Does dental insurance cover Botox for TMJ?

If you have ever had the question, “Does dental insurance cover Botox for TMJ and bruxism?” you’re not alone in thinking this as you suffer from the excruciating TMJ and bruxism symptoms.

As many patients who have the procedure report few side effects and great relief from their TMJ or bruxism, Botox can be a very successful treatment for TMJ (also known as TMD) and bruxism.

But repeated Botox procedures are pricey. Although some medical insurance is used to pay for Botox, many insurance companies do not cover the treatments for TMJ and bruxism.

Dental insurance coverage for Botox for TMJ treatment

If you can afford it, Botox can be a useful treatment for TMJ and bruxism. Instead of dental insurance companies, the operation is generally covered by medical insurance companies. Be aware that the FDA has not yet given the drug approval for the treatment of TMJ and bruxism.

Although the procedure is not typically covered by insurance policies, it never hurts to inquire. Your insurance provider might provide some coverage for Botox to treat TMD and bruxism depending on your plan. But before you get a Botox consultation, you must comprehend your coverage. You will be liable for paying the bill if you receive treatment only to learn later that it is not covered.

Medicare does provide coverage when Botox is used as a medically essential treatment, for instance, according to Healthline.

A single Botox treatment for TMJ or bruxism may cost up to $1,500. You can control your symptoms and safeguard your teeth with other, more reasonable treatment choices if your insurance provider does not cover Botox for the treatment of TMJ and bruxism.

How do Botox Injections treat Bruxism and TMJ?

Botox is an alternative therapy for TMJ and teeth grinding that relieves jaw tension and muscle weakness. The masseter muscle, which is located slightly behind the cheekbones, is where it is commonly injected. You can still grin, chew, and use your jaw normally despite the relaxed state of this muscle.

Botox can lessen symptoms of TMJ and bruxism, despite the FDA’s disapproval in this regard. Additionally, some insurance companies may cover it regardless of FDA approval because it is an effective medication.

Patients who use Botox occasionally have minor side effects including bruising and bleeding where the injection was made. Following repeated use, this side effect can get worse.

How to check if my dental or medical insurance cover Botox 

Examining your policy documentation is the first thing you should do to see whether your insurance covers Botox. It may include both exclusions and a basic list of the ailments and therapies that are covered. But since there probably won’t be a clear answer in your documentation, you’ll also need to contact your insurance company.

You can contact customer support by phone and email from the majority of insurance companies if you have any questions.

Your insurance company will need to specify the purpose of the Botox treatments. Your insurance probably won’t pay it because the FDA does not authorize Botox as a treatment for TMJ issues. However, your insurance company should be able to advise you on the procedures you need to take to get reimbursement for your Botox treatment if your disease is the source of your migraines. 

Before covering Botox injections, several insurance companies demand their members to try out alternative treatment options.

How much does Botox for TMJ cost in Tigard?

 Treating TMJ for Botox typically uses 30-60 units. At our dental office in Tigard we charge $12 a unit. This means the treatment cost for Botox for TMJ can cost between $360-720. 

Should I consider getting Botox treatments for TMJ in Tigard?

It can be difficult to understand the connection between TMJ issues and Botox. If you experience TMJ issues, you should discuss the possibility of receiving Botox injections with your dentist. Additionally, your dentist should be able to provide you with an approximate cost of Botox treatment as well as guidance on whether they believe insurance would cover the procedure. 

Finally, you should make an appointment at our dental office in Tigard to discuss your needs with our team and determine if Botox for TMJ is right for you.

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