A to Z of Wisdom Tooth Extraction Insurance Claims / Gangnam Leon Dental Clinic Wisdom Tooth Extraction Cost

Hello, this is Gangnam Leon Dental Clinic☺

Today, after wisdom tooth extraction,

we would like to look into insurance claims.

From the conditions for eligibility for insurance claims

to how to file a claim, the required documents, and

the cost of wisdom tooth extraction,

we hope this will be helpful for getting reimbursed through insurance.

Wisdom tooth insurance claims are

only possible with 2nd to 4th generation indemnity insurance!

To file an indemnity insurance claim,

you must first check when the policy was purchased.

Wisdom tooth insurance claims are

only available to 2nd to 4th generation policyholders

who enrolled on or after October 1, 2009,

and are not available to 1st generation policyholders who enrolled earlier.

(However, insurance claim eligibility may vary depending on the individual’s situation

and the insurance product,

so we recommend checking with your insurer in advance.)

🖐Question🖐

Can I claim all the costs

of wisdom tooth extraction?

▶ To get straight to the point,

only the covered portion of wisdom tooth extraction can be claimed.

You can claim the out-of-pocket amount paid by the patient

for the portion that is covered.

Because wisdom tooth extraction involves cutting the gums to perform the extraction,

a hemostatic agent is often used to help with bleeding control

and for faster recovery,

but hemostatic agents are classified as non-covered items

and are not eligible for indemnity claims.

Documents needed for

wisdom tooth insurance claims

If you meet the conditions for a wisdom tooth insurance claim,

the following documents are required for the claim.

✔ Medical receipt

✔ Detailed medical bill statement

✔ Document showing the diagnosis and disease code

(Consultation confirmation / outpatient confirmation / prescription)

✔ Pharmacy receipt

In addition to the basic documents above,

requirements may vary by insurer,

so to avoid missing any documents,

it is best to understand your insurance policy terms

and prepare accordingly.

How to file a wisdom tooth insurance claim

The general claim process after wisdom tooth extraction

is as follows.

① Access the insurer’s app or website

Most insurers operate an online claims system,

so you can conveniently file a claim remotely.

② Submit the prepared documents

Scan or take photos of the prepared documents

and upload them on the claims page you accessed.

However, some insurers may require direct submission,

so be sure to check before filing.

③ Confirm the insurance claim details

After the documents are submitted, the insurer reviews the claim details

and informs you of the compensation details and amount.

Processing usually takes 1 to 2 weeks,

and additional documents may be requested if needed.

🖐Question🖐

By when do I need to file

a wisdom tooth insurance claim?

▶ In general, you must file an insurance claim

within 3 years after the extraction,

and the detailed period may vary by insurer,

so please check the policy terms.

Cost of wisdom tooth extraction

There are established pricing criteria for impacted wisdom tooth extraction.

According to the Health Insurance Review and Assessment Service’s second 2021 public data release,

the cost of impacted wisdom tooth extraction

varies by hospital, ranging from less than KRW 10,000 at the low end

to up to KRW 50,000 at the high end.

This varies depending on the degree of impaction of the wisdom tooth

(simple / complex / fully impacted, meaning difficulty level),

the size of the dental clinic and the dental equipment used,

and the amount may also differ depending on whether a CT scan is taken.

Therefore, the cost is charged according to the number of wisdom teeth,

and additional costs may arise if a hemostatic agent is used.

Besides wisdom tooth extraction,

what other dental treatments

can be claimed through indemnity insurance?

In addition to wisdom tooth extraction,

there are other dental treatments that can be claimed through indemnity insurance.

These usually apply to dental treatments for therapeutic purposes,

rather than cosmetic purposes.

⭕ Wisdom tooth treatment and extraction

⭕ Cavity treatment

⭕ Gum treatment

⭕ Root canal treatment

⭕ Scaling for treatment purposes

⭕ Dental X-rays for treatment purposes

Items that are not eligible for indemnity claims

are as follows.

❌ Prosthetic treatment

Implants / dentures, etc.

❌ Cosmetic treatments

Laminates / whitening / crowns, etc.

❌ Orthodontics

❌ Inlays / onlays / resin

❌ Scaling for cosmetic/preventive purposes

However, among the items that are not eligible,

if treatment was received for therapeutic purposes,

some coverage may still be possible,

so it is a good idea to check with your insurer.

Today, we took a detailed look at

insurance claims after wisdom tooth extraction.

If all four impacted wisdom teeth are extracted,

the cost can be higher than expected.

I hope the insurance claim method we covered today

will be of some help.

If you have any other questions,

please feel free to leave a comment anytime.

Gangnam Leon Dental Clinic

Integrated front tooth treatment, NewTis

This is integrated front tooth treatment that covers front tooth discoloration treatment, gum grafting, tooth reshaping,

gum contouring, teeth whitening, gum whitening,

front tooth resin treatment, orthodontics, and NewTis Lamine.

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