TMJ is a potentially disabling jaw condition. Although it may initially be relatively mild, if left untreated it can progress to result in serious pain or even complete immobility of the jaw. From some standpoints, it’s actually no different from other joint problems, except in the eyes in insurance.
To insurance, the temporomandibular joint and its disorders are considered completely separate from other types of joint problems, and, unfortunately, most insurance companies refuse to cover them, unless the state mandates coverage. And, unfortunately, Colorado is not one of the states that mandates coverage of TMJ treatment.
But that doesn’t mean that your insurance definitely doesn’t cover TMJ treatment, just that it probably doesn’t.
Pain and disability makes us think that our condition is serious and should be covered under our health insurance, but, unfortunately, that is not always the standard that insurance companies use.
To insurance companies, coverage guidelines are strict rules that have little if anything to do with the severity of your condition. Before you decide to have any TMJ treatment, it’s best to check with your insurance company to find out if it will be covered or not. Of course, for many of us, treatment of TMJ remains “medically necessary,” whether the insurance company agrees or not.
We can help you determine what TMJ treatments are necessary and whether they may be covered by your insurance. Please call (303) 691-0267 for an appointment with Denver TMJ dentist Dr. Kevin Berry at the TMJ Therapy and Sleep Center of Colorado.
Dr. Kevin Berry, a distinguished Denver TMJ and sleep apnea dentist, is renowned for his expertise in diagnosing and treating TMJ disorders. After graduating with a DDS degree from the University of Denver School of Dental Medicine in 1999 and earning an MS in Orofacial Pain and Oral Medicine from the University of Southern California in 2021, Dr. Berry is a board-certified orofacial pain specialist. He excels in treating jaw pain, bruxism, and constant headaches linked to TMJ, focusing on realigning the TMJ rather than just addressing symptoms. As a member of several prestigious dental organizations and a diplomate of the American Academy of Craniofacial Pain, Dr. Berry's approach considers the mouth, teeth, jaw, head, and neck as interconnected parts, ensuring comprehensive care for his patients.