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A 42-year-old member asked:

How can i get a tmj surgery paid for by insurance?

4 doctor answers13 doctors weighed in
Dr. Anifat Balogun
ENT and Head and Neck Surgery 30 years experience
TMJ surgery: Your otolaryngologist or oral maxillofacial surgeon will be your best avenue to submit any documentation requested by your insurance company and appeal any denial. Ultimately if your insurance company decides not to pay, you will need to discuss options with you surgeons.
Dr. steven Present
Dentistry 44 years experience
Get involved: The surgeon must write a letter of medical necessity to your insurance carrier. He/she must describe in detail the nature of your specific problem, the procedure he/she is to perform, and your prognosis. If this is initially denied you can appeal. It may be a good idea to have your employer (assuming they have the contract) get involved and complain if your claim is not approved.
Dr. Jeffrey Bassman
Dentistry 46 years experience
Need consult: You will need a consult and after your examination, I am sure the receptionist at the surgeons will discuss insurance with you. A predetermination may be required. Also, call your insurance agent.
Dr. Louis Gallia
Surgery - Oral & Maxillofacial 46 years experience
Depends: It depends on your location and your insurance company. Some states mandate treating the TMJ like any other joint (california). Your surgeon must submit documentation of the diagnosis, imaging studies, evidence of lack of response to previous conservative modalities, and evidence of the problems negatively impacting your quality of life.

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Similar questions

A 35-year-old member asked:

How can I get a TMJ surgery paid for by medical insurance?

3 doctor answers12 doctors weighed in
Dr. Addagada Rao
General Surgery 57 years experience
Getting the coverage: Medical insurance some thing simple ' you pay for it you get it' and is no mystery to solve.
A 43-year-old member asked:

How do I go about getting surgery for tmj?

5 doctor answers9 doctors weighed in
Dr. Sami Latif
Dentistry 38 years experience
Tmj pain : I would never recommend it unless it becomes absolutely in able yo open and chew food , i would seek the help of a dentist who can treat TMJ with the help of an orthodontist and reputable oral surgeon should surgery is your only option , most of patients who have had the surgery did not improve and some got worse, good luck.

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Last updated Jan 1, 2021


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