Which Insurance Plan would cover Orthognathic Surgery?

[Guest guest]

Hi,

I am new to this group, but was reading a lot of your posts in the

last couple of days (and nights). I hope you can help me with my

question:

Does anybody know an insurance plan (preferably in GA) which would

cover Orthognathic Surgery? I am in the process of getting new

(individual) health insurance. I am not sure if I'd really need

orthognathic surgery in the future. Still, I want to make sure that I

choose a plan which covers it.

The BlueCross Blue Shield Georgia www.bcbsga.com excludes all oral

surgery from their PPO plans. I could not find HMO for individuals.

Thanks!

Marie

[Guest guest]

In Alabama, Blue Cross has, from time to time, medical policies which

are available -- for a fee -- to persons who cannot get group

coverage. There are usually certain designated sign up periods for

them. Now what I don't know is how good they are about covering such

surgery as this.

I see your point about pre-exisiting conditions, but I haven't heard

of that being cited to deny anyone. It may have happened, but I don't

remember it.

How about this: Call a broker and tell him/her that you're looking

for excellent dental and health insurance (but be prepared to wince

when you get the price quote). Then ask to review a couple of

policies, and see for yourself what they say about coverage. And I

can't imagine that it would hurt your case to ask your general

dentist (or the person who handles insurance claims in his office)

which companies provide the best coverage and offer approval for

varied procedures... That might give you some clues, anyhow.

Bear in mind, too, that each policy is different. You just have to

study the provisions. Some specifically exclude orthognathic surgery.

Cammie

[Guest guest]

One thing that I did when trying to find out what kind of insurance

I should purchase was call the hospital that I knew I would have my

surgery at. My problem was, at first glance every form of insurance

said they excluded orthognathic surgery. After calling my local

hospital, and being transferred several times I found an extremely

helpful billing lady. I told her the specific surgery that I was

having done, as described by my OS, and she looked up all recent

files on people who had recently had the same or similar surgery

done. Of course she could not tell me their names, but she provided

even better information. She could tell me what form of insurance

they had, (Here in Oregon usually Blue Cross or Lifewise), and how

much of the total bill the insurance company had paid. Low and

behold, I found out that the same insurance companies who said they

excluded these procedures actually paid the majority of the hospital

bills. Armed with this info I sat down with my insurance broker and

went over each kind of insurance available. I too recommend using a

broker. My husband actually sells AFLAC, and so deals with

insurance all day, however we used a trusted broker because they are

specialists in what they do. Even though my initial information and

application from Blue Cross/Blue Shield said they denied

orthognathic surgery, when I got my Member Handbook (which you will

not receive until you sign up) stated that indeed they paid for

orthognathic surgery in several different cases, one of which is

mine. So make sure you make the calls to your hospital, and

hopefully they will be able to help you find the insurance that will

allow you to get your surgery. Hope all goes well!

Connie

>

> In Alabama, Blue Cross has, from time to time, medical policies

which

> are available -- for a fee -- to persons who cannot get group

> coverage. There are usually certain designated sign up periods for

> them. Now what I don't know is how good they are about covering

such

> surgery as this.

>

> I see your point about pre-exisiting conditions, but I haven't

heard

> of that being cited to deny anyone. It may have happened, but I

don't

> remember it.

>

> How about this: Call a broker and tell him/her that you're looking

> for excellent dental and health insurance (but be prepared to

wince

> when you get the price quote). Then ask to review a couple of

> policies, and see for yourself what they say about coverage. And I

> can't imagine that it would hurt your case to ask your general

> dentist (or the person who handles insurance claims in his office)

> which companies provide the best coverage and offer approval for

> varied procedures... That might give you some clues, anyhow.

>

> Bear in mind, too, that each policy is different. You just have to

> study the provisions. Some specifically exclude orthognathic

surgery.

>

> Cammie

[Guest guest]

Hi COnnie,

That is an amazing tip! What a great idea! Calling a billing agent

at a hospital is the PERFECT way to determine which insurnace pays

for the very type of surgery your surgeon is recommending! Great

post!!

Fran

> >

> > In Alabama, Blue Cross has, from time to time, medical policies

> which

> > are available -- for a fee -- to persons who cannot get group

> > coverage. There are usually certain designated sign up periods

for

> > them. Now what I don't know is how good they are about covering

> such

> > surgery as this.

> >

> > I see your point about pre-exisiting conditions, but I haven't

> heard

> > of that being cited to deny anyone. It may have happened, but I

> don't

> > remember it.

