Wisdom teeth – dental vs. medical coverage

I'm 35 and I still have my wisdom teeth. I have significant anxiety around dental procedures (even cleanings) as well as surgery. I should've had them out years ago but I've been avoiding it. Trying to be a big girl and get it taken care of, but I'm really frustrated with how I'm going to pay for it.

I need oral surgery with sedation because 3 of them are complete bony impactions and 1 is a partial bony impaction. I have both medical and dental insurance through my employer, same provider. I was hopeful that this could be billed to my medical, but I called my insurance company and they told me that only my dental plan covers it. That seemed odd because oral surgery isn't mentioned ANYWHERE in my plan summary. but ok. The problem? My dental has a maximum benefit of $1000 per coverage year. The cost to have my wisdom teeth removed will obviously be quite a bit more than that. Another problem? I also have some periodontal issues that were addressed with a scaling and root planing last year and have been well managed with more frequent maintenance cleanings (every 3 months). Because of that, I've used around half of my yearly benefit on that so far if not a little more.

If I go ahead with the surgery before coverage resets I'll only get a few hundred dollars from insurance and a large bill for me to pay out of pocket. If I wait until it resets then I'll get the full $1000 and lower out of pocket costs, but have nothing for the rest of the year. The cost for cleanings is manageable, but god forbid I have a complication with the extraction or I get a cavity or need a root canal and I can't delay care, that would also mean a big out of pocket bill. I have the option of delaying for now and going back to a higher deductible plan with the HSA at open enrollment and utilizing the employer contribution and my own contributions to set aside money for this. I don't currently have any major issues, but I do have low-level discomfort in my jaw and occasional irritation of the partially impacted tooth. I was also just trying to make an effort to FINALLY get this done and now it seems like I have to delay.

It seems like my best option is the last one, but before I do that does anyone have ANY thoughts or tips on trying to get this under medical. or am I just totally out of luck?

submitted by /u/somecrazydoglady
[comments]