Surgery and work

[CCinBraces]

Ok so--let me ask THIS--what was the worst part of the whole thing?

And-how long did you stay in the hospital? Apparently the "new" common way of doing jaw surgery is for the surgeon to NOT accept insurance--but instead to bill the patient directly. This means no one is dealing with the big fight with the insurance company in attempt to get them to cover the surgery and results in a FAR less significant cost for the actual procedure. I have been told that WITH insurance, it can range from $30k to 70k. Wow. But by not billing the surgery itself to insurance, the surgeon charges $2500.00 (you read that right) for a single jaw or 4k for double. Then the hospital stay/charges are billed separately...to the insurance...and Im told my length of stay in hospital is "mostly" up to me. (I haven't a clue what the cost of a hospital stay is) This is a strange way of doing things, imo.

[CCinBraces]

Funny thing is...the part I look forward to the least is sleeping upright. THATS how much I hate it. It baffles me that there are people who can sleep in cars or in a chair. I had a previous surgery where I *had* to sleep upright...didnt last long at all.

Rip me apart via surgery...ok I can handle that.

Sleep in upright position....WHAT?!?!?!! Oh no!

[jaime]

Hey CC,

I was only in the hospital one night but I'm in Canada so things are a bit different. The average seems to be 1-2 nights from what I've seen. I was discharged about 24 hours after surgery.

Sleeping upright isn't great of course but there are ways to mitigate the discomfort. I bought a foam wedge off Amazon to make it comfortable.
This is what I bought: https://www.amazon.com/InteVision-Wedge ... foam+wedge

I also made sure to have a nice comfy pillow behind my head. I use down pillows so it cradles my head a bit better. I also rolled up a towel, put a hair elastic around it to secure it, and had that behind my neck. Then I had a pillow under my knees for support. All of that made it MUCH more comfortable, which is why I was able to keep it up for a month.

What was the worst part? Probably the days when I wasn't hungry and didn't make myself eat, which ended up making me really sick. The medication is hard on your stomach. I was so nauseous and in pain that I ended up crying which made the swelling worse, and then I ended up vomiting. Do not let yourself go without food, even if you're not hungry.

[snapdresser]

Apparently the "new" common way of doing jaw surgery is for the surgeon to NOT accept insurance--but instead to bill the patient directly. This means no one is dealing with the big fight with the insurance company in attempt to get them to cover the surgery and results in a FAR less significant cost for the actual procedure. I have been told that WITH insurance, it can range from $30k to 70k. Wow. But by not billing the surgery itself to insurance, the surgeon charges $2500.00 (you read that right) for a single jaw or 4k for double. Then the hospital stay/charges are billed separately...to the insurance...and Im told my length of stay in hospital is "mostly" up to me. (I haven't a clue what the cost of a hospital stay is) This is a strange way of doing things, imo.

This is obviously a different issue than the sleep problem (though perhaps just as annoying ). Many of the "best" (perform the most procedures/year) surgeons don't accept insurance; I'm not sure that that's a 'new common way' but it's something that you do see from certain surgeons, especially those with big commercial fronts, fancy websites, etc. BUT keep in mind that the surgeon's charge isn't usually the biggest bill that you have to pay anyway. For me, the hospital and the anesthesiologist billed for way more than the surgeon alone did. That said, the hospital, anesthesiologist, pre-surgical testing center, and surgeon were all covered by my insurance and it only cost me $2000 total out of pocket for the whole shebang. They billed my insurance over $90k, which was significantly reduced for my plan allowance, but all I had to pay out of pocket was the $2k. My insurance paid $25,194 to the hospital (the plan allowance, otherwise it woulda been $59k), $2,642 to my surgeon (the plan allowance, otherwise it woulda been $13k), and $5,535 to my anesthesiologist (the plan allowance, otherwise it woulda been $15k).

The point is, the surgeons bill the insurance for a lot and if you pay out of pocket they'll probably be willing to reduce it, but what you'll pay the hospital and anesthesiologist will dwarf the charges from the surgeon. If you go to an in-network surgeon, all that stuff will be paid by your insurance (less your copays or whatever) AND the surgeon's rate (because they're in-network) will also be minimal (hundreds up to a couple thousand dollars, probably) instead of the $30-70k you're talking about.

