Monday, February 18, 2013

Braces Insurance Surgery Oh My!

catching up to where I am now-

Braces- I saw the orthodontist in November and got my braces put on in mid December. They were very painful for the first few days or so, but I also had my wisdom teeth out the same week so it was hard to tell where the pain was coming from which was probably a good thing. I had my wires changed for the first time about a month ago and again it hurt so bad that my ears were ringing and wasn't even able to chew anything for several days, but it is much better now and am scheduled to have my wires changed again in two weeks (oh yay)! on the other hand, I can really see a difference in how straight my teeth are over the past 8 week although my bite is so much worse than it was before I got my braces on. I can only touch my very back molars together and has made my jaws hurt a lot more when I'm eating. The orthodontist said that my bite won't be any better till after surgery when they fit my upper and lower jaw together and that he is just trying to get my teeth in position for the surgeon. needless to say, I am looking very forward to my teeth fitting together for the first time since I can remember =)

Braces Day 1

Braces Week 6

Insurance companies- I've learned they are not my friend and are only around to make the process even more difficult. We were able to get the authorization approved to have the joint replacement and jaw surgery which means that they agree that the surgery is medically necessary for me to live a normal life BUT the surgeon and hospital are out of network and they will only pay 50% of what they (the insurance company) says is a reasonable fee for the surgery hospital stay and joint prosthesis,not what the surgeon and Baylor Medical Center actually charge. Our out of pocket cost is quite substantial and I'm just praying that everything comes together.

Surgery Date- Since the insurance company approved the surgery I was able to set up a date to have my joint replacement and it looks like September 5th it is =). It seems so far away and I am so ready to have this over with but they have to have money for the surgeon's fee up front. I am assuming this is because they don't want you to back out after they start making the custom joints and then they lose money. so, we will have to wait several more months before we are able to pay this. Also, once my teeth are ready from an orthodontic standpoint (probaby June) I have to have a CT scan of my head so they can make molds that they will use to make specific joint prosthesis to fit my face and it takes 8 weeks for them to do this before I can have surgery. Even though it sounds so long from now there is no way that I could have the surgery any sooner than September. and as much as I am ready to have surgery and move on I have to admit i'm pretty afraid of the "what if's" during and after surgery. Guess that is the worrier in me and have to learn to just let that go and trust the nurses and surgeons that will be taking care of me.