Cash or Insurance? Is it worth paying Cash for a good surgeon?

[Kellybella]

Underbite patient I've been in treatment almost 3 years, 2.5 years of Invisalign and just got wire braces 3 months ago (long story why it took so long, mostly my fault). Ortho says Im basically "ready" for surgery.

I started this treatment when I was single with terrible insurance. My ortho is golf buddies with Gunson and said he couldn't recommend anyone else. He also said all surgeons in my city (Vegas) are butchers. Upon doing research, this appears to be true. Loved my consult with Gunson but cannot afford him. After extensive research and a consultation I settled on Walline of LACOMS who works with Dr. Relle. Both appear to be excellent and experienced surgeons. Cost with crap insurance: $27000

Fast Forward, I married my husband In May. He is a pilot in the Royal Air Force which now entitles me to care under the NHS. He is stationed here, so it's a bit complicated requiring us to go through the British Embassy. So far it's been a complete nightmare. First off, from my reasearch, results of this surgey under NHS are often subpar and with complications. In addition, they will not cover LACOMS or any decent surgeon and it now looks like they want me to wait until we are restationed in Cyprus or England in the spring to restart care. Leaving me stuck with my underbite at its absolute worst.

Basically, Im considering just paying cash to get this over with. I wouldn't have to go into debt but it would use up most of my life savings. I do not come from money and there is no inheritance in my future. I'm 35.

What do you guys think? Is it worth it to pay for the best and peace of mind? Or should I gamble on NHS covered docs in England or Cyprus and wait a lot longer?

[kavan]

Your ortho, Gunson's golf buddy, told you all maxfax docs in Vegas were butchers? Is your ortho out of Vegas? If so, does he work with doctors in Vegas or refuse to?

That's kind of an odd or 'off' thing to say to a patient unless you are also his buddy and it's just a flippant remark.

[Kellybella]

Maybe the way I wrote it came off as flippant, but that's not how he meant it. He meant it out of concern for me because he is right. There are no decent surgeons in Vegas for this surgery, and yes he is out of Vegas. We have gotten to know each other pretty well and he cares about me. Does he work with them? I know he urges his patients not to use anyone in town, but no I don't think he refuses to work with them if that's who the patient chooses. Is he biased toward Gunson because they're friends? Probably. But it's no secret Gunson is in fact excellent and if I could afford him I would use him without hesitation.

Leaning towards cash with Walline, though my husband is still trying to fight the embassy on this.

[InvisalignOnly]

Hi, I'm British and have some bad news (don't take my word for it though, you should ask others as well as I'm just one person): it would take a long time for you to get this surgery on the NHS even if you moved to the UK now, as you'd have to be referred to a surgeon first (by an orthodontist), then wait to be seen - that process itself can take a few months - and if they decide you're eligible for surgery according to their criteria, you would be put on a waiting list and it would take at least another several months before it would be your turn to get the surgery. So even if all goes well, you're not going to get surgery any time soon on the NHS, plus you don't get to choose your surgeon and would have little control over what they do. I'm part of a Facebook group for jaw surgery patients in the UK, can give you details in a private message if you want and maybe other group members can give you more information. In short, it's amazing that people can get this surgery free on the NHS, on the other hand the process is slow and you don't have much say in your treatment. For example, there are people in the group that have been waiting to start orthodontic treatment for over two years.

[Kellybella]

Thank you so much for the response!

Yes I have surmised as much. I follow a ton of people that have had the surgery on the NHS and some had great results and some the worst Ive seen. Pretty scary if you ask me. I don't indend to wait and go through the NHS in England.

However, my case is tricky. Because my husband is stationed here in the States, our coverage goes through the British Embassy and is a weird insurance. I am entitled to anything covered under the NHS but to have it done here.

Problems we've run into:

-The Embassy insists this surgery is classified as "dental" even though we all know it's medical and have tried to argue as much.
-This means it doesn't fall within an acceptable window of time to them before my husband is restationed in the Spring, hence making me wait
-We are likely to be stationed in Cyprus next where it appears the care is better than England. We cannot search for practitioners there to see if any of the ones that would be covered are good.
-So far, using the Embassy insurance search for practitioners in the states, they only cover glorified tooth pullers. No one we can find that is actually experienced at doing this surgery regularly. Scary.

This is why Im leaning towards paying cash. Wait another year to have no control over who performs the surgery? May be worth the $30,000

[Post bimax]

Are you sure hospital costs are covered with your insurance? That’s typically a huge expense.  Don’t want any rude surprises.

30k is par for the course for a decent surgeon in the US even with good insurance.  You don’t want someone that makes their living off wisdom teeth.