The only way you'd pay $30-70k for a surgeon is if you either: a) don't have insurance and the surgeon won't give you a reduction for paying out of pocket, or b) you have insurance but the surgeon you want to go to isn't in-network. The person telling you that you pay $30-70k for a surgeon when you have insurance is probably talking about b).


PS - I used 2 of the wedges Jaime refers to. It'll suck but you can do it! At least for a while

[CCinBraces]

I'm a pretty tough gal when it comes to pain but my stomach has a serious ability to bring medications right back up. I have no doubt much vomit will be involved. Good to know how long you were on liquids only though. I imagine theres a lot of weight loss involved?

Wedge pillows---got it!

Thank you so much for that financial break-down! That helped greatly! I should have asked the doc about the cost of anesthesia--I had not idea it could be that much.

My ortho recommended two surgeons--the first accepts insurance but is NOT in my network-actually, he is not in ANY network. He takes insurance though, technically. I ruled him out quick. The second surgeon comes highly recommended from two orthos but he is the one who doesn't accept insurance for his portion. Im definitely worried about the hospital costs with him. Ill be back at the ortho on Monday so Im planning on asking for another reference. Obviously, I am trying to find a surgeon is accepts insurance and is in-network. No idea how long it will take to actually schedule the procedure from here.

My coinsurance is $3k which is quite a lot to begin with imo, plus I paid for the braces on my own. The cost of of bad jaw structure!!!

[snapdresser]

Your orthodontist may not be familiar with which surgeons accept what insurance. It's worth a shot to ask for an in-network reference from them IMO, but you may have to just go on your plan's website and find one yourself whose credentials look good. That's what I did and I'm extremely happy with my results

[Branwillaws]

all I can say is us canadians are pretty lucky when it comes to health care costs.

[CCinBraces]

all I can say is us canadians are pretty lucky when it comes to health care costs.

I envy you guys! America is a mess.

[sirwired]

On the costs thing: There are plenty of experienced orthognathic surgeons that take health insurance. Mine was by a OMFS professor at the local dental school, and he does about 400 a year. Maybe not as many as an orthognathic-exclusive surgeon, but he ain't exactly rusty. In any case, x2 on the idea that the hospital costs are no joke. That doesn't mean the surgeon will be cheap, but he/she isn't the only major cost. Don't dare have the surgery done at an out-of-network hospital unless you are made of money.

On the worst thing?: Having to live off of a liquid diet for a week was real dispiriting; there's only so many ways to get all your calories via something you can drink if you don't have an infinite sweet tooth. After I went on no-chew (vs. liquid), defined as "nothing tougher than scrambled eggs" it wasn't as bad. My "go to" meal was canned corned beef fried up in a skillet, mixed with mashed potatoes (just used flakes), and topped with generous cheddar cheese, sriracha, and ketchup. Delicious, although terrible for you if you weren't recovering from surgery.

I don't like sleeping upright either, but narcotics (and later, sleeping pills, after I wasn't taking the narcotics any more... DO NOT COMBINE) took care of that.

And wearing that &%#$#$*^$&@@*&! splint for nine weeks was the ($%&$*&#$&#!((!!! pits. (Thin cortical bone extended healing time.)

[Branwillaws]

Just saw my surgeon (30 day follow up,) I'm cleared to start work tomorrow but with 45 days of light duty. Remember I'm in the airforce so they kinda have to take care of me in that regard. Can't lift anything more than 50 lbs, no contact sports, pretty much obvious stuff. Which means I'll be filling out a lot of aircraft maintenence records... yay me... lol

[CCinBraces]

@sirwired Your go to meal makes me nauseous just thinking about it!!

My boss has been asking me if I am gong through with this or not--havent actually sat down to discuss details yet though...waiting on some concrete info first from the surgeon. I get the military having to back you up but for the others---employers were ok with this? My concern is missing a lot of work and despite it being deemed medically necessary, I am already seeing others think of it differently. Its not that I care what they think---but I care to keep my job.

[snapdresser]

I get the military having to back you up but for the others---employers were ok with this? My concern is missing a lot of work and despite it being deemed medically necessary, I am already seeing others think of it differently. Its not that I care what they think---but I care to keep my job.

My boss was super cool about it. I took 4 weeks off and they didn't make an issue of it at all. That said, the office wasn't getting slammed or anything, but I don't think that would have changed it. If my boss and coworkers noticed aesthetic improvements, they haven't mentioned it to me.