Oral Surgery Coverage

Oral and maxillofacial surgery can correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the mouth.

A medical or dental benefits and insurance plan may cover oral surgery. Which plan covers it depends upon:

  • The treatment needed
  • How your medical or dental plan is designed

Coverage under your medical or dental plan

We define oral surgery in two ways:

  • Dental in nature, or
  • Medical in nature

Oral surgery that is medical in nature is typically covered by a medical plan. It involves:

  • Disease of the facial bones
  • Trauma to the soft and hard tissue structures of the face and oral cavity
  • Treatment of a jaw disorder commonly known as TMJ
  • Correcting facial deformities present at birth or later

Surgery that is dental in nature involves the teeth. Tooth surgery is typically covered by a dental plan.

Getting reimbursed

You will be reimbursed under the plan that considers oral surgery a covered service.

To verify how your surgery may be covered:

  • Get a pre-treatment estimate
  • Call the Customer Service number listed on your Aetna ID card
  • Ask for the Oral Surgery Center of Excellence

Get more information

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