I need your help

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#1 Post by **Lavon05** » Fri May 16, 2008 10:22 am

Hello,
I'm new here. I have been in braces for 6 months. I have a slight underbite with a misaligned jaw, one side grew longer than the other so my smile/jaw is off to the right. My ortho has already told me I need surgery, but I have no insurance so he is trying to fix it as best he can with just braces. I have decided though that I REALLY WANT this surgery done so I can chew my food and not have my jaw clicking on the one side. I am going to have to pay for insurance out of pocket, but I have no idea who will cover jaw surgery. I have been researching this for weeks now. I was wondering those of you who have had or will have surgery, can you tell me what insurance company you use.
Thanks a million!!

#2 Post by **Delag** » Fri May 16, 2008 4:22 pm

Sorry, I can't help as I paid out of pocket, but welcome aboard! I am sure others can answer you question.

#3 Post by **smileyone44** » Fri May 16, 2008 7:33 pm

Hey there, it sounds like my pre-surgery jaw alignment situation was very similar to yours. I have UnitedHealthcare insurance and my surgery was covered. However, a word of warning--the surgery was specifically excluded under my insurance plan, but once my surgeon submitted my x-rays and a letter explaining that the surgery was "medically necessary" the insurance company ended up covering it.

Best of luck to you!

#4 Post by **suetemi** » Fri May 16, 2008 11:16 pm

What city are you in? If there's a dental school nearby, it might be worth contacting the oral/maxillofacial department and seeing if they have discounted rates for people without insurance OR you may be eligible to do surgery at a county hospital for relatively cheap. Just a suggestion...I was going to go down this path myself until my insurance company finally approved.
Is it possible to get insurance through your job or school? Group policies are the way to go, imo.

#5 Post by **ssspidermom** » Sat May 17, 2008 7:48 am

I have Blue Cross/Blue Shield. My OS wrote a "letter of medical necessity" which got it covered, documenting problems with speech and eating, pain, etc. BUT, if you get a new policy as an individual (i.e. NOT in a group) there will most definitely be a 12 month pre-existing condition clause that says you can't get coverage for ANY condition you have had in the past, for the 1st 12 months. ALSO, individual policies will ask about any conditions you have - if you disclose it, they may not cover you or may quote a rate so high, it isn't worth paying for 12 months just so they will pay the 60% or 80% minus deductible. If you DON"T disclose the condition when you apply, they will NOT cover it when you try to get it covered, because of a fraudulent application (happened to a friend, whose husband didn't mention her gall bladder problem when he applied and then she had surgery, and they canceled her policy and didn't cover it!).

Might be cheaper to save the amount you would pay for insurance each month until you have the amount for the surgery.

My OS office also offers something that is like called "care credit" or something like that, that allows you to pay over 12 months same-as-cash, and over 3 years at some interest rate. This would be a really good option for anyone without insurance, as the payments are probably less than ins. premiums.

Good luck to you! There is lots of good advice and support on this message board!
take care,
ssspidermom