Does Private Health Insurance Cover Jaw Surgery

Jaw surgery, or orthognathic surgery, corrects jaw issues but can be costly. Wondering if private insurance covers it? Discover coverage options with Savvy and learn about Medicare assistance.

Private health insurance may cover orthognathic surgery if deemed medically necessary, not cosmetic.

Coverage depends on the procedure, insurance type, and level.

Jaw Surgery health coverage
Jaw Surgery health insurance coverage: Photo source (Healthline)

Insurance might cover surgery for bite problems, injuries, tumors, birth defects, or sleep apnea.

Usually, three phases include orthodontic treatment, surgery, and post-surgery orthodontic care.

Hospital and extras cover can assist with costs.

Hospital policies (silver and gold) cover dental surgery, essential for hospital-based orthognathic surgery.

Does Medicare cover orthognathic surgery?

Medicare might cover medically necessary orthognathic surgery, mainly hospital stays and surgery.

Check Medicare Benefit Schedule online for coverage details.

Orthodontics usually isn’t covered unless medically urgent, with a GP referral.

Consult your surgeon and health fund to understand private insurance and Medicare coverage.

Frequently Asked Questions (FAQs)

Are there waiting periods for jaw surgery coverage under private health insurance?
Hospital cover usually requires a two-month waiting period, while pre-existing conditions might entail a 12-month wait.
Waiting periods for extras cover vary from two to 12 months based on the chosen policy and health fund.
What is the cost of jaw surgery?
Orthognathic surgery costs vary based on complexity, surgeon fees, and location. Out-of-pocket expenses can range from hundreds to thousands of dollars.
What should I do if I need orthognathic surgery and don’t have private health insurance?

Without private insurance, public hospitals offer jaw surgery if medically necessary. However, wait times are long, and surgery timing may be beyond your control.

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