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Oral Surgery FAQs for Individuals and Families

How do I know which plan (medical or dental ) covers oral surgery?
Coverage depends upon the procedures involved and how your dental plan is set up. We suggest you get a pre-treatment estimate (predetermination) for any oral surgery procedure. We'll let you know if your plan covers the care suggested.

For more information, call the Member Services number on your ID card. 

Do I have to get treatment from an oral surgeon, or can my general dentist perform the services I need? 
It depends upon your plan. First, find out if your treatment will be covered under your medical or dental benefits or insurance plan. You or your dentist can send a request for a pre-treatment estimate (predetermination). We'll let you know if and how your plan covers the care suggested. 

How will my oral surgery service be reimbursed if my oral surgeon is in your dental and medical networks?
You will be reimbursed under the plan in which the oral surgery procedures are considered covered services.

Can I go to a participating dental specialist even if my procedures are going to be payable under my medical plan? 
It depends on your medical plan. Call Member Services at the number listed on your ID card. 

Are surgical extractions, such as removal of impacted teeth, considered dental or medical in nature ? 
Surgical dental extractions are considered dental in nature. They are typically covered under an Aetna dental plan. There are exceptions, however. To verify whether your dental or medical plan may cover surgical extractions, call Member Services. 

Page last reviewed January 5, 2016

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