Metal Mouth Message Board

Message

#1 Post by **dye4pooh** » Sun May 01, 2005 4:31 am

Hi I havent posted in a long time, this has been one long process. I havent been braced yet. I went for my consult with the os last week and he said
with my deep overbite and all my other problems that my insurance company will probably cover my surgery so I am keeping my fingers crossed! I go tomorrow to get my molds done. I am nervous although this is the second time because I changed orthos long story but wasnt happy with the first one. My main concern is getting my insurance company to pay for the surgery because with 3 kids I dont want to have to pay for it.

Nancy

#2 Post by **Denakb** » Mon May 02, 2005 6:50 am

Hi there dye4pooh

What surgery are you trying to get your insurance to cover?

I'm having orthognathic surgery sometime this year and I just recently started the pre-approval process with my insurance company. To be honest, I fully expect them to deny it the first time around - I have Cigna and from what I understand they are notorious for that. We shall see... the one thing they don't know is that I'm bound to determined to get them to cover this surgery, so if they want to deny me, they will have a fight on their hands

Now lets hope my resolve pays off!!

Good luck to you!

#3 Post by **fyrelight** » Mon May 02, 2005 6:58 am

I have Cigna DMO, and had no trouble getting them to approve my canine exposure surgery, btw. It was listed in their list of covered benefits, so I guess they couldn't really refuse it.

#4 Post by **Denakb** » Mon May 02, 2005 8:54 am

Yea,, I have never had a problem having them cover oral surgery of different kinds.

Orthognathic surgery seems to be a whole other ball game and is generally under the medical portion of the insurance (as opposed to dental) and a lot of the time, the initial denial is based on their perception of it being "not medically necessary"

#5 Post by **dye4pooh** » Tue May 03, 2005 5:31 pm

Hello again,
I will be having my lower jaw moved forward maybe the top but hopefully just the bottom. Hopefully with the braces on things will move and I will only need the lower done. Went and had more molds done for the braces on monday so I'm on my way to a beautiful smile its just gonna take some time and alot of money!!

Nancy

Sun May 22, 2005 11:38 am

dye4pooh wrote:Hello again,
I will be having my lower jaw moved forward maybe the top but hopefully just the bottom. Hopefully with the braces on things will move and I will only need the lower done. Went and had more molds done for the braces on monday so I'm on my way to a beautiful smile its just gonna take some time and alot of money!!

Nancy

I just hope that you don't have UHC. They're notorious for not doing a thing about TMJ or about oral surgery. Even after appeals, forget it. There can be no fight, because they will tell you "No!--And that's final!" Doesn't matter how much pain you're in, even if it's documented. Doesn't matter if you can't chew food. They don't care.

So for anyone here in need of orthognathic surgery and who has UHC, drop it at once!

#7 Post by **nvcarissa** » Mon May 23, 2005 8:31 am

Hello all! Just discovered you guys today. I've been braced for 13 days. I will need orthognathic surgery to move my lower jaw forward (Class II malocclusion).

I was lucky with UHC, got it approved on the first go-round. Might have had something to do with my OS emphasizing the functional problems I have been having and stating, "It should be noted that this is not being done for cosmetic reasons but for functional problems."

However, my OS did expect problems with approval...a problem with more and more insurance companies...and we were all pleasantly surprised at the approval on the first try.