Sunday, April 1, 2007

And so the adventure begins...

So I began with a consult with the oral surgeon on staff.

No matter what, I needed braces again. I would also need two bottom teeth pulled.

My teeth were pulled May 2006 and braces went on July 2006.

However, I needed to make a decision from the start as to whether I would proceed with the surgery. If I was going to have surgery then the braces would actually make my overbite worse over the next 18 months. This was because they would try and move the lower teeth back in my jaw so the jaw can move farther forward. If I decided not to have the surgery then the braces would focus on masking the overbite. They would use rubber bands from upper to lower jaw to try and correct the overbite but they could never really fix it.

I decided to go for it. I knew up front that it may not be covered by my insurance. I was told it would cost around $5k per jaw. I began saving $10k just in case. After a very long process , my insurance company denied the claim. I went through the appeals process with United Health Care and did not have any luck. They felt it was cosmetic surgery for both jaws. So I went to the surgeon and told him it would not be covered and to let me know how much it would cost. What I was told is that I had way underestimated the cost. He had thought they would at least cover the hospital stay and anesthesia even if they didn't cover the surgery itself. Since they were not covering any of it then I was looking at $5k for each jaw, $10k for the hospital stay, and $10k for the anesthesia.

I remember sitting at my birthday party talking to my whole family about $30k for essentially cosmetic surgery. I had so looked forward to this, but $30k was a big difference from $10k. Even if I could come up with the money, would I want to. How could I justify an expense on myself like that....

I went back to the surgeon to talk to him about the cost. He said that Kaiser may cover it. Kaiser does them often and as long as I fit a certain parameter, I may be covered. I didn't want to put off the surgery for 8 months to switch to Kaiser just to find out they didn't cover it. So, I booked an appointment with a Kaiser surgeon prior to becoming a member and he assured me my case was extensive enough to be covered. He was not sure about the upper jaw so it may be $5k for just his fee.

So I was all set. Just had to sit back and wait to switch to Kaiser and for my teeth to be ready.