Your Insurance and TMJ(D) Treatment - Priya Mistry, DDS (the TMJ doc)

[@AdirondackRuby]

I was able to find a Physical Therapist to help with my TMJ issues, and learned through that process that it's all about wording. She knew what was wrong and how to help with it, but technically she couldn't. We couldn't say I was seeking treatment for TMJ, we specifically had to say Myofascial Pain (or Neck Pain). My insurance accepted that as a treatable condition and I was finally able to get going on the right track. Insurance companies can be very precise, pedantic, and irritating with all the terminology & coding & red tape nonsense. You just have to know how to work around it.

[@theTMJdoc]

Yes I totally agree!!

[@Nonameforyoudangit]

!!!!! Thank you for this nugget, @AndirondackRuby !!!! I've been getting 90 units of Botox injected into my masseters, which is expensive and not a permanent fix. I've had TMJ issues for decades. An initial bite adjustment helped, but that isn't the sole cause of my issues. I don't want to think about the amount of productive time I've lost over the years to this issue. Truly, I thank you for this insurance hack!

[@AdirondackRuby]

@@Nonameforyoudangit I hope it works for you and you finally get some permanent improvement.

[@rainbow20112011]

Insurance is like a roller coaster when it comes to TMJ treatment.

[@theTMJdoc]

Ultimately they just don’t cover it at all or as little as possible.

[@johnnyedify]

I live in NJ. I was always covered for PT treatments that dealt with TMJ/neck...under physical medicine limitations.

[@theTMJdoc]

I’m glad to hear that!

[@perrykeskitalo8735]

Do you ever see this changing? With over 30% of the population suffering, it boggles my mind that it’s not covered. I myself have paid thousands over the years and I’m still struggling.

[@theTMJdoc]

I wish I had a good answer but it's really impossible to say..

[@BL3SSed-Bliss]

If you pay attention to how "minority populations" are [mis]treated-- namely Brown people, and WOMEN altogether (neglect, lack of research, lack of interest, lack of trust, lack of value, lack of proper treatment, and even _ill_ treatment), it wouldn't at all surprise you. Disappoint you, certainly, but such is pretty "normal" for some of us. "Western Medicine" continues to fail us. Still, we hold out hope, and champion those who commit to improvement/reversal/change.

[@nesademuja4623]

Hi,I have all the simptoms for TMJD, my mind its a mess and I dont know how to start treatment,now that I am seen your videos it seems that my problem it will be much bigger because inmy country we dont have specialist for this therapi

[@theTMJdoc]

sorry to hear that!

[@nesademuja4623]

@@theTMJdoc really you are a good person with a good heart also a good doctor,You give me a answer to my replay this dies it mean that you love your job and you are helping the people that realy need you!I know that my result it will be taken time but today I started doing therapi besides in your advise from your videos. All the best for you and your family🥰

[@nesademuja4623]

@@theTMJdoc also doctor one more question I am taking prothesis or praces I dont know if are the same it is good for TMJD or not???

[@Nunyabidness823]

My dental plan has adult orthodontic coverage up to $1500…does that usually cover a TMJ appliance?

[@theTMJdoc]

No it does not. Sorry!

[@bluesdirt6555]

We just paid $7000 and insurance paid $1500.

[@isabelg8788]

From your experience, are TMJ treatments a qualified expense for healthcare spending accounts? Also, it is time for my medical open enrollment and I am trying to decide if switching from HMO to PPO will help as I begin seeking treatment for TMD. I need to decide by October 31 (in 2 days!)

[@theTMJdoc]

From my experience, yes they are qualified for HSAs.

[@GingerAlmanza]

Hello.. Can you recommend someone in San Antonio Texas? I need a tmj doctor that I can trust to help me. 😢 thank you!!

[@theTMJdoc]

I'm sorry but I don't know anyone there.

[@litzlitz8685]

I stay in Chicago . The doctor is old .He is 78 but still he is practicing TMJ.If you can look once . He is affordable compared to other TMJ specialists.He have his own research .

[@Mark-ql5ni]

Cigna told me they consider any TMJ treatment other than surgery, "Experimental" - I don't at all blame the dentists, most dentists truly care about their patients and empathize with people suffering from TMJ. These insurance companies obviously have an incentive to not cover things - they also have large general counsel to draft terms that shield them from any potential cost obligation despite your appeals and the care you need. Lastly, the cost of crowns and implants is pretty absurd in my opinion, I get they're custom but still I don't understand why the costs are as high as they are for the crowns themselves. I was told I need 8 crowns and that's just the bottom. It makes for Phase 2 TMJ/D treatment costs that end up being the cost of new car or more. It's really brutal financially to have that expense hanging over your head for years - adds to jaw clenching :\

[@theTMJdoc]

The cost of crowns has increased with inflation but the insurance coverage for dental treatment has not increased since the 1960s. If crown costs were any lower, dentists would be losing money on those crowns. But yes, I understand it can be brutal financially. I do only Phase 1 treatment for this reason and try my best not to cause bite changes.

[@Mark-ql5ni]

@@theTMJdoc Thanks Priya, definitely the main issue is lack of coverage from dental insurance so that it's fair for both providers and patients. Appreciate your videos! Thank you!

[@cindiobryan5832]

Definitely More TMD doctors needed.

[@theTMJdoc]

Agreed!

[@niharikadasari-c5q]

Hi, can you please suggest someone in Dallas who could treat me for TMJ?

[@theTMJdoc]

I’m sorry I don’t know anyone there

[@christinal434]

Would anyone be interested in a Facebook or some sort of group for all of us dealing with tmjd issues to share information?

[@theTMJdoc]

there are multiple Facebook support groups for people with TMJD :)

[@vajeehasayyed3620]

Hey .. just wanted to know if putting braces would worsen my TMJD or it’s ok ?

[@theTMJdoc]

I never recommend braces if you have head, neck, jaw pain or jaw joint noises or if you're jaw is stuck/locked closed.

[@MeleeKillerYT]

@priya Dr can I get an online consultation with you?

[@theTMJdoc]

Yes please email [e-mail] to set up a zoom meeting with me

[@arshiyashaik9349]

Hlo Dr priyaa ur videos are really good ...love to always watch them. ..u r my inspiration..iam dng oral medicine and radiology postgraduation ..please help me out to decide what to do next which is the best path to follow

[@theTMJdoc]

I'm sorry but I don't have a great recommendation for which path to follow. I was fortunate enough to learn all of this from my mentor.

[@nirmal-randhawa54]

Please suggest me doctor in Vancouver Canada

[@theTMJdoc]

I’m sorry I don’t know anyone there. Many people from there come to see me :)