Jaw Surgery Forums » Pre-Surgery Questions

insurance wont cover anything, What do I do now?!

(17 posts)
12

  1. justjean
    Member

    I was expecting to have my surgery this summer before my senior year of college. I am at the final stage and prepped to go, but my insurance (blue cross) was contacted twice and will not cover anything. It would be about $50,000+ without insurance so there is no way I could do that. What am I supposed to do? Keep braces on for years until I can somehow find a way to have the surgery? Any ideas or suggestions? I need a le fort 1 and a vertical ramus something to fix asymmetry in the lower jaw. My bite is off that sometimes when I'm chewing mindlessly the back teeth will scrap against it and make this horrible unexplainable sound. I always feel like breathing is a heavy task to do, especially when I sleep.

    Posted 1 year ago #

  2. Demi
    Member

    Justjean, I had the same problem out of my insurance company. I had blue cross blue shield of Arkansas and the only place that would take me in my area was the University Mississippi Medical Center. I had previously went to a surgeon that was a closer by where I lived but he wasn't about to take the insurance and nobody else would take my insurance either. My Mom called all over Mississippi and Alabama looking for a place that would take my insurance but the only place was UMC. In the end I am very glad that I went to UMC instead of the other doctor closer to me. My surgeon at UMC had so much compassion and it wasn't about the money. I would suggest looking for a University Medical Center in your area. The great thing about a University Medical Center is is that they work harder to help you. They can put in a special code that will allow you to get the coverage you need and if they insurance company won't work out for you then they should have some type of financial aid for patients who can't pay. I don't know if it is like that at every University Medical Centers but that's how they do it in Mississippi. I hope this helps. Good luck

    Posted 1 year ago #

  3. arqlizcarter
    Member

    I wonder if you can get Kaiser. I didn't have problem getting approved for my surgery.

    30 years old, women, upper jaw surgery, overbite,gummy smile and more:X
    check my blog http://jawsurgery.rosacarter.com/
    YouTube channel http://www.youtube.com/user/arqlizcarter?feature=mhee
    Posted 1 year ago #

  4. justjean
    Member

    Demi, thanks for the info, my dr seems to be really trying to help, his staff has tried multiple times to get insurance coverage from my insurance company which happens to be Regence Blueshield Bluecross from Seattle and they have denied me multiple times. They recently changed their policy though saying jaw surgery is not covered unless it relates to sleep apnea. I have never been tested for sleep apnea but I have been told I snore consistently. Maybe I should look into getting Kaiser. It takes them about 2 months after putting in a letter to get a reply back so at this point I guess I will have to look into getting surgery over Xmas Break or after I graduate =(

    Posted 1 year ago #

  5. Demi
    Member

    When I saw your post, I just had to write you. I can totally relate to what you were saying. I had the run around all the time from my insurance company. And I was finally able to find a surgeon to take me. I wish you the best of luck cause I know how frustrating this stage can be.

    Posted 1 year ago #

  6. justjean
    Member

    I think I've heard good news about Aetna, so I will be trying to get that insurance for now but now my surgery is on hold and I was so excited..

    My orthodontist told me he will have to put me in a retainer until surgery, but I feel very unconfident and hate looking at my face in the mirror as my bite has become more noticeably crooked and more of an underbite since having braces. Who knows how long I will have to stay this way, it wasn't as noticable before braces as all my bottom teeth were curved inwards.

    Posted 1 year ago #

  7. xdianao
    Member

    I had a lot of problems with my insurance before my surgery. I had Amerihealth and they would not cover anything. So the surgery scheduler at my office told me to get Aetna because they cover it.
    So I switched to Aetna and it was covered. It's more expensive than my previous insurance, but it's worth it.

    Posted 1 year ago #

  8. cnelson34
    Member

    JustJean-

    This is a difficult process. I had severe sleep apnea, and that is what brought me down this road to double jaw surgery. It was covered by my insurance after the first denial. My surgeon was at a university hospital too. He had to talk to the insurance company personally to get it approved.

    Sounds like you may have sleep apnea. You should consult an ENT and see if they recommend a sleep study for you. If you have sleep apnea, and depending on the severity, it should be covered. Keep in mind too, if you go forward with the surgery, the surgeon has experience doing the surgery to cure sleep apnea. There is a big difference in the type of surgery.

    Keep at it....it takes awhile to get the answer you want! Good luck:)

    Posted 1 year ago #

  9. mkbannon36
    Member

    Hi justjean - I'm in agreement with cnelson34 - I recommend you have a sleep study - odds are you have apnea and then Blue Cross will cover it. I went through the same situation when I was in my mid twenties - had braces for 2 years and was pre-approved before I started the process and then when surgery came around - Blue Cross denied my claim. So no surgery and my teeth had to be put back - which contributed to my severe sleep apnea. I'm now 45 and have lived with this for 20 years. Get that sleep study and have the surgery is what I say. Don't just live with it.

    Posted 12 months ago #

  10. MikeFoss
    Member

    Hi mkbannon36,

    You just mentioned that you were pre-approved for the surgery first, but as you did your ortho work they then denied the coverage. Could you a little elaborate on why the insurance company can later deny when they've already approved the surgery? It's now got me worrying whether I'll have the same issues with my insurance company too, since there is a possibility that after going through this whole braces hassle, they might deny the coverage when it's the surgery time!

    Posted 12 months ago #

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