Guest guest Posted November 10, 2005 Report Share Posted November 10, 2005 Currently my insurance covers this surgery. However, I did hear that you can fight for it through the insurance company and usually you can win. Something about being the liasion between your insurance company and the OD office, and such. I am not sure on the detailing, but something with insurance companies messing up or 'missing' certain paperwork and/or thinking it is cosmetic, which in you can create a list (through your ortho) and state problem areas in which you need this surgery for medical reasons. Also, if you are going through dental, try your health insurance. Seems like that is a common mistake too. Again this is all hearsay, but thought I would let you know what I have heard through the 'grapevine'. Hope this helps and good luck! Nikki > > My insurance at my present job, and the insurance of two other jobs I > was hired for but did not accept- does not cover jaw surgery at all. > They have specific clauses about it. Are there companies out there > that do cover jaw surgeries or has anybody had any luck fighting > insurance companies on getting them to cover jaw surgery? > Felshie > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2005 Report Share Posted November 10, 2005 Thanks. My insurance is being pretty difficult, and I have fought them once, but it's good to hear that there is hope that other people are making it through it and getting coverage. Felshie --- nrathje23 wrote: > Currently my insurance covers this surgery. However, > I did hear that > you can fight for it through the insurance company > and usually you can > win. Something about being the liasion between your > insurance company > and the OD office, and such. I am not sure on the > detailing, but > something with insurance companies messing up or > 'missing' certain > paperwork and/or thinking it is cosmetic, which in > you can create a > list (through your ortho) and state problem areas in > which you need > this surgery for medical reasons. Also, if you are > going through > dental, try your health insurance. Seems like that > is a common > mistake too. Again this is all hearsay, but thought > I would let you > know what I have heard through the 'grapevine'. > > Hope this helps and good luck! > Nikki > > > > > My insurance at my present job, and the insurance > of two other jobs I > > was hired for but did not accept- does not cover > jaw surgery at all. > > They have specific clauses about it. Are there > companies out there > > that do cover jaw surgeries or has anybody had any > luck fighting > > insurance companies on getting them to cover jaw > surgery? > > Felshie > > > > > > > __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 10, 2005 Report Share Posted November 10, 2005 Felshie - MY insurance thru my employer of twenty-five years, a large hospital no less, doesn't cover this surgery either. The company is Blue Cross of Idaho. Apparently Blue Cross Co.'s in other states do pay for this but apparently I live in the wrong state (I don't intend on moving though, LOL). My OMS will be submitting a pre-authorization anyway, but we don't expect it to be approved. My OMS has privileges at three large hospitals (2 owned by my employer and the other is a competitor) and at a small short-term hospital that charges a quarter to a third of what my employer would be charging for the same exact procedures (BSSO + LeFort). The only good thing about paying for this out-of-pocket is that I will be able to deduct it from my taxes in 2007. So, you are not alone. It's very frustrating. ~~~~ Diane (Idaho)- -- In orthognathicsurgerysupport , " felshie81 " <felshie81@y...> wrote: > > My insurance at my present job, and the insurance of two other jobs I > was hired for but did not accept- does not cover jaw surgery at all. > They have specific clauses about it. Are there companies out there > that do cover jaw surgeries or has anybody had any luck fighting > insurance companies on getting them to cover jaw surgery? > Felshie > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2005 Report Share Posted November 11, 2005 Hi Felshie, Something you probably want to do is go to your human resources or personnel office, or talk to whomever in your workplace handles medical claims. Finding out if your insurance covers orthognathic surgery for medically necessary reasons is very important before making a decision. It is especially important to find out if orthognathic surgery is specifically EXCLUDED. If it is, you will be unable to fight them for coverage. Only if it is allowed can you fight for it to be covered. And then they will have guidlines typically , about how many mm must be moved for you to qualify for the coverage. Your OMS can help you with the appropriately worded and supported evidence to your insurance that you are qualified and meet the guidelines your insurance requires. For me, it was important to have a written preapproval letter in hand before I got my braces applied. Good luck with this! Hugs, Fran > > > > My insurance at my present job, and the insurance of two other jobs I > > was hired for but did not accept- does not cover jaw surgery at all. > > They have specific clauses about it. Are there companies out there > > that do cover jaw surgeries or has anybody had any luck fighting > > insurance companies on getting them to cover jaw surgery? > > Felshie > > > Quote Link to comment Share on other sites More sharing options...
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