Does Anthem Medical Insurance Cover Oral Surgery? Navigating Your Dental Needs

Oral surgery can be a necessary procedure to address various dental issues. If you have Anthem medical insurance, you might wonder if it covers these procedures.

The answer, unfortunately, is not a straightforward yes or no.

Let’s delve deeper into how Anthem medical insurance works and explore alternative options for covering oral surgery.


Does Anthem Medical Insurance Cover Oral Surgery?

While Anthem medical insurance typically doesn’t cover oral surgery, there are specific situations where it might be covered.

Carefully reviewing your plan documents and contacting Anthem for clarification are crucial steps.

Exploring alternative options like dental insurance, discount programs, or financing plans can help make oral surgery more affordable.

Understanding Anthem Medical Insurance

Anthem primarily offers health insurance plans, which focus on medical coverage for doctor visits, hospitalizations, and various illnesses.

These plans typically do not cover dental services like cleanings, fillings, or oral surgery.

This is because dental care falls into a separate category with its own insurance plans.

There are two main types of dental insurance plans:

  • Dental PPO (Preferred Provider Organization): Offers a network of dentists with contracted rates. You’ll pay less if you use in-network providers.
  • Dental Indemnity: Provides a set amount of money for covered services, regardless of the dentist you choose.

Some employers might offer Anthem plans that include dental benefits as part of a combined medical and dental package.

It’s crucial to carefully review your specific Anthem plan documents or contact Anthem directly to confirm if dental coverage is included.

Exploring Alternative Options for Oral Surgery Coverage

If your Anthem medical plan doesn’t cover oral surgery or doesn’t meet your needs, here are alternative options:

  • Dental Insurance: Consider purchasing a separate dental insurance plan. Anthem itself offers stand-alone dental plans with varying coverage levels for procedures like oral surgery.
  • Discount Dental Programs: These programs offer reduced fees for dental services from participating dentists. While not true insurance, they can help make oral surgery more affordable.
  • CareCredit: CareCredit is a healthcare financing option that allows you to pay for medical and dental procedures over time with a monthly payment plan.
  • Flexible Spending Accounts (FSA): An FSA allows you to set aside pre-tax dollars for qualified medical and dental expenses, including oral surgery.

When Anthem Medical Might Cover Oral Surgery

While the primary function of Anthem medical insurance isn’t dental care, there are rare instances where it might cover specific oral surgeries:

  • Medically Necessary Extractions: If a tooth poses a serious health risk, such as causing an infection that could spread to your jawbone or bloodstream, Anthem Medical might cover the extraction as a medically necessary procedure. Documentation from your dentist and doctor supporting the medical necessity is crucial.
  • Facial Injuries: If you sustain facial injuries in an accident that require oral surgery as part of the treatment plan, Anthem medical insurance might cover these costs, depending on your specific plan.

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