Insurance and Out-of-Pocket Time Line

This is Long! Sorry! 2011: The dentist I had seen my entire life had recommended I fix my jaws. I wore braces when I was a teenager and for whatever reason I ended up not doing the surgery. My parents and I have conflicting recollection of why I didn't have it. I remember that the insurance was denying us and I'd been in braces 5 years when I finally said forget it. They remember that I wanted my braces off to look pretty at the Prom. Either way, it wasn't done. 18 years later... The life long dentist retired and I went to a new dentist in Dallas. On my first visit he said the 2 teeth I was using looked terrible. I told him about the headaches and he referred me to a Maxillofacial Surgeon. At the time I had United Healthcare. The doctor he referred me to was not in Network. I chose another doctor I found online. I went to a consultation and he reconfirmed I need double jaw surgery. They requested payment from my insurance. I was denied. No payment plans. 2012: My good friend referred me to a doctor who treated her sister. I went to a consultation and he suggested I get a sleep study. I went to the sleep study. The results were that I do not have sleep apnea, but I do have a restricted airway. This restriction was causing 8 arousals per hour. In sleep apnea, the person stops breathing and in an arousal the muscles jerk the person awake prior to losing their breath. Basically, I wake up 60 times a night. The Sleep Doctor told me that a person can ‘get’ sleep apnea. We took this information and combined with the Acid Reflux, headaches and chewing problems wrote a second request for coverage. Denied. No payment plans. 2013: I changed jobs and the new job did not offer insurance. I applied for BCBS and was denied due to pre-existing conditions. I applied for Cigna and was denied for the same reason. I applied for BCBS Texas Health Pool for people with pre-existing conditions and they accepted me. My monthly premium was $400 and they covered nothing. I met a dental nurse and told her my situation. She referred me to a Doctor in Dallas who she believed could get me a cheap surgery. He was a teacher at Baylor specializing in Jaw surgery. Baylor had a teaching program where the program covers the surgery. I booked a consultation. When I met the doctor he told me that Baylor no longer sponsored those surgeries but I would have been a good candidate. He now runs a private practice and still maintains privileges at Baylor. He reviewed my case and asked if I’d had an MRI. After I told him no, he said, “How did these other doctors diagnose you if they hadn’t seen an MRI?” He told me that the clicking was a TMJ issue. If I had something wrong with my TMJ then that would have to be fixed. He said that if you do orthognathic surgery to correct an open bite and there is a problem with the TMJ, then the bite could return to its previous state after surgery! I booked an MRI. It was $500 since my insurance covered nothing. The MRI results showed that I have dislocated both discs in my TMJ which helps the jaws rotate smoothly. Instead they are scraping against my skull. This doctor told me that I should do the surgery and that it would be a long process and to be prepared. His staff said I could do a payment plan. He laughed when I showed him what the other doctors wanted to charge me for the surgery. He said he would do the top & bottom jaw, the palate and both TMJ replacements for $20,000 less then the others charged for just the double Jaw Surgery. He also offered me a payment plan since I was going to battle this out-of-pocket. April 2013: My Orthodontist reviewed my case and spoke with my surgeon. I had enough recession on my top gums that it could intervene with a surgical cut. They sent me to a Periodontist for gum surgery. I booked the surgery. I first went to my Dentist to remove a bridge I’ve had since childhood. There was a deciduous tooth but not a permanent tooth. They removed it and placed a bridge there. My Dentist broke it off and sent me back to the orthodontist to get my bottom braces put on. May 2013: I went in for gum surgery. It was painful. I was awake during the surgery but didn’t feel anything. I felt it the next day and the 10 days that followed. It was $2500 out-of-pocket since Health Pool doesn’t pay for anything. June 2013: I drop Health Pool. It’s worthless. July 2013: I get my top braces. October 1 2013: Open enrollment begins and the website is non-functional. After 30 days of repetitive efforts I am able to get into the site and fill out the enrollment application. I am given 11 options of Insurance to chose from and the prices range from $265-400. So much for affordable care. My boyfriend and I discuss a quickie courthouse marriage so I can join his insurance policy. That conversation quickly diminished and I have now narrowed my choices down to 2 Cigna policies. I am quite certain that I will not get any help for the surgery. At this point I am trying to save myself from a $30,000 hospital bill. The surgery and hospital stay are separate and I’ve heard that hospital bills can bankrupt people and really drag them through the financial mud for years. I also went to visit my Dentist for a cleaning and was surprised to find he retired! All the staff was gone too, it was kind of weird. I didn't get a note or anything. Ha! This ordeal is taking so long that I've seen two Dentists retire! I hope my Surgeon doesn't retire too. He's pretty young though, so I don't think I have to worry.