A Guide to Filing an Indemnity Health Insurance Claim After Wisdom Tooth Extraction / Gangnam Leon Dental Clinic

Hello, this is Gangnam Leon Dental Clinic🙂

If you are preparing for wisdom tooth extraction

or have recently had an extraction,

you may be wondering about filing an indemnity health insurance claim.

Can wisdom tooth extraction be covered by indemnity health insurance?

How much of the treatment cost can be reimbursed?

Most people searching for information about wisdom tooth insurance claims

have similar questions.

They want to know how much wisdom tooth extraction costs,

the difference in coverage between regular and impacted wisdom teeth,

whether and how they can file an indemnity health insurance claim,

and how much they may actually be reimbursed.

In this post, we will briefly and clearly summarize

the key points of indemnity health insurance coverage for wisdom teeth.

📌 Summary of Wisdom Tooth Insurance Claims

✅ Check which generation of indemnity health insurance you have

✅ Check your out-of-pocket payment

✅ Prepare the documents required for the claim

✅ How to file a claim

How much does wisdom tooth extraction cost?

Before looking into wisdom tooth insurance claims,

the most common question is how much the extraction actually costs.

The cost varies depending on the condition of the tooth, the difficulty of treatment, and the type of medical institution.

Category	Simple impaction	Complex impaction	Complete impaction
Dental clinic	Approximately KRW 14,000	Approximately KRW 20,000	Approximately KRW 28,000
Dental hospital	Approximately KRW 19,000	Approximately KRW 30,000	Approximately KRW 39,000
General hospital	Approximately KRW 28,000	Approximately KRW 40,000	Approximately KRW 50,000
Tertiary general hospital	Approximately KRW 40,000	Approximately KRW 60,000	Approximately KRW 76,000

*These are approximate extraction costs for the extraction procedure only.

Additional treatment or procedures depending on the condition, as well as non-covered items,

are excluded.

Types of wisdom tooth impaction

✅ Simple extraction

The wisdom tooth has erupted normally

and can be removed immediately without a separate gum incision.

The extraction takes relatively little time, and recovery is generally quick.

✅ Simple impaction

Part of the wisdom tooth has emerged from the gum

or is partially covered by the gum.

It is extracted using a minimally invasive procedure

or after a simple incision.

✅ Complex impaction

Part of the wisdom tooth is embedded in the gum and bone,

and a gum incision or tooth sectioning

is often required during extraction.

✅ Complete impaction

The wisdom tooth is completely embedded

in the gum and jawbone.

This is the most difficult type of extraction,

and surgical extraction is often required.

Wisdom Tooth Indemnity Health Insurance Claims

1️⃣

Wisdom tooth extractions eligible for a claim

Once you have checked the approximate cost of wisdom tooth extraction,

the next question is whether it is covered by indemnity health insurance.

Indemnity health insurance, also known as actual-loss medical insurance, generally

covers medical expenses incurred to treat an illness or injury.

Therefore, wisdom tooth extraction may also be eligible for an indemnity health insurance claim if it is performed for treatment purposes.

✅ Extraction due to tooth decay

✅ Gum inflammation

✅ Treatment due to pain

✅ Impacted wisdom tooth extraction

✅ Removal accompanied by cyst removal

*Extractions for orthodontic purposes or preventive purposes

may be subject to restrictions.

*Insurance claim eligibility and payment amounts may vary depending on the individual’s circumstances and the insurance product,

so you must confirm the details accurately with your insurance company.

2️⃣

When you enrolled in indemnity health insurance

Whether wisdom tooth extraction is covered

depends on when you enrolled in indemnity health insurance.

In general, if you enrolled before September 2009,

dental treatment coverage is very limited.

If you enrolled after September 2009,

covered treatment items performed for treatment purposes, such as wisdom tooth extraction,

may be eligible for a claim.

Generation	Out-of-pocket payment ratio
Generation 1 (through September 2009)	Dental treatment not covered or very limited coverage
Generation 2 (October 2009–March 2017)	10%
Generation 3 (April 2017–June 2021)	10–20%
Generation 4 (July 2021 onward)	20%

*Insurance claim eligibility and payment amounts may vary depending on the individual’s circumstances and the insurance product,

so you must confirm the details accurately with your insurance company.

3️⃣

Documents required when filing

a wisdom tooth insurance claim

The documents generally required for an indemnity health insurance claim

are listed below.

Requirements may vary by insurance company,

so we recommend contacting your insurance company

to confirm the exact requirements.

✅ Medical expense receipt

✅ Detailed statement of medical expenses

✅ Prescription

👉 If necessary

✅ Confirmation of outpatient treatment

✅ Medical certificate

4️⃣

How to file a wisdom tooth

indemnity health insurance claim

The claim process generally works as follows.

① Prepare the documents

Check which documents are required,

then request and prepare them from the dental clinic.

(Medical expense receipt/detailed statement of medical expenses, etc.)

② Access the insurance company’s app or website

These days, most insurance companies

support online claims.

③ Upload the documents

Take photos of the prepared documents

and upload them to complete the submission.

④ Claim review

The insurance company reviews the claim

based on the submitted documents.

The process is usually completed within one to two weeks,

after which the company will inform you whether compensation is available and the amount.

Additional documents may be requested at this stage.

⑤ Payment of the insurance benefit

Once the review is complete,

the insurance benefit is paid into the registered account.

Wisdom Tooth Insurance Claims

FAQ

Q. Will indemnity health insurance always pay for wisdom tooth extraction?

This may vary depending on the generation of insurance you enrolled in and the policy terms.

Preventive or cosmetic procedures may be subject to restrictions.

Q. How long do I have to file a claim after wisdom tooth extraction?

Insurance claims can generally

be filed within three years of the date of treatment.

Q. Are hemostatic agents also covered by indemnity health insurance?

Hemostatic agents are often excluded from coverage.

If you are preparing to file an indemnity health insurance claim after wisdom tooth extraction,

we hope this guide is helpful.

In particular, when the need for treatment is clear, as with an impacted wisdom tooth,

the procedure may be eligible for an indemnity health insurance claim,

so please prepare the necessary documents and check your eligibility.

Previous image Next image