Insurance and Other Worries

[smylex]

I went in for my final consultation yesterday to see about getting braces to get this whole thing started for the orthognathic surgery. This is the second orthodontist that I've seen and, while she works directly with the oral maxillofacial surgeon (they're married), she offered me what's essentially the same treatment plan as the previous orthodontist.

The main difference is the fee that she's charging. The first ortho quoted me about $4,600 before insurance and they work directly with the insurance company. He asked for a $460 down payment. The second ortho is asking for $1,500 down and approximately $6,000 total before insurance. She doesn't work directly with my insurance company, so I'll have to wait to be reimbursed for the bracing.

Has anyone else worked in this situation before? $1,500 is a lot of cash all at once, and more than half of my monthly take home pay. Does anyone know how long I can expect to wait before I see reimbursment from my insurance company? This has me worried.

[annabella]

Hi Smylex
Wow tough one to answer. Did you call your insurance? I had the same thing some ortho did the insurance themselves other I had to submit the claims. I ended up with an ortho who does it for me. I paid 200 at records and 700 when she(my daughter) got Braced. But I did call the insurance to ask them how it works. Ok Cigna is mine they did a percentage. So I would an amount for downpayment then get installments like quarterly during the length of treatment. It definetly did not sound as easy as just paying a monthly charge to the ortho and having them deal with it. Our total outpcket 4800 ins paid 1250. Anyway call the isurance ask how they do, they can fax/ you the process and ask the orthos if they give you something or at least call the insurance detailing your plan and that your a patient. As to the cost differences was the timeframe the same, are they different brackets ceramic vs metal. If similar ask what could be different, maybe just higher overhead? One ortho had just remodeled granitetops, wood very nice office but wow he was expensive, so could figure out the difference used trad brackets w/ ligs, nothing fancy and he didn't even have his own digital xray as others. So I think he was paying off his office. Also ask if you can get a discount for using their recommended oral surgeon. You can explain that the cost difference is too great for both of them.
Did you consult with other orthos. Then you could get more of an idea of costs.
Well good luck it is a hard choice.

[smylex]

I'm not sure what the overhead difference is for both doctors. I do know that I'm going to be having steel braces since I'm building up to orthognathic surgery. Both orthos want to remove my impacted upper right canine, as well as my 2nd upper left bicuspid. The second ortho was taking a wait and see approach to the bottom arch before removing any bottom arch teeth, and both doctors want to start me off with braces on the lower arch before getting the upper arch braces put on.

The main differences between both ortho's is the $700 difference and their methods of insurance handling.

[Denise]

Wow, $700 is a lot of money for difference in price. Also you'll definitely want to call your insurance company and ask them how the reimbursement process works. If you don't have the money to pay the ortho up front, and have the wiggle room to wait for the reimbursement check, it may be best to go with the ortho who deals with the insurance directly. Mine deals directly and it's really nice. I have one low monthly payment and never have to worry about additional fees. So that's another thing to consider, do you want to deal with this every month (or however often you need to) for the next 2 or more years. If the money is all it comes down to, and not the actual care they're providing, then I'd personally go with the person who dealt directly. But you should go with the one you feel will do the best job with your teeth, ultimately the money is a moot point if you're not getting good care.

Good luck!!

[smylex]

Thanks. After getting home, I looked at the information I have from the previous orthodontist, and the amount difference that I received from him is $1,339, not $700 as I originally thought, for the same time frame/braces work.

[smylex]

And, I spoke with the insurance company yesterday. Guess they pay reimbursements 30 days after they get the claim and only 1/2 at a time. So much for that...

[annabella]

I am sorry, I know ours was not ideal either so that was a factor in choosing too. Thank godness the ortho we picked does it for us. No hassle and just a monthly payment to them that's all..... Maybe you should have more consult w/ others orthos.
Good luck it is an ordeal.