Re: Has anyone switched insurance in the middle of this process?

[Guest guest]

Hello,

How far are you into this process? And exactly what did you current

insurance company say about why they wouldn't cover the doctor's fees

or the hospital stay? I've had my braces on for about 4 months and I

still haven't gotten the insurance to approve my claim. I'm hopeful

though because my insurance lists orthognathic surgery as a covered

item...they initially denied me due to medical necessity. I have Blue

Cross Blue Shield and I hear they cover these procedure if you can get

your surgeon's office to say the procedure is medically needed. I'm

not sure about other insurance companies, though. Good luck and I'm

sure others will post their own opinions.

-Nate

[Guest guest]

They said it was not medically necessary although my OS appealed to

say that it was and Cigna says it is not a covered benefit so I have

no appeals rights.

Hope you have better luck than I did.

> Hello,

>

> How far are you into this process? And exactly what did you

current

> insurance company say about why they wouldn't cover the doctor's

fees

> or the hospital stay? I've had my braces on for about 4 months

and I

> still haven't gotten the insurance to approve my claim. I'm

hopeful

> though because my insurance lists orthognathic surgery as a

covered

> item...they initially denied me due to medical necessity. I have

Blue

> Cross Blue Shield and I hear they cover these procedure if you can

get

> your surgeon's office to say the procedure is medically needed.

I'm

> not sure about other insurance companies, though. Good luck and

I'm

> sure others will post their own opinions.

>

> -Nate

[Guest guest]

Hello - My insurance doesn't cover this either, so don't feel bad-

you're not alone. What I've been thinking of doing is to contact some

insurance brokers in my area and purchase a " rider " that would cover

the surgery and maybe the orthodontic treatment. My insurance

company is Blue Cross of Idaho, and my policy is thru work. I work for

the largest hospital system here in Idaho and I find it hard to believe

that a hospital won't take better care of its employees: I'm very

disappointed to say the least. My policy will only cover $1000 of my

orthodontia, which is probably one-fifth of what my treatment will be

costing me.(I haven't even been to an ortho yet - I'm still in the early

stages - just decided to go thru all this fun). My hospital does offer a FSA

(flexible spending acct.), so I can use that for my orthodontia. Hang in

there, ./ I'll be buying some lottery tickets - LOL!! / Diane- In

orthognathicsurgerysupport , " angela82462 "

<@a...> wrote:

> We just learned that Cigna will not pay for this procedure or the

> hospital costs. But I am not going to be ready for the surgery until

> 2006. So I am considering switching insurance companies to see if the

> new company will pay for it. Has anyone done this? Can I ask which

> insurance companies are better at paying for this type or surgery. I

> know Aetna is another option through my husband's company.

>

>

[Guest guest]

The surgeon has already appealed it and Cigna says I have no appeal

rights. Our next step is to talk to HR and see what we can find out.

> It might be worth your while, and your $$$ to find a lawyer who

> specialises in such, and ask him to fire off a letter (for which you

> would pay) to demand a review.

>

> Two other suggestions: Get your surgeon involved, and get the human

> resources department at your workplace involved, as well..

>

> C.