Guest guest Posted June 28, 2005 Report Share Posted June 28, 2005 Hi Vinayak, Insurance policies vary widely even with the same carrier. You might check with the human resourses department or medical claims rep for your policy regarding orthognathic surgery. Sometimes it is an excluded benefit. That means no amount of contesting will provide coverage. If it is not an excluded benefit, your OD and OS can provide written info to your insurance as the the medical necessity of your surgery. It is good to get it preauthorized in writing from your insurance before you begin treatment, as they will try to delay your request beyond the time the payments are due. Then getting reimbursed is a real nightmare!! So try to get it preauthorized if possible. Let us know what you find out! Fran > Hi all, > > My name is Vinayak and I'm a recent college graduate who is going to > start work in New York City in a few weeks. I have been told that my > medical benefits are provided by CIGNA. However, I noticed on this > message board that several people have recently been denied by CIGNA. > Since I just began a new round of treatment, my estimated surgery > date is about a year away. Any advice on what options I have with > regards to insurance coverage? Has anyone had any good results from > CIGNA? Is there any supplemental insurance I can purchase on the > side? How do you go about contesting a claim that they deny? > > I just would like to be prepared with regards to the finances. The > orthodontic treatment in the first year alone will cost about $15,000 > (NYC is ridiculously expensive!) and my insurance only covers about > 10% max of that. Plus, I may have to get chin/nose procedures that > are not covered, so I would like to minimize all possible expenses on > the surgery itself. Thanks so much for any input. > > Vinayak Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2005 Report Share Posted August 19, 2005 Thank you for posting this. I was given similar advice for here in Virginia. Something else for me to do! Thank you again. - H > I'm not sure what other states do in regards to RSS but in Minnesota > they have a program called TEFRA (part of MA) that covers all the costs > for my RSS daughter, including growth hormone and needles. When I had > her on a regular HMO, the co-pays literally bankrupted. I applied for > MA for my daughter, got her certified as disabled due to her feeding > needs and have had no worries since. Quote Link to comment Share on other sites More sharing options...
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