Experience with Kaiser Insurance? Other Insurances?

[Guest guest]

Hi! My orthodontist has recommended that I apply for the Kaiser

Individual plan to cover my jaw surgery. I need both upper and lower.

I currently have Blue Cross/Blue Shield PPO plan but have not gone in

to do the pre approval yet. Does anyone have experience with Kaiser

Insurance in regards to covering their surgery? If so please share

your experience.

How about other types of insurances? Please share your stories of how

you were able to cover your surgeries.

Thanks

[Guest guest]

I know plans vary by state and your employer's (or individual)

contract, but I have Blue Cross PPO (they split with Blue Sheild) and

they approved the surgery on the first request. My surgeon just

submitted the standard paperwork (I " m not sure what that is,

pictures, molds, measurements, etc) and it was approved. I was

actually very surprised because after reading everyone's post I was

gearing up for a battle. My insurance actually told me that the

surgery itself does not require pre-approval, but the hospital stay

would. I didn't believe them though, so I made them send me a letter

anyway.

Kim

> Hi! My orthodontist has recommended that I apply for the Kaiser

> Individual plan to cover my jaw surgery. I need both upper and

lower.

> I currently have Blue Cross/Blue Shield PPO plan but have not gone

in

> to do the pre approval yet. Does anyone have experience with Kaiser

> Insurance in regards to covering their surgery? If so please share

> your experience.

> How about other types of insurances? Please share your stories of

how

> you were able to cover your surgeries.

>

> Thanks

>

>

[Guest guest]

I also have BCBS PPO - my surgery was pre-approved, although the

claim was initially denied. After providing a new set of x-rays and

presumably some additional information, my surgery was approved.

My surgeon was in-network as was the hospital. I can't tell you

exactly what I will pay as I have not yet received the bills, but I

expect it will be in the neighborhood of 10%.

Jay

> Hi! My orthodontist has recommended that I apply for the Kaiser

> Individual plan to cover my jaw surgery. I need both upper and

lower.

> I currently have Blue Cross/Blue Shield PPO plan but have not gone

in

> to do the pre approval yet. Does anyone have experience with

Kaiser

> Insurance in regards to covering their surgery? If so please share

> your experience.

> How about other types of insurances? Please share your stories of

how

> you were able to cover your surgeries.

>

> Thanks

>

>

[Guest guest]

,

It does seem like Kaiser has a better history of covering

orthognathic procedures than other insurances. In my case, I had

CIGNA and had no problem getting pre-approved. Then, 9 months into

my braces, I had to change insurance due to my company dropping

CIGNA. I changed to Kaiser, and had an even easier time with the

approval.

With Kaiser my Primary Care Doc referred me to the MaxioFacial

Surgeon (Oral Surgeon). It just so happens that here in Denver that

speciality isn't in network, but they refer all their orthognathic

candidates to this one practice. He took one look, and approved my

surgery on the spot and began preparation for the surgery. I asked

him if I needed to go back and update my referral or anything, and he

said no. He makes the decisions based on pre-approved measurements,

and he makes the final call.

Dammit

> Hi! My orthodontist has recommended that I apply for the Kaiser

> Individual plan to cover my jaw surgery. I need both upper and

lower.

> I currently have Blue Cross/Blue Shield PPO plan but have not gone

in

> to do the pre approval yet. Does anyone have experience with Kaiser

> Insurance in regards to covering their surgery? If so please share

> your experience.

> How about other types of insurances? Please share your stories of

how

> you were able to cover your surgeries.

>

> Thanks

>

>

[Guest guest]

I also had bc/bs in Alabama, and they gave pre-certification on the

first request, and renewed it when I was ready. (The precert, I

think, was good only for six months or a year, and it took longer

than that to get my teeth ready for surgery.)

Cammie

> > Hi! My orthodontist has recommended that I apply for the Kaiser

> > Individual plan to cover my jaw surgery. I need both upper and

> lower.

> > I currently have Blue Cross/Blue Shield PPO plan but have not

gone

> in

> > to do the pre approval yet. Does anyone have experience with

> Kaiser

> > Insurance in regards to covering their surgery? If so please

share

> > your experience.

> > How about other types of insurances? Please share your stories of

> how

> > you were able to cover your surgeries.

> >

> > Thanks

> >

> >