Insurance & Finance
Oral Surgery Insurance and Financing in Los Angeles
Understanding your insurance coverage is often the first question patients have before scheduling oral surgery. At Wilshire Oral Surgery and Implant Center, our administrative team walks you through your coverage, your out-of-pocket estimate, and your financing choices before treatment begins, so you can make informed decisions without surprises. Our goal is to remove financial uncertainty from the process so you can focus on your health.
Dr. Jonathan R. Shadi and Dr. Saman Vahedi are board-certified oral and maxillofacial surgeons who believe that cost uncertainty should never be a barrier to getting the care you need. Learn more about our team and our approach on our Meet Us page.
Dental Insurance We Accept
We accept most major PPO dental insurance plans and bill your insurance as a courtesy on your behalf. Carriers we commonly work with include Delta Dental, Aetna, Cigna, MetLife, Blue Cross Blue Shield of California, Guardian, and United Concordia. If you are unsure whether we work with your specific plan, call our office before your first visit and a team member will verify your coverage.
PPO plans generally allow you to receive care from out-of-network providers while still applying your benefits toward the cost, though your cost share may vary depending on your plan design. According to the American Dental Association, most commercial dental plans are structured as PPOs, which means the majority of patients can apply their existing benefits here without needing a referral or in-network restriction.
We do not participate in HMO or Denti-Cal plans. If you carry a PPO plan from a carrier not listed above, our team can still submit a claim on your behalf and help you understand what reimbursement you may receive. We will never recommend treatment based on what your insurance company will or will not pay. Your treatment plan is driven entirely by your clinical needs.
How Dental Insurance Works for Oral Surgery
Dental insurance for oral surgery works differently than general dentistry coverage, and knowing the basics helps you plan ahead. Here is what to keep in mind before your appointment:
Annual Plan Maximum
Most PPO plans reset their annual maximum on January 1. If your plan year is ending, scheduling before the reset lets you use remaining benefits before they expire.
Deductible
Your deductible is the amount you pay before insurance begins contributing. If your deductible has already been met for the year, you may pay less out of pocket than you expect.
Co-insurance
After your deductible, your plan typically pays a percentage of the covered procedure cost and you pay the remainder. Our team will show you this estimate before treatment begins.
Pre-Authorization
For complex procedures such as jaw surgery, bone grafting, or full-mouth reconstruction, we can submit a pre-authorization request to your insurer so you know your coverage before committing to treatment.
Coverage varies by plan and by procedure. Many oral surgery procedures, including wisdom teeth removal, bone grafting, and dental implants, may be covered in full or in part depending on your specific plan. Our team provides you with a detailed, procedure-specific cost estimate based on your verified benefits before any work is scheduled.
Medical Insurance and Oral Surgery
One of the most common things patients do not know is that some oral surgery procedures may be eligible for coverage under your medical insurance, not just your dental plan. When a procedure has documented medical necessity, medical insurance may contribute to the cost, sometimes significantly.
Procedures that may qualify for medical insurance coverage include:
Our administrative team has experience coordinating between dental and medical insurers. If you have coverage through your employer or a private plan, bring that insurance card to your first visit as well. We will review both your dental and medical benefits at your consultation and help you understand whether a combined claim approach may reduce your out-of-pocket responsibility.
How We Maximize Your Benefits
Our team takes a proactive approach to insurance so that you are never left guessing. Here is what that process looks like from your first contact with our office through your procedure date:
Accepted Payment Methods
For your convenience, we accept the following forms of payment at the time of service:
Payment for your portion of the treatment is due at the time of service. For larger treatment plans, we encourage you to speak with our administrative team about financing arrangements in advance of your procedure date so everything is in place before you arrive.
Flexible Financing Options
Not all oral surgery procedures are fully covered by insurance, and that should not prevent you from getting the care you need. We offer financing through CareCredit and Alphaeon Credit, two of the most widely used healthcare financing providers, to help you spread the cost of treatment over time. Both options offer flexible monthly payment plans that can be arranged before your surgery date.
CareCredit and Alphaeon Credit are available for a wide range of procedures we perform, including dental implants, wisdom teeth removal, bone grafting, and full-mouth reconstruction. You can apply online in advance or ask our team to walk you through the application at your consultation.
What to Bring to Your First Visit
To help our team verify your benefits as efficiently as possible, we recommend bringing the following to your consultation:
You can also complete your new patient registration forms in advance through our Patient Center. Arriving prepared helps our team spend more of your appointment time on your care and less on administrative paperwork.
What to Expect at Your Consultation
At your first visit, our team will review your insurance benefits, provide a detailed treatment estimate, and answer any questions you have about your out-of-pocket costs. Our goal is to make sure you leave that appointment with a clear understanding of what your care will involve, financially and clinically, before any next steps are scheduled.
Dr. Shadi and Dr. Vahedi are board-certified oral and maxillofacial surgeons who take the time to walk through your treatment plan in plain language and work with you to find a path that fits your needs and your budget. Learn more about their training and credentials on the Meet Us page.
Frequently Asked Questions
Do you accept my dental insurance?
We accept most major PPO dental insurance plans, including Delta Dental, Aetna, Cigna, MetLife, Blue Cross Blue Shield of California, Guardian, and United Concordia. If you are unsure whether your specific plan is accepted, call our office and a team member will verify your benefits before your visit. We do not participate in HMO or Denti-Cal plans.
What is the difference between in-network and out-of-network coverage?
In-network providers have negotiated rates with your insurance carrier, which typically results in lower out-of-pocket costs for you. Out-of-network providers may still be covered by your PPO plan, but your cost share may be higher. We will review your specific plan benefits with you at your consultation and give you a clear estimate before treatment begins.
Does insurance cover dental implants or wisdom teeth removal?
Coverage depends on your individual plan and the medical necessity of the procedure. Wisdom teeth removal is frequently covered, either in part or in full, when medically indicated. Dental implants may be partially covered by some plans, particularly when tooth loss involves a documented medical condition. Our team will help you understand exactly what your plan covers before you proceed.
Can I get a pre-authorization before my procedure?
Yes. For more complex procedures, including bone grafting, jaw surgery, and full-mouth reconstruction, our team can submit a pre-authorization request to your insurer before your treatment date. This gives you a clear picture of what your plan will cover before you commit to moving forward. Not all plans require pre-authorization, but it can be a useful tool for larger cases.
Can medical insurance help cover oral surgery?
In some cases, yes. Certain procedures, including jaw surgery, facial trauma repair, oral pathology biopsies, and complex bone reconstruction, may qualify for medical insurance coverage when there is documented medical necessity. Our team will review both your dental and medical benefits at your consultation to identify every available coverage option.
What financing options are available if my procedure is not covered by insurance?
We offer financing through CareCredit and Alphaeon Credit, both of which provide flexible monthly payment plans for healthcare procedures. You can apply online before your appointment or ask our team to assist you in the office. These options are available for most procedures we perform, including dental implants, bone grafting, and full-mouth reconstruction.
When is payment due?
Payment for your portion of the treatment is due at the time of service. If you are using financing through CareCredit or Alphaeon Credit, we recommend arranging that before your procedure date. If you have any questions about your balance or need to discuss other arrangements, please contact our office in advance.
Ready to Schedule Your Consultation?
Our team is here to help you navigate your insurance coverage and find a payment approach that works for you. Wilshire Oral Surgery and Implant Center serves patients throughout Los Angeles, Brentwood, Santa Monica, Bel Air, and the surrounding West Side communities. If you have questions about your plan, your benefits, or your financing options, call us at (310) 846-8978 or request an appointment online. We look forward to helping you get the care you need.