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Medical Jaw Surgery and Blue Cross Insurance coverage?

For years I have been self conscious about my smile/bite and even more now that I'm trying to exercise my Management/Accounting career. I'm almost 30 and am determined to have it regardless the efforts needed and my fear,but I need to find out about Insurance Cos. that may help with this. After a recent consultation with a specialist he said I need braces and a corrective jaw surgery and should seek to enroll in a PPO plan,however,when I called Blue Cross they said an HMO plan would cover my braces but a PPO wouldn't. I didn't mention about the surgery because of fear of them rejecting my application for insurance but I was wondering,if they don't cover a simple procedure as braces,I highly doubt they would cover a corrective surgery? I've never had insurance before so does anyone know if Blue Cross or what companies cover it? Do I need to be enrolled a minimum of X months in order for the insurance to consider paying for it or once I start the plan I am elegible to apply for it?

Public Comments

1. You would need to talk to BC/BS's dental insurance department---they would handle braces. The jaw surgery---if the doctor will fill out the paperwork and state that it is "medically necessary" and not a cosmetic surgery, then BC/BS may cover some of it. There are LOTS of different plans in each insurance company and it depends on which one you have or get.
2. You know, I've dealt with dental insurance companies for over 28 years and your guess is as good as mine! First, are you talking about taking out a dental plan with Empire Blue Cross or a medical plan. There is a big difference. Each plan is different. Most dental plans will not cover adult orthodontics. The usual cut off age is 19 years old. If you are planning on going through your health insurance, there has to be a reason, other than aesthetics, for why you need the orthodontics and the surgery. Severe malocclusion causing a neuromuscular pathology (TMJ) and/or migraine headaches, might allow for the treatment you desire. But, you also have to make sure that there is no "preexisting condition" clause in the plan. This would mean that there might be a waiting period before coverage would be given or, there might be no coverage at all.You have to remember that every plan is different and that you have to really search out the information that you need. Sorry that I couldn't be more helpful. Good luck.