Re: HOW TO PPL PAY FOR THIS SURGERY!!

[Guest guest]

Jaw surgery is generally covered by medical insurance, NOT dental

insurance. The cost varies depending on your plan-

coverage/copays/etc. Things to look into would be how long the

surgeon would have you stay in the hospital. Is your surgeon a

provider with your insurance company. He would be able to generally

let you know if your specific insurance company generally coveries the

surgeries or not. Mine knew immediately that my company always covers

the surgery and is never a problem. Other local companies aren't so

cooperative from what I was told. Anyway, he can give you a general

idea of that. Or you can check with your insurance plan/company. Also,

as the surgeon how long you'd be in the hospital so you can check what

your hospitalization copays would be. There are different places to

start gathering information about potential costs right now. If I had

not elected to have a genioplasty done in conjunction with my upper

and lower jaw surgery (a cosmetic procedure not covered by insurance)

I would have only paid $60 for EVERYTHING- hospital, insurance, etc.

Well, that and copays for prescriptions, but that was neglibible. So

you get the idea! Do your homework! As for my braces, I opted for the

more expensive ceramic brackets (I'm self-conscious!).. that increased

my total cost by maybe $300. My cost for the braces is $4600. That

wasn't covered by anything- medical or dental, so I've paid for it out

of pocket entirely. I hope this is helpful. For context, if I had NO

insurance coverage... my surgery would have probably cost me around

$25,000. I guess I got my money's worth out of my monthly premiums,

huh?!?!

Good luck and let us know what you decide. Feel free to ask more

questions.... and welcome to the group!

Katja

>

> Hi everyone,

> I need braces and when I heard the price for them I was in awe

> because they are expensive. But when my doctor told me I need jaw

> surgery also ~ I asked about how much that was going to cost he said

it

> could cost up to $15,000. and I was wondering how much ppl pay after

> insurance. Also, is jaw surgery covered by medical insurance too?? +

> (plus) dental insurance????

>

[Guest guest]

Hi there.

The surgery itself should be covered until your medical plan, not dental. This

also depends on the type of coverage you have and whether your surgeon is in or

out of your network at the most basic level.

In my experience, in addition to having a surgeon that you trust, I highly

recommend befriending the person at the surgeon's office who deals exclusively

with insurance. Mine has been a godsend dealing with my insurance company

directly, coordinating with my ortho and my surgeon, and then also following up

when my insurance company tried to renig on their pre-approval letter. She also

was able to give me the exact language to use with the insurance company to

check to see whether my surgery was covered.

Unfortunately most dental insurance does not cover the cost of braces.

Hope this is helpful.

Welcome to the group!

Sophia

grantangel321 <no_reply > wrote:

Hi everyone,

I need braces and when I heard the price for them I was in awe

because they are expensive. But when my doctor told me I need jaw

surgery also ~ I asked about how much that was going to cost he said it

could cost up to $15,000. and I was wondering how much ppl pay after

insurance. Also, is jaw surgery covered by medical insurance too?? +

(plus) dental insurance????

[Guest guest]

Hi Grantangel321,

I agree that your medical insurance is the one that would possibly

cover the surgery. Some cover it and some don't. You can talk to

your human resources or personnel officer who handles medical claims,

or call your insurance directly and ask if the cover " medically

necessary orthognathic surgery " . Some specifically exclude

orthognathic surgery of any kind. Some cover it if you have TMJ, most

cover it if you have sleep apnea, some cover it if it meets certain

jaw measurement guidelines, some cover it only if TMJ is NOT involved,

some cover it only if it is the result of jaw trauma. What I am

getting at, is you really need to find out the specific language in

your plan.

Most OMS offices have a specialist who deals with insurance claims for

their office. They usually have a good idea of most major carriers

policies and can find out with a simple computer check what your plan

usually pays. It is a good idea to get a preauthorization letter in

hand before you initiate your braces, if insurance coverage is a

deciding factor for you in getting started. With a preauthorization

letter in your file (I keep the original in my own home file), even if

your insurance later denies payment, the letter is a strong document

that can be used to force them to ante up.

My braces were not covered at all. Some people have a smaller amount,

like $1000-$1500 for adult braces, and if you are under 19, oftentimes

a parents plan may have some coverage for you. The good news is that

most OD offices take a smaller down payment, and will let you make

monthly payment, interest free, for usually 18-24 months. My OD

office did that! It makes the out of pocket not nearly so painful.

Most OD offices offer some sort of payment plan. If your OD does not,

try getting a few other OD consults and see what they do too. Just

make sure it is someone who works with your OMS well.

Good luck with this. Let us know what you find out! Crossing my

fingers for you!

Hugs,

Fran

>

> Hi everyone,

> I need braces and when I heard the price for them I was in awe

> because they are expensive. But when my doctor told me I need jaw

> surgery also ~ I asked about how much that was going to cost he said

it

> could cost up to $15,000. and I was wondering how much ppl pay after

> insurance. Also, is jaw surgery covered by medical insurance too?? +

> (plus) dental insurance????

>

[Guest guest]

My braces cost $8000. My mom only got $2500 back from our Dental Plan.

My Surgery cost $4500, nothing covered that, so I had to sell my car

<sigh> but it was worth every penny. So in total my mouth cost almost

$13,000. That's one expensive mouth! lol

[Guest guest]

i believe all in all my surgery was above 50000.

luckily, my insurance covered all of it! in the end,

my surgeons office owed us money because we had to

initially put 2000 down. so, i really think it

depends on insurance and how well your doctor can sell

your case to them.

