Insurance Uncertainty

This forum is for discussions relating to oral surgery for orthodontics.

Moderator: bbsadmin

Post Reply
Message
Author
Marisama
Posts: 233
Joined: Mon May 11, 2009 4:02 am
Location: USA
Contact:

Insurance Uncertainty

#1 Post by Marisama »

I've been to a number of Oral Surgeons that all say I would benefit from Orthognathic Surgery to fix my slight asymmetry and TMJ issues. I currently have University Health Insurance, which unfortunately has an exclusion for jaw surgery.
I need to choose from Blue Cross Blue Shield, Cigna, or Aetna. These are the companies that my surgeon, Dr. Reed Day in Phoenix, works with the most.
Does anybody have any advice about which insurance company is more likely to cover a surgery that is considered medically necessary by my surgeon?
Should I be concerned that my situation is a pre-existing condition?

Any help is greatly appreciated.

Thanks,
Ryan

cvn
Posts: 141
Joined: Thu Jul 09, 2009 9:56 pm

#2 Post by cvn »

Ask the surgeon which one he has had better luck with and generally pays out more. If he has an insurance person, pick that person's brain.

You will probably have trouble with a pre-existing condition, but you'll have to research the different plans to know for certain what you are looking at. Stuff I looked at generally had exclusions of around 18m+ before surgeries, but it depends on the plan. Depending on where you are in treatment, it might not be a big deal. Get copies of the plans and read over them with a fine toothed comb.

queenofoverbite
Posts: 101
Joined: Mon Nov 30, 2009 11:46 pm
Location: Kansas City

tip

#3 Post by queenofoverbite »

Blue Cross Blue Shield rejected mine as a "birth defect". WTF?
BSSO in Fall 2010!

CFP
Posts: 3
Joined: Tue May 10, 2011 8:23 pm
Location: Arizona

Re: Insurance Uncertainty

#4 Post by CFP »

RYANvaughn,
Hi I just came across your post and was wondering what insurance you ended up with and if they covered your surgery? I am also interested in your thought on Dr Day? I have an appt with him next week. Thank you!

streo
Posts: 61
Joined: Wed Apr 13, 2011 6:21 am

Re: tip

#5 Post by streo »

queenofoverbite wrote:Blue Cross Blue Shield rejected mine as a "birth defect". WTF?

I have BCBS as well. Do they cover anything at all? I've saved up money over the past two years to have this surgery done just in case insurance covers nothing, but it would be comforting to hear what exactly the breakdown is and where insurance leaves you high-and-dry. If they don't cover the stay at the hospital, then I guess I'll have to save up again to purchase that home I've always wanted!

Post Reply