself.

 

[ktkerber]

I would get a second opinion on whether you really need to have your wisdom teeth pulled. I am 35 as well and have all 4 of my wisdom teeth. I just started going to a new dentist, who was surprised that I still had all of my wisdom teeth. He said at my age he would never pull out wisdom teeth unless they were really bothering me or infected. He sent me to a oral surgeon though just for a consult. The oral surgeon agreed and said at my age that there can be significant nerve damage caused when removing wisdom teeth that can cause you to not be able to feel your bottom lip and affect how you eat and drink. He described it as being the feeling you have when novacaine is wearing off. It all sounded pretty scary to me. He said they normally pull those teeth when you are teenager because the nerves haven't fully grown and they can take the teeth out without any worry of nerve damage. He said as you get past your teen years those nerves grow and get wrapped around your wisdom teeth.

 

[mrsbornkuntry]

I would get a second opinion on whether you really need to have your wisdom teeth pulled. I am 35 as well and have all 4 of my wisdom teeth. I just started going to a new dentist, who was surprised that I still had all of my wisdom teeth. He said at my age he would never pull out wisdom teeth unless they were really bothering me or infected. He sent me to a oral surgeon though just for a consult. The oral surgeon agreed and said at my age that there can be significant nerve damage caused when removing wisdom teeth that can cause you to not be able to feel your bottom lip and affect how you eat and drink. He described it as being the feeling you have when novacaine is wearing off. It all sounded pretty scary to me. He said they normally pull those teeth when you are teenager because the nerves haven't fully grown and they can take the teeth out without any worry of nerve damage. He said as you get past your teen years those nerves grow and get wrapped around your wisdom teeth.

Wow, I never heard this. Last year I had to have my bottom one cut out on one side because it was impacted and it was hitting the tooth next to it which damaged it, too (and was very painful). They went ahead and did the one on top, too. I was supposed to go back to have the wisdom teeth on the other side taken out, but my DH deployed so with no one to watch the kids I haven't done it yet and I was worried about it. I read that if they're impacted they can damage the molars next to them (like my one did) so it's a good idea to have them taken out before they do.

My dental insurance covered some of it, but it went over my max. for the year so I had to pay oop too. I didn't know to ask if my medical would cover it.

 

[jcemom]

Not trying to hijack the OP's thread... but I'm scheduled to have one wisdom tooth on the bottom extracted on Tuesday. I have all of my teeth as of today and I'm 37. I don't even like visiting the dentist for cleanings, though I do. I haven't had an anxiety attack... yet... but it really really stresses me out. I'm scared silly to go on Tuesday and if it weren't for the tooth bothering me and my worry that it will get much worse I'd cancel. I don't know why I'm so anxious about it, but I am. I've had kids, stitches, surgery, a tattoo, LOL, but this extraction is causing me to lose sleep.

Is it really horrible, for those who have had them out? I'm envisioning them pulling and pulling at my head, blood, excruciating pain... ugh! When I made the appointment I was told it would be done with just novocaine, unless I wanted it otherwise. I don't like being 'out of it' so I said that was good. Now I'm so stressed out that I don't know, maybe I should have been knocked out. Ack. I wish I could just ignore it and have it go away.

 

[Lives4Disney]

Not trying to hijack the OP's thread... but I'm scheduled to have one wisdom tooth on the bottom extracted on Tuesday. I have all of my teeth as of today and I'm 37. I don't even like visiting the dentist for cleanings, though I do. I haven't had an anxiety attack... yet... but it really really stresses me out. I'm scared silly to go on Tuesday and if it weren't for the tooth bothering me and my worry that it will get much worse I'd cancel. I don't know why I'm so anxious about it, but I am. I've had kids, stitches, surgery, a tattoo, LOL, but this extraction is causing me to lose sleep.

Is it really horrible, for those who have had them out? I'm envisioning them pulling and pulling at my head, blood, excruciating pain... ugh! When I made the appointment I was told it would be done with just novocaine, unless I wanted it otherwise. I don't like being 'out of it' so I said that was good. Now I'm so stressed out that I don't know, maybe I should have been knocked out. Ack. I wish I could just ignore it and have it go away.

I want to know too!! Good luck to you - I hope you do fine.

DS16 had his 4 wisdom teeth out last winter and it cost me $1300 out of pocket. Total bill was just over $2600. The office said they file only under dental and our dumb dental only pays 50% of anything. My medical is a PPO and would have paid all but a copay if it would have been covered.

Now I have 3 wisdom teeth that are showing decay and have been for about a year now but I am chicken to have this taken care of......my dentist told me that I should go for crown lengthening ($750/tooth) and then he'd do crowns.....(another $700-800/tooth )...I am thinking no way for wisdom teeth - but I am scared to do a thing about it - PLUS the cost!!!!! They aren't bugging me at all now so it's easy to put off, lol......I am a 41 yr old chicken and after reading the PP about nerves and damage - I am even more anxious about this whole mess. I don't want to wait until I am in excruciating pain, but not sure what I want to do.

Lives4Disney

 

[PeachesDoesHair]

After my dentist assured me only my bottom wisdom teeth needed to come out...after asking him to pull all four and him repeatedly saying my upper teeth did not need it....you guessed it...my upper wisdom teeth need to come out.

It will be through our medical insurance. I have to see an oral surgeon. I wouldn't want them done in an office with me awake anyway. For us, we have to meet our deductible and pay 20%.