Ashlea, I don't know where you are from or nothing like that but I can tell you that if you have a University Medical Center anywhere near you, more than likely your insurance will cover it. I have Blue Cross of Arkansas and they actually paid 80% for me. I am 20 years old and was finally able to get mine done. I have had braces for four years and in March it'll be five. I was only supposed to wear my braces for two years but because of my previous insurance and the picky oral surgeons I had went to before, wouldn't accept me. I finally found this Oral surgeon at the University Medical Center in Jackson, Mississippi and I can tell you he is fantastic. He was not all about the money as opposed to the two other oral surgeons I had went to before. I know what it is like to be denied because I am just now getting to my final result after four years. Good luck to you and I hope that this helps.
Jaw Surgery Forums » Pre-Surgery Questions
What should I do??
(17 posts)-
Demi
MemberPosted 1 year ago # -
chasethechief77
MemberI'd reccomend you start reaching out to other oral surgeons, more hands on with insurance fighting oral surgeons.
Oral surgeons want money, they have to get insurance companies to pay for these surgeries if they want to get paid. They are incentivized to help you. This person clearly does not want to help you/ has given up.
maybe you should call some surgeons that are from out of town and giving them your insurance info and approximate mm of surgical movement, see if they can get it approved. Tell them if they can get it approved then you're in, see how fast they jump on that bangdwagon.
Posted 1 year ago # -
Lediva
MemberChange insurance, and try a new surgeon, one of the things I did before I picked my doctor, was to make sure he knew what insurance they accepted, what were the possibilities of being denied, specially because of my age, how soon it was going to be until they approved my surgery, and of course I needed to make sure that I could trust my doctor.
Waiting for a change!Posted 1 year ago # -
ashlea_hinkle
MemberThanks everyone for your responses. They have definitely helped!:)
I have been talking to several surgeons the last couple of week and I had found out some more information. One lady in particular works with these kinds of problems all the time and she pretty much told me everything I already knew but she did say I really have no chance of getting approved. She told me that my surgeon should have told me If I was approved or not before getting braces but in my case BSBC is most likely not going to approve no matter what I do. Although I have all the medical reasons why I need this surgery it states clearly in their policy that they will not cover an individual who is over the age 19. She told me that the only way to go around this is to get on a group policy( to get a full-time job who has good insurance) or get the braces taken off and wait till Im on my own and have the money. She did say she could help me lower the cost if I wanted to pay out of pocket, she gave me a price range around 15,000$ which is better than my original surgeon but I still dont have that kind of money. The last thing Im going to try is to go ahead and try to appeal it AGAIN and send them all my documents, if that doesnt work Im going to see if I can switch insurance AGAIN if neither of those work I guess I will have to get my braces taken and wait till Im out of college! :/ Any other suggestions?Posted 1 year ago # -
glittermouth
MemberTry to appeal through your state insurance commission. Sometimes they can be of help. Did you have surgery authorized as a part of your original treatment plan when you were under the age of 19?
Posted 1 year ago # -
doggydog
MemberHi ashlea_hinkle,
I'm sorry you have to go through this. It really is an unfortunate situation to be in. If they aren't going to cover the surgery perhaps you'll simply need to find the money. Do you have any family or friends who are willing to lend you some money? Do you have any assets to sell (eg. a car, electronics?). Are any surgeons willing to put you on a payment plan (as was done with your braces)? If you did have a full time job for a year and saved most of it you should be able to come up with $15,000. In my case I have to pay outright, and that includes braces before surgery which are actually the most expensive part of it for me! Altogether my out-of-pocket is about $15,000. The only reason I'm able to proceed in the first place was because my older siblings had lent me money so I didn't have to wait, and meanwhile I am working to save up and cover the bills as they come and then after all that pay my siblings back what they lent me to get started.
What country are you living in presently? Seeing as jaw surgery is quite expensive to pay outright ($15,000) in your country, you could always consider the option of flying overseas and having the surgery done there. In Australia I was quoted $6000 for upper, or $9000 if both jaws need moving. But, I would apparently get 30% back from medicare or something, so in my case I'll be paying about $4000 out of pocket for the surgery itself (upper jaw only). I don't know the full details about how medicare and all that would work if you were to come here specifically though. I'm fairly sure there are surgeons here who would do the surgery even cheaper, but I am more confident in this surgery in particular. The medical teaching school surgeons for example, I'm not sure how experienced they are in it yet.
Your braces seem like they are already quite an investment and taking them out doesn't seem like a pleasant process to go through. I would hate to have to do that, but if you don't feel you have any options you could possibly restart the whole process once you have money saved. In my opinion, you may want to try the overseas travel idea. Unfortunately I couldn't really recommend you the best place to travel to though for the lowest price / professional surgeons. Don't forget that you would need to stay overseas for a while for recovery too, so the expenses are not just a plane ticket but the cost of living overseas for the week or however long is needed. It would be good if you had family/friends overseas or if someone came with you for a trip. Overseas travel just for surgery isn't exactly ideal but I've read of people doing that (not for jaw surgery specifically).
I really do hope your appeals work out for you, but even if they don't, if you can find the money and maybe get a lower surgery cost or a payment plan, or a combination, it may make jaw surgery affordable enough.
Posted 1 year ago # -
OpenBite
MemberGood luck appealing again! I hope you get it!
Posted 1 year ago #
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