Re: Insurance Questions. Looking for some answers please!!!

[Guest guest]

I am still going through the insurance phase. I'm not sure what they

will and will not pay and won't know until I get the whole work-up from

the ortho on the 19th. (We should know what all needs to be done

then) At this point, we are not sure about the upper jaw. I have

chosen a provider in my network. I know someone who went out of

network and the surgeon alone was $9,000. Her insurance paid $3,500.

of that. I'm not sure if that is customary since this is the only

example I have.

In response to your question about the cost of braces, I am not sure

(again Sep 19th is the magic day. My son has the same ortho and his

braces were $4,800. and the covers everything from beginning to end.

> For those of you that chose a surgeon out of your insurance network,

> did you have to pay a lot of money?? I have BlueCross BlueShield as

my

> health insurance, and some of the best surgeons in my area aren't in

my

> network of providers. My situation is pretty complex (I am going to

> need upper, lower, and a genio. I have an underbite, crossbite, and

an

> open bite) so I don't want to go to someone that is only so-so. Does

> it make sense for me to go out of network, or will I be paying an arm

> and a leg for that??

>

> Thanks,

> Sam

[Guest guest]

Sam - My surgeon (and all the OS's here) are out-of-network; I have my

insurance thru Blue Cross of Idaho. I will be having my surgery at a

small short-term hospital here in Boise that my OMS has privileges at;

in fact, he does most of his surgeries there. I am employed at one of

the large hospitals in town, but I can't afford to have the surgery

there. Orthognathic surgery is an excluded benefit with my insurance

that I have thru my employer. By having my surgery at the small

hospital, I will only be charged one-quarter to one-third of what my

hospital/employer would be charging me - it's a no-brainer! My surgery

will probably be a BSSO set-back & a LeFort to advance my maxilla. My

surgeon's fee for just a BSSO is $6K and the hospital charges will

range from $2.5K to $6K. This will all be out-of-pocket for me. I feel

my OMS is the BEST one in this city and I would never trust someone

else to do this. I hope all this helps. ~~ Diane

> For those of you that chose a surgeon out of your insurance network,

> did you have to pay a lot of money?? I have BlueCross BlueShield as

my

> health insurance, and some of the best surgeons in my area aren't in

my

> network of providers. My situation is pretty complex (I am going to

> need upper, lower, and a genio. I have an underbite, crossbite, and

an

> open bite) so I don't want to go to someone that is only so-so.

Does

> it make sense for me to go out of network, or will I be paying an

arm

> and a leg for that??

>

> Thanks,

> Sam