-sarah

__________________________________

Yahoo! Mail - PC Magazine Editors' Choice 2005

http://mail.yahoo.com

[Guest guest]

Hello and welcome to this group! My insurance situation is a sad one:

my insurance lists Orthognathic Surgery as an excluded benefit, so I

will be paying for my surgery out-of-pocket! What seems so ironic

about this is that I have been employed for the last twenty-five

years by the largest hospital system in Idaho. This is how poorly my

employer takes care of its people!! My OMS has privileges at four

hospitals: two owned by my employer, one other large competitor, and

a small (9-bed/4-O.R.) short-term hospital. The latter is where I

will be having my surgery, as they charge one-quarter to one-third of

what my employer charges for the same exact procedures. I have an

underbite; I will be having a BSSO (lower, to set back my mandible),

a LeFort 1-piece (upper, to advance my maxilla), and some chin/neck

Lipo. BTW, my employer charges $10K for a BSSO (lower) and $10K for a

LeFort (upper). The short-term hospital charges $2.5K for a BSSO, and

$2.5K for the LeFort. The Anesthesiologist, hospital room, meds, etc.

are part of a " package " . My OMS's fee is somewhere between $6K and

$10K - I will get all the exact amounts at my Dec. appointment. My

insurance does pay $1K of the $5K total for my braces. I will be

giving lots of negative feedback to my employer after I undergo all

this, as I feel they have really let me and others down by not

providing the best insurance coverage they can. My insurance co. is

Blue Cross of Idaho. I'm sorry to share all this with you, but I

think it's important for you and anyone else just starting the

journey to know that not all insurance companies cover this; not

everyone has a happy insurance story to tell. The only good thing

about having to pay out-of-pocket is that I will be able to claim

this on my tax return in 2007. Good luck.~~~~~ Diane (Idaho)

>

> Hi everyone,

> I need braces and when I heard the price for them I was in awe

> because they are expensive. But when my doctor told me I need jaw

> surgery also ~ I asked about how much that was going to cost he

said it

> could cost up to $15,000. and I was wondering how much ppl pay

after

> insurance. Also, is jaw surgery covered by medical insurance too??

+

> (plus) dental insurance????

>

[Guest guest]

Do any of ya think Medicaid might cover it?? this is a serious question

cuaes thats the insurance i only have.

[Guest guest]

hey there,

i live in Canada, so our national gov't healthcare covered all aspects of my

surgery (including hospital care, anesthesia, etc, etc.), no questions asked

(though that's because jaw surgery is accepted here as a medical treatment...a

purely cosmetic " nose job " would obviously not be covered).

The braces, however, are not covered and i'm paying around $7500 CAD for that

(around $6000 USD). I pay monthly for that though, spread over two years, and

there's no interest. However, there are some insurance plans that would cover

braces partially, but as far as I know, both here and in the US, most insurance

plans don't cover braces (which annoys me, cuz it's strange how my jaw surgery

is covered, but the braces which are being used essentially for the jaw surgery,

are not covered).

-jessica

grantangel321 <no_reply > wrote:

Hi everyone,

I need braces and when I heard the price for them I was in awe

because they are expensive. But when my doctor told me I need jaw

surgery also ~ I asked about how much that was going to cost he said it

could cost up to $15,000. and I was wondering how much ppl pay after

insurance. Also, is jaw surgery covered by medical insurance too?? +

(plus) dental insurance????

[Guest guest]

Hi ,

A fellow Canuck here - actually the coverage varies from province to

province, it's not a federal heathcare plan that covers the costs

but the provincial plan.

In Ontario, where I am, the surgery was covered 100% by OHIP. But in

Alberta and BC, it's not 100% coverage. Nova Scotia and Quebec cover

100% as well, but I'm not sure about other provinces.

As for braces, private insurance plans do usually cover them, if you

have dental coverage, but only up to a lifetime amount (my plan,

with SunLife, covered C$ 2,500). Ortho treatment for me was C

$10,000. I also paid C$ 1,200 to my surgeon for out-of-hospital care

(visits to his office).

Keep all your receipts and be sure to consider a claim for medical

expenses on your income tax return.

>

> hey there,

>

> i live in Canada, so our national gov't healthcare covered all

aspects of my surgery (including hospital care, anesthesia, etc,

etc.), no questions asked (though that's because jaw surgery is

accepted here as a medical treatment...a purely cosmetic " nose job "

would obviously not be covered).

>

> The braces, however, are not covered and i'm paying around $7500

CAD for that (around $6000 USD). I pay monthly for that though,

spread over two years, and there's no interest. However, there are

some insurance plans that would cover braces partially, but as far

as I know, both here and in the US, most insurance plans don't cover

braces (which annoys me, cuz it's strange how my jaw surgery is

covered, but the braces which are being used essentially for the jaw

surgery, are not covered).

>

> -jessica

[Guest guest]

Hi LuvProfusedChulo,

I don't know if Medicade will pay for this surgery. You could

probably call your state offices and ask them directly about it. If

they don't cover it there may be other options, however. Many cities

have clincs where dentists do pro bono (free) work. They can refer

you to the network of charitable dental health care in your area.

Many times there are dental schools which train dental specialties who

will do work, and probably have contacts in the communtity to OMS's wo

will provide this kind of care. It will probably require more

planning and research on your part, but I think there are options you

can see if will work for you. Please let us know what you find out.

What you discover might help others in similar situations also. Good

luck with this!

Hugs,

Fran

>

> Do any of ya think Medicaid might cover it?? this is a serious

question

> cuaes thats the insurance i only have.

>

>

>