r/HealthInsurance 7d ago

Dental/Vision Will insurance cover my infected wisdom tooth if I call ?

Hi, my wisdom tooth partially ruptured on Monday and I’ve been in extreme pain since. I went to my apt today and they said it has 2 infections and they could not extract it because it’s preventing my mouth to only be able to move partially open. My throat also hurts and I’m having trouble swallowing and half my face is swollen including my throat, it looks like I’ve been punched in the face. My dentist told me I will have to wait a week before they can take it out and “do at home stretches with popsicle sticks” to get my mouth open. I can’t even move my mouth open more than half way so idk how this is going to work. I’m already on antibiotics I got through urgent care because they told me over the phone I couldn’t go 24 hours. They also said the infection may spread in the next week causing my airways to be blocked and I may have to go to ER.

I have BCBS. With this anesthesia pill it’s looking like it will be $896 and my insurance only covers the 1 tooth and not the anesthesia so I’m paying $500. I paid that today but my question is did I get bamboozled? Should I call my insurance myself? My grandmother who works in a doctors office and has a lot of medical knowledge called me and said I could get the whole thing covered if it was deemed “medically necessary” since it’s infected but I would need a referral to an oral surgeon. I also don’t know how they expect me to go back to work like this for the next week, I can barely talk or open my mouth and I’m a lawyer. Please advise.

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