FREQUENTLY ASKED QUESTIONS
ABOUT TREATMENT & INSURANCE

Q: How long, on average, does treatment take?
A: It depends on the case. Remember that in those cases where the onset of symptoms was not a result of traumatic injury, the TMJ condition develops slowly over time. That which takes years to develop does not necessarily take only weeks to resolve. This is not to say that treatment takes years, but it probably will require weekly visits for a number of weeks. Again, this is a very specific issue relating to each individual case and to the way an individual patient responds to the treatment modalities.

Q: I have some TMJ symptoms, but I just don’t want to take the time or spend the money for treatment right now. What will happen if I put it off?
A: It depends on how serious your symptoms are. The odds are, that your TM joints are in almost constant use, when you talk, when you chew and even when you think they are not being used.
For example:

Q: Will a TMJ condition ever go away by itself?
A: Sure. No one is suggesting that you rush off for treatment the first time one of your joints click. Minor muscle sprains frequently resolve by themselves. You’ll know when you need treatment. You’ll know when you WANT treatment and you’ll certainly know when you MUST have treatment.

Q: Is TMJ treatment covered under my Dental or Medical policy?
A: Non-surgical treatment of the TMJ is generally covered under the patient’s medical plan. This is because it is generally accepted that TM joint disorders are considered orthopedic in nature. However, it is always a good idea to first check with your insurance company.

Q: Do all insurance companies cover non-surgical treatment of the TMJ?
A: NO! – Be very careful. Call your insurance company and ask these questions:

TIP: Always ask for the name of the person you are speaking with and make a note of the date and time of the conversation. If you are not satisfied with the answers you are getting, do not be afraid to ask to speak to a Claims Supervisor.

Q: I have a friend whose employer is different from mine. Her insurance company is the same one I have coverage with. Her TMJ treatment was covered by her insurance and mine is not. Why?
A: There are several explanations. First of all, insurance companies offer several different plan options. The employer chooses which coverages to offer their employees. Second, insurance companies not only offer their own plans, they also contract with self-insured employers to administer the employer’s health plan. The result is that although you and your friend are both insured by the same company, you have different plans. Here again, the best bet is to call your insurance company before you proceed with diagnostic or treatment services and find out what YOUR plan covers.