Best country for jaw surgery?

[stymiedintheusa]

Hi all, I'm new here.
16 years ago I was hit by a car while riding my motorcycle and my mandible was broken into four pieces. Surgery did not go well. I won't bore you all w the details. It's been a saga. The short of it is that I need upper and lower jaw advancement to correct my airway size etc. I can't afford to have this done in California, where I live. I'm open to traveling and would appreciate any knowledge that any of you can share with me, especially first hand accounts of overseas surgeries experienced by anyone here.

Thank you,

Stymiedintheusa

[SingleJawMelb]

What's your budget? Not sure why you can't get it done where you live?

[glennstanzalone]

Hi all, I'm new here.
16 years ago I was hit by a car while riding my motorcycle and my mandible was broken into four pieces. Surgery did not go well. I won't bore you all w the details. It's been a saga. The short of it is that I need upper and lower jaw advancement to correct my airway size etc. I can't afford to have this done in California, where I live. I'm open to traveling and would appreciate any knowledge that any of you can share with me, especially first hand accounts of overseas surgeries experienced by anyone here.

Thank you,

Stymiedintheusa

If you can afford to travel and stay in another country while you recover from the surgery, I suggest purchasing insurance out of pocket and going through that avenue. That's what I did and my copay was about $200, the hospital billed insurance over 90k (what you pay without insurance) and the contracted allowable amount paid thru insurance was about 22k.

[stymiedintheusa]

I'd be happy to be able to figure out having the surgery in the US, trouble is, the doctor I trust to do the revision (3 failed surgeries elsewhere so far) charges $32,000 for his own and his assistant's fee and accepts no insurance because none of the insurance companies actually pay the bill, they only pay a small percentage of it. Which I guess a lot of people on here understand better than I do. Stanford charges approx. $150,000 for the use of their hospital where the surgery would take place. I don't want to ruin my credit over this. I don't want to go to a novice surgeon again, I have nerve damage and a receding jaw after that route. I'm totally confused by the insurance debacle. The hospital and the doctor each want a certain amount. The insurance companies cover much less than half of that. What happens to the remaining unpaid bill? Are we supposed to take out loans to cover it or something? Why even have insurance when we aren't actually insured if we do? I don't get it.

[SingleJawMelb]

You had your three surgeries done in USA?

[snapdresser]

I'd be happy to be able to figure out having the surgery in the US, trouble is, the doctor I trust to do the revision (3 failed surgeries elsewhere so far) charges $32,000 for his own and his assistant's fee and accepts no insurance because none of the insurance companies actually pay the bill, they only pay a small percentage of it. Which I guess a lot of people on here understand better than I do. Stanford charges approx. $150,000 for the use of their hospital where the surgery would take place. I don't want to ruin my credit over this. I don't want to go to a novice surgeon again, I have nerve damage and a receding jaw after that route. I'm totally confused by the insurance debacle. The hospital and the doctor each want a certain amount. The insurance companies cover much less than half of that. What happens to the remaining unpaid bill? Are we supposed to take out loans to cover it or something? Why even have insurance when we aren't actually insured if we do? I don't get it.

I kind of doubt you'll be able to find a great surgeon (with a thorough knowledge of complex revisions) for cheap in another country. Maybe you should consider looking for another doctor that you trust in the US? Also, I've read stories on here about people getting expensive specialists paid for by their insurance because their insurance acknowledged that the regular "Preferred" surgeons weren't adequate for the revision they required. Maybe that's worth looking into? Good luck, buddy. I can only imagine what it would be like to get a bimax 4 times.

[glennstanzalone]

I'd be happy to be able to figure out having the surgery in the US, trouble is, the doctor I trust to do the revision (3 failed surgeries elsewhere so far) charges $32,000 for his own and his assistant's fee and accepts no insurance because none of the insurance companies actually pay the bill, they only pay a small percentage of it. Which I guess a lot of people on here understand better than I do. Stanford charges approx. $150,000 for the use of their hospital where the surgery would take place. I don't want to ruin my credit over this. I don't want to go to a novice surgeon again, I have nerve damage and a receding jaw after that route. I'm totally confused by the insurance debacle. The hospital and the doctor each want a certain amount. The insurance companies cover much less than half of that. What happens to the remaining unpaid bill? Are we supposed to take out loans to cover it or something? Why even have insurance when we aren't actually insured if we do? I don't get it.

