Re: question for all

[Guest guest]

Hi Amelia,

Under my employment I have Cigna, my husband has Aetna. Cigna did

not approve my surgery. My surgeon said he has problems with getting

approval from Cigna, but said he has had success when working hard on

them. As it turned out, he didn't have to push Cigna, because Aetna

approved my surgery.

In my case, I have a Class II malocclusion, i.e. a very deep

overbite. As a result, I have TMJ and arthritis in my left joint. I

don't have headaches, I did loose my hearing once in my left ear at a

time I was really grinding my teeth at night, but it came back. I

have popping and grinding noises in my left joint. Sometimes I have

to push my jaw to the left to unsnap it, because it get's locked.

Hope this helps. You'll need a doctor who is willing to be

persistent with Cigna.

Virginia

> Now that I'm in the process of trying to justify my jaw surgery to

my insurance

> (Cigna), I'm curious about those of you who've had the surgery.

What was it

> about your condition that cleared the " medical necessity " hurdle

with the

> insurance people?

>

> I'm not shopping for ideas. I believe I have justification of my

own, based on

> eating difficulties, excessive teeth wear, muscle tension to force

my lips

> closed, and general tmj-related stuff like headaches, ringing ears,

extreme

> jaw fatigue, etc.

>

> I'm just curious about what, exactly, they consider " functional

impairment " to

> be, and also what the rest of you have suffered as a result of your

jaw

> misalignment.

>

> By the way, I have a class II occlusion with an anterior open bite.

I don't know

> how wide the open bite is, but my surgeon and orthodontist

described it as

> " signficant. "

>

> Thanks!

> --Amelia