How To Get Insurance To Cover Jaw Surgery

If you dont have a coverage booklet you received at work or by mail log in to the website for your medical insurance. The following represents exceptions to the orthognathic jaw surgery exclusion and may be eligible for coverage as reconstructive and medically necessary.

Orthognathic Surgery All Alaska Oral Craniofacial Surgery

Luckily I have Kaiser through my employer so my projected cost for outpatient surgery is only 15.

How to get insurance to cover jaw surgery. Get Instant Quality Results Now. Two examples are Aetna. Find out how we can make it possible for most patients to obtain this procedure.

The easiest way to find out if your jaw surgery will be covered by your medical insurance is to look at your plan. Your doctor has access to departments and decision-makers that you do not. Does Insurance Cover Jaw Surgery.

Here is a checklist when first examining if you will have coverage or not. If you have purchased a Medigap supplemental insurance it may help pay for some of the out-of-pocket costs. This way your physician and the OMS can determine whether or not you have a skeletal deformity as many medical insurance plans will not take a referral from an orthodontist or dentist.

Some types of medical insurance policies require that your provider bill the dental insurance company first and then once that claim is processed you can file a claim toward medical insurance. They will cover my surgery because it is considered medically necessary but are billing it under CPU Codes for Medicare. This is the first step in getting approval for jaw surgery.

Ive found that its best to have a cephalometric x-ray in hand when you go. So many people have been denied jaw surgery coverage myself included for legitimate functional reasons simply due to the fact that their employers health plan has a direct exclusion for jaw surgery. I am 26 and it has been recommended by my orthodontist to have jaw surgery to fix my underbite.

I have had a very weak chin and jawline most of my life. If your surgeon is worth anything he can get insurance to see it your way even if it means making it sound as awful as heshe can. I have also snored my whole life.

You should get a detailed reason why its denied many elective procedures are if they are not medically necessary which can be a vague term. Is orthognathic surgery a covered benefit in your insurance. Acute traumatic injury Cancerous or non-cancerous tumors and cysts Obstructive sleep apnea.

Most plans have minimum criteria to consider jaw surgery a medically necessary procedure that they will cover IE. Jaw Surgery Your medical insurance might cover corrective Orthognathic jaw surgery when medically necessary. I have heard that a recessed chin could be the cause of this.

Get your doctor involved. Jul 13 2012 Corrective jaw surgery is necessary surgery which is typically covered under your health insurance. Insurance companies are cancer they are only there to make money so you gotta squeeze them a bit to receive help sometimes.

I refused jaw surgery about 12 years ago and now I am regretting it as my bite has gotten worse. If you have Original Medicare jaw surgery will be covered like most other surgical procedures at 80 leaving the patient to cover the remaining 20 of the cost. Does Medicare pay for jaw surgery.

Look for Your Medical Insurance Coverage PDF File. For anyone else that is looking to switch to Kaiser for surgery Kaiser only has HMO plans. I posted in PF today Put Jaw Surgery 20k on Credit Card or Take Out Loan it was suggested to post on here too.

I am aware there is a 12 month waiting period on this surgery so I want to sign up for health insurance asap. I have no health insurance. Aug 27 2021 The surgery was covered by his Premera Blue Cross plan 5000 lifetime limit on coverage for the reconstructive jaw procedure known as 32.

I had braces for 3 years in my teens. For more information please. If I have OSA I.

After you discuss your case with the insurance company representative and you are approved ask them to send an approval letter to you. If considering TMJ surgery ask the surgeon to send your insurance company a letter of medical necessity which details why you need the surgery what the procedure entails any hospital stays etc. Under those codes I am only reimbursed 29k for the 20k surgery.

Orthognathic jaw surgery is a standard exclusion from coverage in most fully-insured plans. They all cover the surgery. I know thats rather vague so let me describe what I mean.

Skeletal discrepancy of at least 5mm sleep study showing apnea nutritional deficiency because your bite is so off etc. For example some insurance companies eg. They then have to delay major life decisions buying a home due to needing to use savingsloans to pay for surgery.

Get Instant Quality Results Now. While many patients come to us with 31. I have Cigna with my firm.

My insurance wont cover surgery unless it is medically necessary. If you have purchased a Medigap supplemental insurance it may help pay for some of the out-of-pocket costs. Get it in writing.

Aetna consider jaw surgeries to be medically necessary if the skeletal irregularities cause sleep apnea disorder breathing issues andor severe speech impediments. If you have Original Medicare jaw surgery will be covered like most other surgical procedures at 80 leaving the patient to cover the remaining 20 of the cost. Most the time it isnt even a doctor denying you getting your work done.

Grant discusses this very common question. How Much Does Medicare Cover for Jaw Surgery. If you have health insurance orthognathic surgery may be covered in some cases.

You can appeal anything. Ad Get Get Insurance. Ad Get Get Insurance.

Many Medicare recipients choose to get their Part A and Part B benefits through a. But your actual copaycoinsurance will vary depending on how good your plan is. Have this letter detail specifics on what treatments are covered.

Get their reasoning and check. You can sue for anything. Answer 1 of 3.

The operative procedure treats an illness injury condition disease or its symptoms. Your dentist or oral surgeon will need to provide supportive data and clinical notes to support why a particular procedure needs to be completed a certain way. Call often after the letter of medical necessity is sent.

Oral surgeons can perform operations on your jaw for many different reasons and some fit the coverage criteria exactly not at all and somewhere in between.

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