Is there a logical explanation for why no health coverage will pay for treatment pertaining to the jaw?
January 15, 2010 11:32 PM Subscribe
What is the logic behind exclusion for treatment for TMJ by nearly all insurance companies and Medicare?
posted by naplesyellow to health & fitness (6 answers total) 1 user marked this as a favorite
I would like to understand why TMJ is "not covered" and/or excluded by insurance companies and Medicare. Any claims for treatment of TMJ are always rejected out-of-hand. Other disorders in joints (such as knee, wrist, ankle, etc) are recognized as legitimate pertaining to treatment and payment for treatment.
Why do insurance companies regard the joint of the jaw as "baseless" for problems? Isn't it logical that any and all joints in the human body are susceptible to deterioration/malfunction?
I am simply asking in an effort to determine the logic behind the across the board denial of any claims for TMJ by insurance companies and Medicare.