The remaining amount of the bill is forgiven. Insurance contracts with certain hospitals and doctors to offer services hence in network and out of network. Hospitals bill as much as possible and insurance says "hey we have already negotiated to pay this much for that service". Hospitals says ok cool. You only have to pay your copay and coinsurance. Sounds like you should get a referral from the surgeon you trust to someone who accepts your insurance. Or get a policy that covers a substantial amount for an out of network provider and find out who is contracted in network for stanford hospital. I'm honestly surprised your surgeon doesn't have a billing specialist that will help you with this.

[stymiedintheusa]

Much thanks for the explanation of insurance coverage. The surgeon's office has a person who handles insurance, but she didn't mention anything about any portion of the bill being forgiven. Any chance you're in CA and have had a good experience w a surgeon here?

[wcom939]

It depends the agreement the hospital has with the insurance company and if the Doctor is also considered "in network" or "out of network."

Also Stanford charging 150k might be the "chargemaster" price but not the actual out of pocket price, also remember some hospitals contract out their anesthesia services and those aren't included in the bill / will also need to be approved by insurance.


I had my surgery done in New York State (where I live), for the most part dental insurance is irrelevant for this procedure so I'll only refer to my medical insurance in this example, I have a BCBS PPO plan.

My surgeon accepts BCBS PPO but charges for what BCBS refuses to pay as far as consultation fees go. I am unsure if he is going to charge for the amount of the surgery BCBS won't pay for (they have approved the procedures, so they will give him something), but as he is a private physician he is not bound by a contract to accept what BCBS gives him and walk away.

The hospital however is different, every hospital has whats called a chargemaster which is a reference of all charges super 150-300% inflated the actual cost used internally in the hospital. If you pay out of pocket you might notice that suddenly you'll see a 150-300% discount applied that is due to the fact the chargemaster price is inflated on purpose to haggle with insurance companies so hospitals can get the most possible amount of money.

In my case since I went to an "in-network" hospital my hospital might ask for $150,000, BCBS might say Nah but we'll give you 32k and the hospital will say thank you and walk away.

The issue is in Cali i know everything's all messed up as far as insurance goes. I believe all the kaiser hospitals for example charge you chargemaster prices even if you pay out of pocket, so unfortunately I don't have much advice there.

What I can suggest you do is poll what insurance options you do have/can afford, then call your surgeon and see what they believe the costs will be for each one, and then call the hospital and ask if they are "in-network" with the insurance companies you polled.

Just remember though for this surgery most insurance companies will require a pre-approval and a ton of paperwork backing that up, in my case I got lucky and my insurance company allowed my surgeon to file the appeals so I didn't have to do anything, however some insurance companies require you to file the appeal which might seem overwhelming.

[glennstanzalone]

YAS what the previous poster said. Unfortunately I got my surgery in Arizona. I'm sorry I can't help out more!

[SingleJawMelb]

I wonder why Australia seems a lot cheaper?

I had mine done through health insurance. My surgey cost $8k, of which I could get back $2k through insurance. The hospital cost me nothing, but I believe it's around $600 per night.

Not sure how much it would cost out of pocket without insurance. I paid my surgey in full before treatment, and claimed the rest back.

I'm an international student BTW. I'm not suggesting you all come and study for a short time, I just wonder why it's so cheap.

[stymiedintheusa]

Thank you all who have taken the time to try to help me figure this out. I'm having a phone meeting w the dr. who I hope to receive an operation from shortly, to learn whether or not Medi-Cal is something he's willing to work w. Rebeccaa, I have family in the Newcastle area north of Sydney. I could stay there before/after the surgery if I come to Oz to have it done. Do you know if the dr. you went to is capable of complex revision surgery? I already have titanium plates in my mandible, one of them in the left joint, incorrectly placed. It's not going to be a standard surgery. I could afford to pay the $8k for the surgery, but I'm confused about whether that's the amount a person without insurance pays or if I have to purchase insurance to get that price, and then get partially reimbursed like you did. The complexity of the insurance schemes are absurd. Here in the states it's difficult to know what the bill will be until after the surgery.

