Dental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans

Aetna medical plans cover medically necessary oral and maxillofacial surgery and related dental services when tied to a medical condition (e.g., reduction of facial bone fractures, removal of tumors, treatment of oral trauma/infections, and surgical removal of impacted teeth per plan), while routine dental care and cosmetic/elective orthodontics are excluded. Coverage of comprehensive orthodontics for children/adolescents requires documentation of a severe handicapping malocclusion related to a qualifying medical condition and a Modified Salzmann Index score ≥42 (with plan-specific differences for surgical tooth removal and a limited bone-grafting exception for significant third-molar defects in patients ≥26).

"Submission of a proposed treatment plan to Aetna for review in plans with precertification provisions (e."

Sign up to see full coverage criteria, indications, and limitations.