Canadians please respond - TMJ Disorder -TemporoMandibular Joint Message Board

ryanpaus · 08-18-2003, 11:30 AM

Alright guys I have heard before that all dental expenses related to TMJD can be claimed under myofacial pain. So this mean that your medial insurance will cover your bills if you dont have dental insurance. But what if you live in canada? Have any Canadians been successfull in claiming TMJD expenses(slpints, braces, crowns, etc.) under your medial insurance?

crystalll · 08-18-2003, 11:54 AM

Hi,

The laws in Canada are very different from the laws in the States. Some states have mandated that insurance companies MUST cover certain medical expenses related to myofascial pain and TMJD.
Here in Canada, it's different in that the insurance companies only have to cover what they have outlined in their benefits packages. These can vary from company to company. Your employer can pick and choose which coverage they want for their employees as well.

For example, I've had dealings with both Manulife and Greenshield. They admit that TMJD and/or myofascial pain is considered to be a medical problem, but as long as I'm being treated by a dentist they refuse to cover it under medical. And since it's not outlined in my dental coverage, it's not covered under dental either.
They really know how to cover their behinds.

My only advice is to contact your Human Resources or insurance company directly, and try to coerce them into covering some of your expenses.

Best of luck!

Crystal

Anastasia · 08-18-2003, 12:54 PM

hi guys

i on the other hand was lucky and got my dental insurance to cover my bills. i agree with crystal, you have to push your insurance company, eventually they will decide on either medical or dental coverage.

Good Luck

Anastasia

kami-girl · 08-18-2003, 06:27 PM

I am from BC and neither tmj or myofacial pain dysfunction are covered by BC medical. They say it is because the College of Dentists will not contract with the government for payment. I have Pacific Blue Cross extended health coverage which has paid for consults, splint ( 1 every 3 yrs. ) and X-Rays but the rest is out of pocket. I am seeing a neurmuscular dentist whom I have paid $2500.00 over and above the initial consult. I have asked if they can somehow give me a breakdown of the treatment in hopes that some of it will be covered and if not I think it can be claimed at the end of the year on income tax.

Grace