Re: Dr. West

[Guest guest]

Hi Luna,

Sorry to take so long to get back to you. I have my first consult

with Dr West April 14th. I am still kind of iffy about the whole

process, as I don't know if I will do this if my mouth volume (I

don't know if that is the correct term) cannot be addressed with any

significant improvement. My orthodontist agrees, and is sending me

to Dr West with models and xrays before finalizing using him as my

orthodontist! Pretty nice guy I think! He wants to make sure we

have a workable plan before he starts from his end too. He said we

would have to have a plan with the Dr West, himself, a periodontist

(sp) and my regular dentist who will do the whole mouth rehab part

of it. My head spins when I think about it!

The only good news is that surgery may be in about 12 months. Of

course, from reading this board, I know that 12 months might

actually be 18 months or more. Or maybe 8 months! lol

I have ILWU-PMA insurance (westcoast longshore). The maximum I will

be out for the surgery itself is $1000 even though Dr West is out of

network (that is the maximum out of pocket for any medically

necessary procedure with our plan). They don't have any orthognathic

surgeons in network, so they are going to look at my case and see

what related expenses they may cover. It is a self funded insurance

plan (employer pays without an insurance company), so it is really

flexible with the benefits, even if it is not traditionally covered

by policy. Actual insurance companies are prohibited from being that

flexible. So they may pick up some of my orthodontia, even though

adult orthodontia is not generally covered. They said they may

cover the orthodontia, as it is not a problem with my bite (in my

case), but is a jaw problem that will require the teeth to be moved,

even to maintain the same position in the bite relationship it now

has. I don't see what difference that makes, but apparently it does

to my insurance. But what I have described here probably won't help

anyone who has insurance with an insurance company to know this. It

might be helpful if you have a self funded plan though.

I really wish everyone had great medical benefits. From being on

this board and another surgery related board, it is so distressing

to see so many people who are left high and dry even with coverage.

And while one plan pays everything, even for lesser problems,

another pays nothing, and gives the consumer the runaround to

boot! I really wish you good luck in getting some help with your

insurance. Hang in there with it. Sometimes by rewording or

looking at your policy you can find ways to have it reconsidered. I

will cross my fingers for you!

Fran

> > > > Does anyone have any experiences with Dr. Roger West in

Seattle?

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> > > > Thanks.

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