Oral Surgery

Oral surgery performed by a physician is a medical benefit of most HMSA group plans. Benefit coverage is limited to the following services:

• Removal of tumors, cysts, or bony protrusions from or treatment of accidental injuries to the:
  • Jaw
  • Cheeks
  • Lips
  • Tongue
  • Roof of mouth
  • Floor of mouth
  • Surgical drainage of abscesses or cellulitis
• Minor surgery of soft tissues and gums such as:
  • Frenectomy
  • Tissue grafts
  • Alveolectomy
  • Vestibuloplasty
  • Alveolar ridge augmentation

Hospital Services

Hospital services may be payable if the patient has a medical problem, such as hemophilia, that makes it medically necessary for the patient to be hospitalized to safely receive these services. Such hospitalization is subject to pre-admission review. To initiate the precertification process, please call HMSA's Managed Care Unit two or more working days prior to the planned admission:

Oahu: 808-948-6464
Neighbor Islands: 1-800-344-6122

The Managed Care Unit's hours are 8 a.m. to 4 p.m., Monday through Friday. If you call after hours, please leave a message on the voice mail. You may also fax information to Managed Care Unit at 808-944-5611.

Note: Certain oral surgery procedures may be paid under HMSA's Medicare-based plans (e.g., 65C Plus); however, under Medicare guidelines routine dental procedures are not covered.

Revision History