By looking at this ceph, what can you tell?

[hmatt330]

Can you tell if I have an obstructed airway?

Would jaw surgery help at all? Insurance/ Can it make a case for medically necessary?

Teeth seem to be fitting in the back, but in the front, it seems that my 6/7 months of braces compensated heavily by pulling lower teeth forward and pushing upper teeth back

[Trader]

Both of your jaws are recessed, especially your lower. You would need advancement of your upper and lower jaws with counterclockwise rotation.

Your airway doesn't look as bad as one might suspect for your degree of jaw retrusion. I think this could a result of your forward head posture though -- if you were to stand in the most anatomically correct position, your airway would likely be way too small for you.

You should get a sleep study to see whether you have sleep apnea. If you do have it, your doctors shouldn't have a hard time getting insurance to cover it.

[ditterbo]

I bet you have mild OSA, like on the scale of 10-15.  Report back ya hear!

[kjohnt]

You are tilting your head too far forward in the ceph, but definitely have incisor compensation nevertheless.  Airway not too bad, could be bigger but not osa inducing I'd guess.  Your issues are probably cosmetic only.

[Trader]

You are tilting your head too far forward in the ceph, but definitely have incisor compensation nevertheless.  Airway not too bad, could be bigger but not osa inducing I'd guess.  Your issues are probably cosmetic only.

Cosmetic only?

He'd have a much larger airway and better posture if his jaw were advanced. A disproportionately small mandible is never only a cosmetic problem.

[kjohnt]

Cosmetic only?

He'd have a much larger airway and better posture if his jaw were advanced. A disproportionately small mandible is never only a cosmetic problem.

I was answering in regard to this:

...Can you tell if I have an obstructed airway?

Would jaw surgery help at all? Insurance/ Can it make a case for medically necessary?...

Based on what I've seen, an insurance company will not pay for this surgery unless OSA is an issue and less costly methods (e.g. CPAP) haven't been successful.  I do not think this will be the case here.

Further, a haircut could be considered more than cosmetic if one argues it can poke the eyes.  That's a dumb example but you should understand the point in that you are reaching for medical necessity when OP is more than likely medically fine.  Don't get me wrong - I'd totally get the surgery if I was him as I think there would be tremendous psychological benefit, but I'm just calling it as I see it.

[Trader]

I was answering in regard to this:

Based on what I've seen, an insurance company will not pay for this surgery unless OSA is an issue and less costly methods (e.g. CPAP) haven't been successful.  I do not think this will be the case here.

Further, a haircut could be considered more than cosmetic if one argues it can poke the eyes.  That's a dumb example but you should understand the point in that you are reaching for medical necessity when OP is more than likely medically fine.  Don't get me wrong - I'd totally get the surgery if I was him as I think there would be tremendous psychological benefit, but I'm just calling it as I see it.

I don't think he's medically fine though. I've seen people with much larger airways than his develop severe sleep apnea. If he sleeps on his back during a sleep study, I have no doubt that he will present with at least mild sleep apnea (especially if he's able to fall deeply asleep -- I recommend a sleep aid for that reason). Given his age and the fact that he's not overweight and does have a severe case of mandibular hypoplasia, a good surgeon should be able to convince an insurance company to cover him. Also, a surgeon will likely argue that his jaw deformity is causing joint issues and chronic headaches -- they aren't opposed to a little exaggeration.

I don't mean to quibble with you -- I think you're a great poster -- but I think you're being overly pessimistic here.

[hmatt330]

Ah thank you, especially to the optimistic poster. I will certainly take this to a couple more surgeons to confirm it will be possible before I make this decision

[ditterbo]

Just for full comprehensiveness on insurance, even if insurance pays, lets just assume he picks an out of network doctor.. OP, if you pick in-network, ignore the following.  His insurance will cover at an out of network rate, let's say 60%, of the allowed amount.  That allowed amount can possibly be like 20-40% of the doctor's fee.  Then chop like 40% off the allowed amount, and that is all insurance will pay towards the doctor's fee.  So if you go to any of the schmucks with their 50-100 grand fee's, expect to pay the lions share anyways.

If you really want insurance coverage, then take the CPAP device after you're diagnosed with OSA, use it for a while and claim it's not working, can't be tolerated etc.. That might check off the box for insurance that less extreme measures were tried first.  Don't take this as gospel, but that's just what I've been told. 

[hmatt330]

Crazy.

If I pick In network they'll usually cover all?

And can I just buy another insurance policy a couple months before to cover my doc in network fully?

[Bobbit]

The really good jaw surgeons learn very quickly that they cannot make a living on in-network re-imbursements.

So they drop their networking with the insurance companies.  Then they can take payments from their patients at free-market competitive pricing levels.

You simply will not find any really top of the line jaw surgeon who is "in network" with any insurance company.

Yes... the medical system is  all screwed up.  But that is the way it is.

[hmatt330]

The really good jaw surgeons learn very quickly that they cannot make a living on in-network re-imbursements.

So they drop their networking with the insurance companies.  Then they can take payments from their patients at free-market competitive pricing levels.

You simply will not find any really top of the line jaw surgeon who is "in network" with any insurance company.

Yes... the medical system is  all screwed up.  But that is the way it is.

that is very very dissapointing. Don't have the money for this; what would you do if you were me? Get a sliding genioplasty, or just wait till I can save up for it?