> >

> > How about this: Call a broker and tell him/her that you're

looking

> > for excellent dental and health insurance (but be prepared to

> wince

> > when you get the price quote). Then ask to review a couple of

> > policies, and see for yourself what they say about coverage. And

I

> > can't imagine that it would hurt your case to ask your general

> > dentist (or the person who handles insurance claims in his

office)

> > which companies provide the best coverage and offer approval for

> > varied procedures... That might give you some clues, anyhow.

> >

> > Bear in mind, too, that each policy is different. You just have

to

> > study the provisions. Some specifically exclude orthognathic

> surgery.

> >

> > Cammie

[Guest guest]

My comapny has CIGNA PPO and my ortho surgery is covered, so maybe you could try

them.

>

>

> Date: 2005/04/05 Tue PM 10:36:59 EDT

> To: orthognathicsurgerysupport

> Subject: [Orthognathic Surgery Support ] Which Insurance Plan would cover

Orthognathic Surgery?

>

>

[Guest guest]

I think there aren't many of us who aren't terrified. And I think

most of us, in retrospect after the surgery, think that terror

really wasn't justified.

Still. It's scary.

BC/BS of Alabama did cover my surgery. But there are policies and

policies. Read any you contemplate taking on. I am fortunate in that

mine is very good, and mostly paid for by my employer.

And no, I don't think you made a mistake in being candid with your

docs. They can be your best source of support and help in these

matters.

C.

> >

> > In Alabama, Blue Cross has, from time to time, medical policies

> which

> > are available -- for a fee -- to persons who cannot get group

> > coverage. There are usually certain designated sign up periods

for

> > them. Now what I don't know is how good they are about covering

> such

> > surgery as this.

> >

> > I see your point about pre-exisiting conditions, but I haven't

> heard

> > of that being cited to deny anyone. It may have happened, but I

> don't

> > remember it.

> >

> > How about this: Call a broker and tell him/her that you're

looking

> > for excellent dental and health insurance (but be prepared to

wince

> > when you get the price quote). Then ask to review a couple of

> > policies, and see for yourself what they say about coverage. And

I

> > can't imagine that it would hurt your case to ask your general

> > dentist (or the person who handles insurance claims in his

office)

> > which companies provide the best coverage and offer approval for

> > varied procedures... That might give you some clues, anyhow.

> >

> > Bear in mind, too, that each policy is different. You just have

to

> > study the provisions. Some specifically exclude orthognathic

> surgery.

> >

> > Cammie

>

>

>

> Hello everyone, I am a newbie and this post/subject is SO

INFORMATIVE

> for me right now. I have just been told I am going to need

> Orthognathic surgery to advance my upper jaw---and I do not have

> medical/dental insurance coverage right now either.

>

> I live in Birmingham, Alabama and I went for a consult one of the

top

> dentists in Alabama just to see how my dental work was coming

along---

> and to ask him about redoing my front crowns(for the third time)

and

> to ask him if he thought I was ready to get the four implants I

will

> need for my four back molar teeth.

>

> I was floored to hear him say that he really thought I should see

an

> orthodontist before I got the implants & new crowns done- b/c he

> thought I would need surgery to advance my upper jaw a tiny bit

b/c

> my teeth do not constantly meet in the front. I knew my teeth did

> not slightly overlap like they are supposed to---but I NEVER

thought

> I would hear I needed surgery b/c my front teeth would always be

> getting too much pressure, etc... I could feel the blood run out

of

> my face as I heard him describe the surgery and heard the

words " cut

> the jaw and move it forward " . EEK.

>

> I went to the ortho appointment and prayed I would hear him say

that

> that I was ready to get my implants this summer like I planned and

> that the most I might need from him might be a tiny amount of time

in

> braces---BUT, he agreed that surgery was the best option. I told

him

> if I did choose to do this surgery I would have to find insurance

> that would pay for it. Was that a bad idea to tell him that??

>

> He gave me a referral for the oral surgeon that did my extractions

> and I was considering him to do my implants his summer. I now

have

> an appt for April 26 w/him for the surgery consult. I know the

> members here & this board will be SO helpful if I do indeed choose

to

> go through with what right now still sounds like a TERRIFYING

SURGERY

> so THANK YOU to each of you! I know I am a big baby. At the very

> least, I appreciate the doctors advising me of doing the jaw

surgery

> FIRST---BEFORE the implants instead of finding out after spending

a

> fortune on implants that surgery should have been done beforehand.

>

> SO, that is the point I am at in this adventure----I am writing

down

> all the advice I find-b/c I know most of you have already been

down

> this road yourselves. Calling the hospital to find out which

> plans people used to cover the exact surgery I will need was an

> especially good tip and I am going to try that before my

appointment

> with my OSurgeon. I will keep everyone posted!

>

> Thank you for any advice and encouragement you can give me!

> JMarie