New to the boards - questions about insurance (United Healthcare in particular)

[Guest guest]

Hello! I'm new here and just wanted to say what a huge help this

site has been so far. I'm 29 years old and am getting ready to have

jaw surgery for the 2nd time. I had a fairly severe underbite and crossbite as

a child

and had surgery for it when I was 14 years old. It was a pretty rough experience

but I'm

glad I did it. The orthodontist that I've been seeing was schocked that I had

the

surgery so young. My surgeon thought that I had quit growing but - surprise! -

I didn't

and my bite has relapsed over the years. I have my first surgery consultation

this

Wednesday with a Dr.Roser at the Emory Orthognathics Dept in Atlanta. I'm

nervous but

also a little be excited....I've known for a long time that I needed to have

surgery

again and finally feel ready to go through the process all over again.

My biggest concern right now is with insurance coverage. My first surgery was

not

covered (even after many appeals) and it cost over $50K! (I almost died when my

mother

told me how much it had all cost) From what I've been reading it seems like the

prices

have come down but I'm still terrified at the idea of paying for this out of

pocket. I have

United Healthcare and have been looking through my booklet on their exclusions

and

included services - in one section it says any orthgnathics procedure is not

covered but

then somewhere else it says that treatment for TMJ would be covered. I don't

really have a

lot of jaw pain (TMJ) but I wondered - how willing are surgeons to help you out

with

submitting something under a certain code, even if that code does not

necessarily best fit

your problem? I'm just wondering if there is a way to approach this with the

insurance

company that would make it more likely to be accepted?

If anyone has any advice on insurance codes or working with United Healthcare I

would

greatly appreciate it!

Thanks!

W.