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First best step: find a surgeon you trust for the surgery who is

attuned to helping you get it covered. Mine was wonderful about this;

some others sometimes just seem to wash their hands of it.

For me, the approval came first time we asked. Some others have to

battle and battle, and even get lawyers or go to court. Some never

win approval.

Ask your surgeon what he/she thinks about your chances of getting

approval from your company.

It seems to me that I've read about Kaiser generally being pretty

cooperative. Cigna, I think, has a rep for being really tough about

it. You also need to read your policy carefully (particularly your

MEDICAL policy, as that's what usually covers it, rather than your

DENTAL insurance -- which latter, though, may pay a portion of your

orthodontic fees), to see what exclusions there are.

Good luck.

Cammie

> Is it hard to get insurance to pay for this type of surgery? I

> really need to have it done, but wonder how hard it is to get

> insurance to pay for it.

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First best step: find a surgeon you trust for the surgery who is

attuned to helping you get it covered. Mine was wonderful about this;

some others sometimes just seem to wash their hands of it.

For me, the approval came first time we asked. Some others have to

battle and battle, and even get lawyers or go to court. Some never

win approval.

Ask your surgeon what he/she thinks about your chances of getting

approval from your company.

It seems to me that I've read about Kaiser generally being pretty

cooperative. Cigna, I think, has a rep for being really tough about

it. You also need to read your policy carefully (particularly your

MEDICAL policy, as that's what usually covers it, rather than your

DENTAL insurance -- which latter, though, may pay a portion of your

orthodontic fees), to see what exclusions there are.

Good luck.

Cammie

> Is it hard to get insurance to pay for this type of surgery? I

> really need to have it done, but wonder how hard it is to get

> insurance to pay for it.

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  • 2 months later...

The actual cost of my surgery was 75,204.75, sorry I was off by a

few thousand. The reason the cost of my surgery was higher than

most was because I had to have the surgery re-done two days after

the first. The approximate breakdown of charges was $7500 for a

private room, $1,650 for pharmacy, $23,300 for supplies/devices,

$500 for lab, $31,500 for the operating room, $8,800 for anesthesia,

and $2,000 for the recovery room. Thank goodness for insurance!

Shayna

> > >

> > > Did you guys have any trouble getting your surgery approved by

> > your

> > > Medical Insurance? I have BC/BS of California and I don't know

if

> > > they will cover my surgery. Does anyone know?

> > >

> > > Second question, how much further do I have to go when my

> > > Orthodontist is already closing the spaces between my teeth and

> he

> > > said to me that his getting me ready for Surgery.

> >

> >

> >

> >

> >

> >

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The actual cost of my surgery was 75,204.75, sorry I was off by a

few thousand. The reason the cost of my surgery was higher than

most was because I had to have the surgery re-done two days after

the first. The approximate breakdown of charges was $7500 for a

private room, $1,650 for pharmacy, $23,300 for supplies/devices,

$500 for lab, $31,500 for the operating room, $8,800 for anesthesia,

and $2,000 for the recovery room. Thank goodness for insurance!

Shayna

> > >

> > > Did you guys have any trouble getting your surgery approved by

> > your

> > > Medical Insurance? I have BC/BS of California and I don't know

if

> > > they will cover my surgery. Does anyone know?

> > >

> > > Second question, how much further do I have to go when my

> > > Orthodontist is already closing the spaces between my teeth and

> he

> > > said to me that his getting me ready for Surgery.

> >

> >

> >

> >

> >

> >

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Shayna, wow, but how much was the surgeons fee? Our hospital bill was

covered 100%.

WENDY

Re: Insurance

The actual cost of my surgery was 75,204.75, sorry I was off by a few

thousand. The reason the cost of my surgery was higher than most was

because I had to have the surgery re-done two days after the first. The

approximate breakdown of charges was $7500 for a private room, $1,650

for pharmacy, $23,300 for supplies/devices, $500 for lab, $31,500 for

the operating room, $8,800 for anesthesia, and $2,000 for the recovery

room. Thank goodness for insurance!

Shayna

> > >

> > > Did you guys have any trouble getting your surgery approved by

> > your

> > > Medical Insurance? I have BC/BS of California and I don't know

if

> > > they will cover my surgery. Does anyone know?

> > >

> > > Second question, how much further do I have to go when my

> > > Orthodontist is already closing the spaces between my teeth and

> he

> > > said to me that his getting me ready for Surgery.

> >

> >

> >

> >

> >

> >

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Shayna, wow, but how much was the surgeons fee? Our hospital bill was

covered 100%.

WENDY

Re: Insurance

The actual cost of my surgery was 75,204.75, sorry I was off by a few

thousand. The reason the cost of my surgery was higher than most was

because I had to have the surgery re-done two days after the first. The

approximate breakdown of charges was $7500 for a private room, $1,650

for pharmacy, $23,300 for supplies/devices, $500 for lab, $31,500 for

the operating room, $8,800 for anesthesia, and $2,000 for the recovery

room. Thank goodness for insurance!

Shayna

> > >

> > > Did you guys have any trouble getting your surgery approved by

> > your

> > > Medical Insurance? I have BC/BS of California and I don't know

if

> > > they will cover my surgery. Does anyone know?

> > >

> > > Second question, how much further do I have to go when my

> > > Orthodontist is already closing the spaces between my teeth and

> he

> > > said to me that his getting me ready for Surgery.

> >

> >

> >

> >

> >

> >

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,

On my itemized bill, it doesn't show what the surgeon's fee was.

I'm guessing it was around $18,000. There are two charges listed

under Level 2, the first for $12,420 on June 7th, and the second for

$5,520 on June 9th. There is also a charge of $1800 for both of

those days listed under Level 2 - I. I'm not sure what that is for.

Shayna

> > > >

> > > > Did you guys have any trouble getting your surgery approved

by

> > > your

> > > > Medical Insurance? I have BC/BS of California and I don't

know

> if

> > > > they will cover my surgery. Does anyone know?

> > > >

> > > > Second question, how much further do I have to go when my

> > > > Orthodontist is already closing the spaces between my teeth

and

> > he

> > > > said to me that his getting me ready for Surgery.

> > >

> > >

> > >

> > >

> > >

> > >

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,

On my itemized bill, it doesn't show what the surgeon's fee was.

I'm guessing it was around $18,000. There are two charges listed

under Level 2, the first for $12,420 on June 7th, and the second for

$5,520 on June 9th. There is also a charge of $1800 for both of

those days listed under Level 2 - I. I'm not sure what that is for.

Shayna

> > > >

> > > > Did you guys have any trouble getting your surgery approved

by

> > > your

> > > > Medical Insurance? I have BC/BS of California and I don't

know

> if

> > > > they will cover my surgery. Does anyone know?

> > > >

> > > > Second question, how much further do I have to go when my

> > > > Orthodontist is already closing the spaces between my teeth

and

> > he

> > > > said to me that his getting me ready for Surgery.

> > >

> > >

> > >

> > >

> > >

> > >

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