Discussing Jaw Concerns w/ Physician?

[dayeangphurr]

I would like to take the opportunity of being under my parent's insurance to present a medical necessity of undergoing orthognathic surgery and being covered for the procedure. Therefore, two prominent concerns of mines is my mouth breathing and recessed jaw. I'm 22 and I've been a mouth breather almost my whole life as I can remember. I haven't discussed my intentions for the surgery with my parents as I prefer to maintain the subject matter private until I receive a proper assessment on my situation.

I'm planning to request a referral from my physician for a sleep study, however, should I address my concerns regarding my jaws to him?

I want to avoid being suggested the CPAP treatment as the surgery is overall, more beneficial in the long run.

[Nathaniel]

I would like to take the opportunity of being under my parent's insurance to present a medical necessity of undergoing orthognathic surgery and being covered for the procedure. Therefore, two prominent concerns of mines is my mouth breathing and recessed jaw. I'm 22 and I've been a mouth breather almost my whole life as I can remember. I haven't discussed my intentions for the surgery with my parents as I prefer to maintain the subject matter private until I receive a proper assessment on my situation.

I'm planning to request a referral from my physician for a sleep study, however, should I address my concerns regarding my jaws to him?

I want to avoid being suggested the CPAP treatment as the surgery is overall, more beneficial in the long run.

I'm not too sure how the system works in the U.S., though here in order to see an oral surgeon you generally need to be referred to them by an orthodontist. Perhaps a family doctor can do the same, though I'm not sure.

That said, there are many threads/posts on the forums here that discuss insurance coverage. Many get approved, though from what I recall not all costs are covered, there's always something that comes out of the pocket; and then there's something about the surgeons being in your insurance' network.

Sorry I couldn't provide too much insight. I do believe you have a very valid reason though! Mouth breathing/jaw problems can cause medial issues down the road. I would believe the insurance companies would understand that, its just the general public that views it more as a cosmetic thing. Those in the know, know it's not all about appearance.

Best of luck!

[dayeangphurr]

Thanks for your response Nathaniel.

[Christina28]

I'm not sure if your question is primarily health or insurance related, but if it is an option for you I'd suggest seeing an oral surgeon who does a large number of jaw surgeries and is well versed in these issues. Physicians vary greatly in their knowledge base about these type of surgeries. Oral surgeons are your best bet for a quicker diagnosis keeping in mind that not all oral surgeons do this type of surgery also. In picking an oral surgeon, one of the questions I'd ask is "on average how many jaw surgeries do you typically do per year?". You want a substantial number. Don't hestitate to get more than one opinion. The sleep study can be helpful in getting insurance approval if sleep apnea is an issue, but there are other valid medical reasons for the jaw surgery.

[dayeangphurr]

Hey Christina28,

I'm slightly hesitant of going around consulting with different surgeons because of the consultation fees. Doesn't the rate of the consultation fees vary on whether the patient has insurance or not?

[dayeangphurr]

But if the rate of the consultation fees remain the same for all patients regardless of being insured or not, I'll still have to cough up about an estimate of $200 to every consultation I attend to. The last time I called UCLA's oral surgery department inquiring their fee - it was $200. And I don't believe that included the x-ray fee if I wanted one, which I would go for as well. I plan on consulting with a minimum of 2 or 3 different surgeons, but that's also quite the load of money. Although, I definitely haven't ruled out that option. It's still very early on in this process and I'm awaiting for my approval for a sleep study so I'll see.

[dayeangphurr]

Oh, this whole insurance coverage ordeal has got to be one of the most frustrating and confusing things ever! Haha. I'm trying to understand how the system works without the convenience of asking my parents, not easy.

[bbsadmin]

Just call the insurance company and ask them. If you know the insurance policy number or what type of plan they have, the company will tell you what they'll cover.

[dayeangphurr]

Thanks bbsadmin.