wife of a surgery candidate

[Guest guest]

Hi - My husband has an open bite, and has been meeting with

maxiofacial surgeons and orthodontists about correcting it. As the

concerned spouse, I am seeking answers to such questions as

1. Is surgery/braces the only and/or best option? and

2. Why does insurance cover only the surgery and not the braces?

Any input you can give will be greatly appreciated. Thanks!

[Guest guest]

I think only an orthodontist and an oral surgeon can answer your

question 1. I have read, though, that true open bites can be tough to

manage and retain. So be careful what you choose.

2. I believe that the surgery is generally covered as medical,

correction of a congenital anomaly. The braces are covered, if at

all, by the dental policy. Usually there is a cap on what the

insurance company will pay, lifetime. (Mine was in the $1,000-$1,200

range, and I paid for the rest of it.)

One OS's receptionist once told me: " If it is about the jaw, it's

medical. If it's about the tooth, it's dental. " I haven't found that

to be precisely true, but it's a characteristic approach, and many

times is the case.

Cammie

> Hi - My husband has an open bite, and has been meeting with

> maxiofacial surgeons and orthodontists about correcting it. As the

> concerned spouse, I am seeking answers to such questions as

> 1. Is surgery/braces the only and/or best option? and

> 2. Why does insurance cover only the surgery and not the braces?

> Any input you can give will be greatly appreciated. Thanks!

[Guest guest]

You know, that's a very good question:

If you can justify the surgery on " functional " grounds, then why not

the braces as well? Especially if the braces are required in order

to perform the surgery.

I do not know the answer. Has anybody here ever tried it? I am

willing to bet that your insurance company has no orthodontic

providers. Therefore you would have to go " out of network " and be

subject to a higher deductible and copayment.

I just went ahead and paid for the braces since there were no

providers. However, I am using a " Health Care FSA (Flexible

Spending Account) " to pay for the braces. That way, I am using " pre-

tax " money, which results in a savings of about 30%. Also, all of

your surgery expenses, copayments, prescriptions, etc. can be paid

from the FSA, with similar savings.

Jay

> Hi - My husband has an open bite, and has been meeting with

> maxiofacial surgeons and orthodontists about correcting it. As

the

> concerned spouse, I am seeking answers to such questions as

> 1. Is surgery/braces the only and/or best option? and

> 2. Why does insurance cover only the surgery and not the braces?

> Any input you can give will be greatly appreciated. Thanks!