health insurance scam - TMJ Disorder -TemporoMandibular Joint Message Board

PINKYPRISCILLA · 09-18-2003, 01:40 PM

When I appealed the rejection on tmj treatment from my
health insurance co they responded with some bogus quote
from the "policy" :

TMJ is not covered, however, Sleep apnea is covered, along with a mouth guard, and othognatic surgery(Open
jaw surgery) to treat sleep apnea?
Does this make sense ? Anyone? I don't think sleep apnea is treated with jaw surgery? Another insurance company cop out scam.

PINKYPRISCILLA · 09-18-2003, 01:42 PM

Oh and to top it off a so called :"Doctor" evaluated my case and that is what he came up with.

mdla · 09-20-2003, 03:10 AM

Hi,

Im at my wits end too with insurance cos. They don't seem to believe that TMJ is as devistatingly painful as it is or disabling.

TiffanyAnn · 09-21-2003, 06:28 PM

Hi Pinky:
I'm not sure this will work but you might try contacting the insurance commissioner in the state where you live and asking for some assistance from them. When I was looking for some help with insurance I spoke to the one in my state and they helped quite a bit {much to my surprise}. It's just an idea. I'm just so damm sick of being ripped off.
Tiffany

Michelle W · 09-22-2003, 08:53 AM

I agree insurance is a major problem. I have not had any treatment covered. I had to take out a home improvement loan for my treatment. My isurance told me that TMJ is considered a dental problem. I checked into dental coverage, and it was not covered under dental.