Should medical insurance cover such procedures as collegin injections or silicon implants to try and form my mouth into a better more functioning mouth? Hopefully to improve eating swallowing and speaking....or is that something that I will need to pay as it is considered cosmetic?

I'm certain it depends on the policy, but I would think if it is to improve eating and swallowing, it would. My policy is very gray on speech rehabilation so read yours carefully. It will probably require a letter of medical necessity and prior approval. Many plastic surgery procedures are approved if as a result of another disease and medically necessary.

Dental insurance is the one that doesn't think we need teeth after they janked them all for radiation, but some people have beat that. Think it depends on your policy.

Don't give up if they say 'no' initially, unless they quote you chanpter and verse from policy that says it is not covered. Chase it up the chain. Is this an employee policy and is it jsut being managed by insurance company because if the company is self-insuring, you may have some leverage there if they are willing to override the denial. After all, it is their money.

Take care,
Eileen
Eileen

Hi Happy and welcome!
I had my lower left jaw removed 2 1/2 years ago and also had radiation. My left lower lip lost all feeling and without teeth there to support it, the lip has sunken in and withered a bit. I went and had some surgery done in Feb. that involved some collagen and botox, something else but can't remember what it was. It was totally paid for. I start the process of implants (finally) in about a month and will have more reconstructive surgery on my lip and chin. It will all be covered.
Hope this helps.
Minnie

And Minnie you look beautiful!!!! Love, Carol

Thank You Carol, that was really sweet of you.
I read your message you sent me about the thyroid issues you're having. The problems with my thyroid are probably some of my most troublesome. I have gained almost 50 pounds, which makes someone used to being small feel like a different person! I also get confused easily it seems, and I forget stuff. Maybe that's old age, lol. I stay cold but I had issues with that before all of this, it just seems worse now.
Let me know how your doing with it, we can compare notes.
Take care,
Minnie

Minnie, is it against OCF rule to tell us who your insurance co. is? I am so tired of fighting John's ins. [John Alden, now Assurant Health]I think it would be of GREAT benefit to this forum to know the names of the Ins. Co's and what they have agreed to cover for patients on this forum. Amy

You can talk about insurance companies all you wish, keep it honest and factual and we won't get our butts sued. I'd be curious to hear the stories of the good and the bad.

Hi Amy,
My insurance company is Anthem Healthkeepers. The only thing they have fought me on are the implants. They will approve for the surgery for removal of teeth but will not pay for the implants to replace. This is the only time they have denied me anything. I called my Ombudsmen and they sent me paperwork to take it up the chain of command a bit. I will be starting my implants soon but we have saved (and saved, and saved, lol) to pay for them as I simply cannot wait any longer. But, I'm hoping that, with the help of my doctors, that we can create legislation to mandate payment for implants for oral cancer survivors. This same process had to take place for breast cancer survivors also. Now insurance companies are required to pay for rebuilding the affected breast AND if the unaffected breast doesn't "match up", then it will cover for the woman to have THAT breast worked on so that she has a matched set!
My insurance company would pay for my implants if I had gone to a bar, gotten shit faced drunk, drove home and wrapped my car around a tree, knocking all my teeth out. THEN they would pay for it. But, they will not pay if the cause is disease. Go figure that one out!

Thanks everybody for all the support. I have an appointment with my plastic surgion in the morning and feel much more confident to discuss options with him. Due to the implaint rejection my mouth and face have been sliding and falling in all sorts of directions. Great to hear that some options are available and that there is a chance insurance may cover something!

I have Blue Cross Federal and they covered everything for me including the bone transplant from my iliac crest to my jaw and the dental implants that followed. All worked out very well!

I did have one billing issue on my initial surgery to remove the cancer, they had to first remove three teeth. Insurance initially saw this as a dental procedure and didn't pay. After calling them and explaining, they covered it without further question.

I've been cancer free 5 years (Oct 10th) and have had my new teeth for about three years.

Good Luck!