I have heard good things about the quality of surgical work done in Berlin. Has anyone here any experience there?

Thanks, all of you.

[wcom939]

Be aware that if you do this in another country alot of the rates people in those countries experience will be alot less than yours as most european countries (and canada, and Australia) have some sort of tax subsidized health scheme. If you are a foreign national you're going to be looking at a substantially higher cost.

I believe (And correct me if I'm wrong) in Austrailia there is a basic national health service plan + the option of buying private insurance. The previous poster who said they got 2k back probably had private insurance, that 8k figure is for those folks with public insurance, since you'd be a foreign national (unless you have dual Aussie/US citizenship if that's possible) you're looking at a substantially higher figure.

Now while it is true that US health is usually 10-15% premium over other countries (30% premium on big pharma) the hassle of going to another country, staying there for X months, applying for visas, currency exchange, etc probably outweigh most options with the exception of Canada which is still going to be a high cost for surgery as foreign nationals are not covered under health Canada.

As far as countries in general that perform the most Orthognathic surgeries are basically the USA and the UK with Austrailia coming in as a distant third. The pound is significantly stronger than the dollar so regardless doing it in the UK will be extremely expensive, the aussie dollar is weaker but the cost of living is higher through taxes and whatnot, you have family there so Austrailia might be an option for you but definitely realize that 8k figure is probably nowhere near the ballpark of the actual figure a foreign national will get charged.

Your better option might be looking in to a different state for example doing the surgery in Seattle or Portland might be cheaper.

[wcom939]

Actually slight correction on the above post, South Korea performs a significant amount of these surgeries as well but mainly for cosmetic purposes.

[SingleJawMelb]

Be aware that if you do this in another country alot of the rates people in those countries experience will be alot less than yours as most european countries (and canada, and Australia) have some sort of tax subsidized health scheme. If you are a foreign national you're going to be looking at a substantially higher cost.

I believe (And correct me if I'm wrong) in Austrailia there is a basic national health service plan + the option of buying private insurance. The previous poster who said they got 2k back probably had private insurance, that 8k figure is for those folks with public insurance, since you'd be a foreign national (unless you have dual Aussie/US citizenship if that's possible) you're looking at a substantially higher figure.

Now while it is true that US health is usually 10-15% premium over other countries (30% premium on big pharma) the hassle of going to another country, staying there for X months, applying for visas, currency exchange, etc probably outweigh most options with the exception of Canada which is still going to be a high cost for surgery as foreign nationals are not covered under health Canada.

As far as countries in general that perform the most Orthognathic surgeries are basically the USA and the UK with Austrailia coming in as a distant third. The pound is significantly stronger than the dollar so regardless doing it in the UK will be extremely expensive, the aussie dollar is weaker but the cost of living is higher through taxes and whatnot, you have family there so Austrailia might be an option for you but definitely realize that 8k figure is probably nowhere near the ballpark of the actual figure a foreign national will get charged.

Your better option might be looking in to a different state for example doing the surgery in Seattle or Portland might be cheaper.

I'm a student in Aus, I'm not a resident, and part of the agreement means I have to have private health insurance (known as overseas student health cover - OSHC). When I had my surgey, the public system (which I also benefit from, being British, known as "recipical benefit") wouldn't pay me anything. However the health insurance would. I had to pay $8k up front, even though the surgeon has the ability to claim from the health fund. I paid my surgeon upfront, but the ananestestic guy I paid the "gap". It's also worth noting $2k of surgey came from wisdom tooth removal (which is probable in almost all surgeries). So the cost was $6k, of course the hospital charged their fees (of which I paid nothing).

I think the best thing I can do is ask my surgeon for guidence.

Interesting you say the UK performs a lot of these surgeries - public or private? They are completely different systems, but in Aus the public purse does give a small amount to most surgeries.

When I was in England I was told I could get jaw surgey to fix my bite but braces were for "cosmetic reasons" and wouldn't be put on. My Melbourne surgeon suggested I might need double surgey (pre braces consult) but braces meant I only needed single. Why would they perform more surgey than needed, higher risks and worse result!