Is TMJ/TMD covered by insurance?
Because of confusion in the medical and dental profession in this area, many insurance companies have “TMJ (or TMD) exclusions” in their coverage contracts. We will provide any patient in our office with an insurance statement you can send to your insurance company. Most TMD claims will be filed with your medical insurance, not dental insurance. Because of the wide range of coverage, we ask that you pay for your treatments and submit a claim for reimbursement to your insurance company. Our office manager will be pleased to make financial arrangements with you. This unfortunate situation could be easily remedied if the responsible organizations (ADA and AMA) would recognize a specialty in treating TMD and orofacial pain. There are now one- and two-year university residency programs in major dental schools where doctors who have special interest in these fields are trained.
