Re: Want to go through procedure, need to know how to go about it

[Guest guest]

First, read your insurance policy carefully. Be aware of whether

there are specific exclusions for treatment of TMJ, or for

orthognathic surgery. (In some states, it is illegal, I think, to

exclude orthognathic surgery if they cover other repairs of skeletal

defects, which this is also. They can't pay for repair of a clubbed

foot and deny payment for repair of mismatched jaws.)

My surgeon was, as I have said before, very knowledgeable about

dealing with the insurance folks. We have a really excellent policy,

and it covered my lower advancement completely.

Second, if you already have an oral surgeon you know you want to use,

why not ask him for a referral to an orthodontist.

If you have DENTAL insurance, it may cover at least a part of the

braces. (Mine has a cap of about $1,200, I'm thinking, lifetime, for

orthodontia.) The orthodontic part of my treatment was about $5,600,

best I'm remembering. I was in braces a total of 20 months, having

the surgery at month 16; I did have the ceramic brackets on upper and

metal on the lower.

There's been a lot of discussion about pros and cons of different

types of braces. Some people are delighted with the ceramic ones, or

with the clear ones, which can be almost invisible for most of the

time you're in treatment. If I were doing it again, I'd use all

metal. (And you should know that some orthos and surgeons refuse to

use anything but metal for the surgery, as there is a tiny chance

that the ceramic ones can chip in the course of surgery, and x-ray

can't pick the chip up if it makes its way into a lung, for example.

NOTE: I do not know of anyone to whom this has happened, but I had to

sign a release about it.) The metal ones were just more comfortable

all around, to me.

Look to your MEDICAL insurance, though, for help with the surgery.

There are, I think, several sample letters on Fiddlesticks'

geocities site. I know nothing about your particular insurance

company. If you do have battles with the insurance company, get

everything in writing, keep careful records of any conversations with

them (with whom, and when, you spoke and what they said).

I wouldn't think it would hurt to wait until you have insurance, but

your ortho and/or your oral surgeon are in a much better position

than am I to advise you on this point. (They also like to get paid,

which may make them sympathetic to your waiting!)

Be prepared: If genioplasty (work on the chin) is involved, insurance

companies often consider it cosmetic and refuse to pay for that part.

I have seen figures from $3,000 to $6,000 quoted for the genio.

For the lower advancement, I paid the surgeon $5,600 (funny how that

figure keeps coming up!); his partner another $550 or so to assist;

the hospital, about $10,000. (Actually, my insurance company did.)

There were a few other incidental fees along the way -- about $150

for the first meeting with the surgeon; a records fee for the ortho;

and I can't remember what else.

Cammie

>

> Hi everyone,

>

> I posted about a year ago, after I visited my oral surgeon. I

> recently graduated college, and just started working a new job. I

> have already made the decision to have the procedure taken care of,

> and am wondering when and how to approach it to give myself the

best

> chance of having the procedure covered by insurance. I know the

> braces will probably not be covered by insurance, any tips or

advice

> on what type of braces to get, or what the approximate cost of

braces

> will be?

> Of course, being new at my job, insurance doesn't kick in until

after

> 90 days, so I won't be covered by any insurance until mid april, I

> assume I shouldn't get the process started until then right? Does

> anyone know how hard/easy it is to deal with Pacificare in terms of

> coverage?

>

> I was told a year and a half for braces, and two weeks recovery for

> the surgery, because I am only doing lower jaw movement, is this

> realistic? Sorry to ask all these questions, but this is a major

> decision for me, and I don't know very much about how to go about

> this in the right way, especially in terms of dealing with

insurance,

> which could save me over 9 grand. Any input would be greatly

> appreciated.

>

> Chris

[Guest guest]

Cammie,

Thanks for your informative and thorough answer...I think my surgeon

was quoting me around 8 grand for the lower advance, and he seems like

a nice guy. I am not sure whether he would help me with the insurance

aspect of it though, which is a pretty large consideration. I will

keep you updated, also thx for the braces advice, I am not sure what

the difference between ceramic and metal are though, a long time ago I

think I had metal.

Chris

[Guest guest]

You probably had metal a long time ago, because I don't think that

there was anything else.

New glues and new products have wrought a revolution in ortho.

If you look in the photos, you can see different types.

Ceramic ones are made of ceramic, and are more or less tooth colored

brackets that hold the archwires. Each bracket is glued to one tooth,

or, in the back (or in the front if you have particular problems with

them sticking to your teeth) bands can be used to hold the bracket in

place. Most people have at least some bands in the back, on molars,

and the rest of the brackets glued on... the metal ones are

traditional metal brackets. There are sapphire or quartz ones that

are clear. There are even gold ones, if you're feeling ritzy!

Cammie

>

> Cammie,

>

> Thanks for your informative and thorough answer...I think my surgeon

> was quoting me around 8 grand for the lower advance, and he seems

like

> a nice guy. I am not sure whether he would help me with the

insurance

> aspect of it though, which is a pretty large consideration. I will

> keep you updated, also thx for the braces advice, I am not sure what

> the difference between ceramic and metal are though, a long time

ago I

> think I had metal.

>

> Chris

[Guest guest]

And if you do a google search for " orthodontic brackets " you'll come

up with many manufacturers etc., and can have a look at lots of

types...

Ask your ortho, though, what he uses and what he recommends. I want

my docs using whatever works best in their hands...

C.

>

> Cammie,

>

> Thanks for your informative and thorough answer...I think my surgeon

> was quoting me around 8 grand for the lower advance, and he seems

like

> a nice guy. I am not sure whether he would help me with the

insurance

> aspect of it though, which is a pretty large consideration. I will

> keep you updated, also thx for the braces advice, I am not sure what

> the difference between ceramic and metal are though, a long time

ago I

> think I had metal.

>

> Chris