RE: Confused

[Guest guest]

I understand your concerns. I'm new to this board...my first posting.

I first consulted an orthodontist Nov. 2004. He referred me to an

orthognathic surgeon. I have blue cross and they paid 80% of the surgeon

visit. However, they've denied my $1,200 so far in orthodontic visits (not

including braces). They're now billing dental for the $1,200. I'm hoping for

a 50% benefit.

The surgeon's office sent me a six-page questionnaire to help out with

insurance on the surgery. They suggested I submit the questionnaire soon as

it takes three months or more for insurance review, etc. I plan to answer

the questions truthfully, but am not sure what they're looking for to say

it's TMJ-related.

Money was a huge thing for me..and very stressful. I talked with my husband

and decided I was going ahead with braces and surgery on my own. If

insurance picks up part of the cost, great. So, I took out a line of credit

on my home. This way I know the money is there if I need it and I can write

the interest off on my taxes.

I'm getting braces March 14 and at this point will have lower jaw surgery

(possibly upper jaw, too) in about 9 - 12 months.

Good luck!

>

>Reply-To: orthognathicsurgerysupport

>To: orthognathicsurgerysupport

>Subject: [Orthognathic Surgery Support ] Confused

>Date: Thu, 24 Feb 2005 02:46:01 -0000

>

[Guest guest]

Usually, dental ins. covers the ortho -- at least up to its cap,

which is usually a lifetime cap.

Usually MEDICAL insurance covers the surgery, on the grounds that it

is necessary repair of a congenital, skeletal defect. Be careful of

the TMJ argument, as some policies specifically exclude surgical

treatment of TMJD.

I would suggest that you be purely truthful with that questionnaire.

If you have headaches, say so. If you have grinding and are wearing

tooth surfaces, or cracking your teeth, say so. If you have popping

and/or clicking in your jaws, or if your jaw locks, say so. If you

have trouble eating (which sometimes leads to digestive disorders,)

say so.

> I understand your concerns. I'm new to this board...my first

posting.

>

> I first consulted an orthodontist Nov. 2004. He referred me to an

> orthognathic surgeon. I have blue cross and they paid 80% of the

surgeon

> visit. However, they've denied my $1,200 so far in orthodontic

visits (not

> including braces). They're now billing dental for the $1,200. I'm

hoping for

> a 50% benefit.

>

> The surgeon's office sent me a six-page questionnaire to help out

with

> insurance on the surgery. They suggested I submit the questionnaire

soon as

> it takes three months or more for insurance review, etc. I plan to

answer

> the questions truthfully, but am not sure what they're looking for

to say

> it's TMJ-related.

>

> Money was a huge thing for me..and very stressful. I talked with my

husband

> and decided I was going ahead with braces and surgery on my own. If

> insurance picks up part of the cost, great. So, I took out a line

of credit

> on my home. This way I know the money is there if I need it and I

can write

> the interest off on my taxes.

>

> I'm getting braces March 14 and at this point will have lower jaw

surgery

> (possibly upper jaw, too) in about 9 - 12 months.

>

> Good luck!

[Guest guest]

I am also a worrier. I didn't get my braces on untill I found out my

insurance approved the surgery but I dont know if that was the best

way to go. It took 9 months for my old insurance company to keep

denying coverage, 1 month to switch insurance companies and 3 months

for the new insurance to approve. If I had braces all that time my

surgery would have been done last year. Instead, I am only 9 months

into braces but I have peace of mind knowing my insurance should pay

and that I found a surgeon. It also cost me more money because the

orthodontists fees went up and he had to start all over because so

much time had passed. In any case I do think you should consult a

surgeon first. I would have been way too scared going into this

without knowing the costs with or without insurance. I also found

that I got more information that way. I don't know if it was because

the surgeon and the ortodontist described the surgery differently or

hearing it twice gave me a better idea of what I was looking at. My

dentist actually sent me to a surgeon first and the surgeon refered

me to the orthodontist. The orthodontist wanted me to come back with

a family member and then put my braces on - without insurance

approval for the surgery first. Once the braces were on there would

be no going back because they would make my bite much worse and I

was too confused at that point to get my braces on. I then consulted

a surgeon that dosn't do this surgery anymore(I had no clue what I

was doing) He recomended geting the braces on and interviewing

surgeons and he gave me the name of a surgeon that does this

surgery. The new surgeon got the surgery approved then I went back

to the orthodontist. It was kind of a mess and a little expensive

but I'm not worried anymore.

My first insurance company didn't pay for my consultation with the

first surgeon but, my new insurance did pay. It was just something

the first didn't cover they also wouldn't cover the surgery. If you

are confused call your Orthodontist they may be able to point you in

the right direction atleast.

>

> Hello, I didnt know that this process was going to be so stressful

and

> confusing. I thought I would get braces and that would be that!

> How many of you had braces on first and than consulted with a

surgeon?

> I dont know where to go from here, should I have braces put on and

> find out about insurance for the surgery when the time comes or

should

> I find out all I can first. I am a big worrywart! I like to know

> before things happen so if the insurance isnt going to cover this

> procedure i want to know but some people say they wont say way

ahead

> of time. The consultion fee with the surgeon is $266 insurance may

> cover or not but if they wont approve so soon why go this early at

> least I will have straight healthy teeth. I am confused on where

to go

> from here please help, it would help to hear how other people have

> went down this road.

> Thanks

>