Active Duty Military & Insurance Coverage

[Austinou88]

Anyone know anything about out-of-network coverage, for people who are active duty military?

[XXRyanXXL]

What is your insurance?
Many insurance policies stipulate what conditions apply for out of network payments.
Some require that it is medically necessary, or that you must prove you are unable to receive the necessary medical attention in your state or from providers approved under your insurance.

[Austinou88]

Maybe it's too late to resurrect this post, but wanted to see.
Health Insurance is Tricare Prime at the moment.

Here's there little policy on it: https://tricare.mil/CoveredServices/IsItCovered/OralSurgery.aspx

Although if performed on base it seems to be free.
Just am concerned about the surgeons experience.

[XXRyanXXL]

There is a consensus among the OMS community that any type of oral surgery that is covered free is usually under the care of a "learning surgeon" or learning hospital. That's right, surgeons just completing there residency program, who can afford to make and learn there mistakes off YOU. If your case is complex, I wouldn't even fathom going through any type of university hospital or state funded medicaid (or military insurance). Simple movements (advancements or extractions) is pretty much all you'll get. If you need rotations, bone implants, bony contour issues, breathing problems, facial aesthetics, I would go to private practice and even then you'll want to research the surgeon and make sure he has the credentials and work to prove it, and I'd go as far as to refer his plan-out with another surgeon.

[kavan]

Maybe it's too late to resurrect this post, but wanted to see.
Health Insurance is Tricare Prime at the moment.

Here's there little policy on it: https://tricare.mil/CoveredServices/IsItCovered/OralSurgery.aspx

Although if performed on base it seems to be free.
Just am concerned about the surgeons experience.

Are you inquring about getting a jaw surgery for better AESTHETICS and ASSUMING your policy covers that??

If so, IDK, a little reading comprehension of your policy should have allowed you conclude they don't cover surgery for aesthetic reasons in the first place. Hence moot point to inquire about a referral for one outside the military (with your insurance coverage).

Anyone have any experience/knowledge dealing with Tricare health insurance?
I'm trying to get preferred over to a jaw surgeon who isn't military.

Appreciate the Feedback

Your insurance, TRICARE, like many insurance policies,  doesn't cover:

[Treatment ........ occlusal equilibration and restorative occlusal rehabilitation]

This means they don't even cover devices (like braces) to get your 'bite right' even for those who DON'T need jaw surgery to do so. So they won't be covering braces needed to prep for an AESTHETIC jaw surgery yet alone the jaw surgery for a NON DEFORMED person.

They cover jaw surgery BUT for those with with legit cranio-facial ABNORMALITIES: [Surgical correction of prognathism and micrognathism and congenital craniofacial anomalies (i.e., Treacher-Collins syndrome, hemifacial microsomia, etc.)]