Jaw Surgery Forums » Share Your Jaw Surgery Experience!

please help

(6 posts)
  • Started 2 years ago by Tommy3133
  • Latest reply from liberty_1776

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  1. Tommy3133
    Member

    Hi everyone my name is Thomas i'm 21 and i just found out the other day that i half to get Jaw surgery can anyone give my any information on good dental insurance companys to go through to cover the surgery.

    Posted 2 years ago #

  2. Brandon
    Site Administrator

    Hi Tommy,

    Insurance can be a tricky subject with this surgery, because it really depends on a lot of factors, whether or not they will consider it medical or cosmetic and/or cover it at all.

    I personally have Anthem, but just having them doesn't guarantee they will cover the surgery, and I had to wait 12-18 months after signing up with them before they would cover it.

    I hope that helps, but the best way to find out would be to visit your local surgeon's office, as they can usually recommend something better based on your specific situation.

    I'm Brandon, the creator of JawSurgeryBlog.com. I personally had upper and lower jaw surgery on October 30, 2007. Thankfully, everything went beautifully, so I'm trying to make sure everyone else's surgery goes smoothly as well!

    http://www.facebook.com/pages/Corrective-Jaw-Surgery/114627165257701
    Posted 2 years ago #

  3. Paula
    Member

    Hey, just wanted to add a little insight on the insurance thing, it is not dental insurance that covers the surgery, in my case it is my health insurance that is covering it, and they are covering 100%. I have Aetna, i pay almost 60 bucks a week for my insurnce plan, but i got it to prepair for the surgery. I also have dental insurance but that was useless, I only used it to see a dentist to refer me to an orthadontist, who in turn referred me to my suregon. I have almost had the insurance for 2 years. There was a year waiting period before anything major to be covered. My suergon said he works with insurance companies to try to get these surgeries covered, so I think he was a major help. I know they had to mail molds and xrays to the insurance company for it to be covered. I know if it is strickly cosmetic, it will not be covered, but if you are having trouble eating, talking and pain, that helps the decision to be in your favor. Hope this helps!

    Posted 2 years ago #

  4. Brandon
    Site Administrator

    Great summary Paula, thanks!

    Posted 2 years ago #

  5. tgrlily317
    Member

    I don't know how helpful this will be, but my orthodontist told me that sometimes insurance companies can be a little difficult to work with, because some of them will refuse to cover you for a pre-existing condition, which a diagnosis of malocclusion can be. The advice I got was to put off getting referred to a surgeon. Wait until after you've gotten the insurance, and THEN have your orthodontist refer you, and it might work better for you.

    In any case, my insurance company is Kaiser, which I think they only have in a half-dozen states, but they did agree to pay for the whole thing. My dental insurance (Delta) was so useless that even though my orthodontist told them it was not cosmetic braces, they still refused to pay for them (because I had to get on two sets and they had partly paid for the first when I was 8, I guess).

    Posted 2 years ago #

  6. liberty_1776
    Member

    Hi Tommy,

    It has been a few months since your post, so you probably figured your insurance out by now but just in case there are newcomers (like me) reading this with the same question I wanted to offer a few thoughts on the subject.

    I have anthem, which will pay for my surgery because my case is "medically necessary". My orthodontist said his experience is that most insurers will consider it a medical issue if your jaw deviates 4mm or more from normal.

    My issue is that Anthem has Zero, None, Nil, Zilch - in network surgeons within 60 miles of my house! They will allow me to pick a surgeon and provide in-network benefit amounts but the surgeon isn't contractually obligated to accept the amount Anthem is willing to pay, so I'll have to pay any difference out of pocket. Totally sucks!

    Upper & lower jaw surgery planned for summer 2010! Woohoo! =)
    Posted 1 year ago #

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