Does Blue Cross Medical Insurance Cover Oral Surgery: Overview, Cost, Duration, Surgeon, Clinic & Recovery

Does Blue Cross Medical Insurance Cover Oral Surgery: Unveiling the Truth.!!!

An image illustration of Oral Surgery
Discover the extent of Blue Cross medical insurance coverage for oral surgery.

Oral surgery encompasses a variety of procedures aimed at addressing issues within the mouth, teeth, or jaw.

These procedures, ranging from tooth extractions to dental implants, jaw surgeries, and biopsies, play a vital role in enhancing oral health, appearance, and overall quality of life.

However, understanding the potential costs and whether Blue Cross Medical Insurance provides coverage is crucial.

This blog post aims to provide answers to these questions and offer insights into finding the most suitable oral surgeon and clinic.

What Constitutes Oral Surgery and How Does it Function?

Oral surgery, falling under the domain of dentistry, focuses on diagnosing and treating conditions affecting the oral and maxillofacial region.

Oral surgeons, having undergone additional training and certification, perform various surgical procedures, including:

  1. Tooth Extractions: Removal of damaged, decayed, or impacted teeth to prevent infection, pain, and further complications.
  2. Dental Implants: Placement of artificial tooth roots into the jawbone to support replacement teeth, restoring both function and appearance.
  3. Jaw Surgery: Correction of jaw and teeth alignment issues, addressing conditions like overbite, underbite, crossbite, and TMJ disorder, thereby improving chewing, speaking, and breathing.
  4. Biopsies: Extraction of small tissue samples from the mouth or jaw for examination, aiding in the diagnosis of oral cancer and other diseases.

Typically performed under local or general anesthesia, oral surgery involves incisions in the mouth or jaw using specialized instruments.

The surgeon closes these incisions with stitches or glue and provides post-operative care and recovery instructions.

While oral surgery offers benefits such as pain relief, functional restoration, and aesthetic enhancement, it is not without risks, including:

Bleeding, infection, swelling, bruising, nerve damage, and the potential for dry socket.

The success and longevity of the procedure are also influenced by the patient’s oral health and habits.

Does Blue Cross Medical Insurance Cover Oral Surgery?

Coverage for oral surgery by Blue Cross Medical Insurance depends on the nature and purpose of the procedure, as well as the specifics outlined in your insurance plan.

Generally, most health insurance companies, including Blue Cross, do not cover oral surgery for cosmetic reasons, necessitating self-payment for the entire surgical cost.

Exceptions exist where oral surgery may be deemed medically necessary, thus qualifying for insurance coverage.

These exceptions include:

  1. Oral surgery as a treatment for oral cancer or diseases affecting the mouth or jaw.
  2. Oral surgery as part of reconstructive surgery to restore the normal appearance and function of the mouth or jaw following an injury, disease, or birth defect.
  3. Oral surgery as part of a medically necessary dental procedure, such as tooth extraction for an infected tooth or a dental implant for a missing tooth.

For coverage eligibility, obtaining prior authorization from your Blue Cross Medical Insurance provider is essential.

Documentation from your oral surgeon validating the medical necessity of the procedure, including a letter of recommendation, diagnosis, treatment plan, and prognosis, is also required.

The extent of coverage under your Blue Cross Medical Insurance plan varies based on your deductible, co-pay, co-insurance, and out-of-pocket maximum.

It is advisable to consult with your insurance provider before scheduling oral surgery to ascertain precise details regarding benefits and limitations.

Finding the Right Oral Surgeon and Clinic for You

Embarking on the path of oral surgery prompts the need to identify a trustworthy oral surgeon and clinic capable of providing a safe and effective treatment.

To guide you in this crucial decision-making process, consider the following tips:

1. Conduct Thorough Research:

  • Explore reputable and experienced oral surgeons and clinics within your locality. Utilize online directories like Zocdoc or Delta Dental to identify board-certified and qualified professionals.
  • Delve into reviews, testimonials, and ratings from previous patients to gauge the quality of service and overall satisfaction.

2. Price Comparison:

  • Recognize that oral surgery costs can fluctuate based on various factors, including the oral surgeon, clinic, location, technique, and the complexity of the procedure.
  • Obtain quotes from a minimum of three different providers, meticulously comparing them. Additionally, inquire about supplementary fees such as anesthesia, facility charges, medication, and post-operative care.
  • Keep in mind that prioritizing health and safety is paramount, and the cheapest option may not necessarily be the most suitable one.

3. Pose Informed Questions:

  • Upon narrowing down your choices, schedule a consultation with potential oral surgeons to gain deeper insights.
  • Inquire about their credentials, experience, success rates, potential complications, and request to view before-and-after photos.
  • Seek clarity on the oral surgery procedure itself, including the technique employed, associated risks, anticipated recovery, and expected results.
  • Ensure that your interaction leaves you feeling comfortable and confident in your chosen oral surgeon.

What is the Recovery Time for Oral Surgery?

  • Recovery duration varies among individuals and is influenced by the extent of the surgery, the healing process, and adherence to aftercare instructions.
  • Typically, normal activities can resume within a few days to a few weeks post oral surgery. However, strenuous exercise, heavy lifting, and smoking should be avoided for at least 4 to 6 weeks.
  • Compliance with oral surgeon instructions, encompassing the use of painkillers, antibiotics, anti-inflammatory drugs, ice packs, saltwater rinses, and a soft food diet, contributes to optimal recovery.
  • Final results manifest after 3 to 6 months, coinciding with the reduction of swelling and inflammation.

What is the Average Cost of Oral Surgery?

  • Statcare Urgent Care estimates the average cost of oral surgery in the United States to be around $2,000.

This figure serves as a general estimate and excludes additional expenses like anesthesia, facility charges, medication, and post-operative care.

  • The overall cost can fluctuate significantly, ranging from $500 to $10,000 or more, contingent on various influencing factors.


Q: How Long Does Oral Surgery Take?

  • The duration of oral surgery hinges on the number and size of treated areas, as well as the chosen technique.
  • Generally spanning from 15 minutes to 4 hours or more, additional time in the clinic or hospital may be necessary based on individual conditions and recovery progress.


Spread the love