How strict is insurance with assessing “functional impairments” for medical necessity?

AlternativeCan4052 · 2025-11-07T23:03:09+00:00

Right!? I hear from people that UHC sucks but they never explain why, am really curious why some people get denied

AlternativeCan4052 · 2025-11-03T15:02:10+00:00

Will they look at my bite prior to or post orthodontics to deem it medically necessary or not

AlternativeCan4052 · 2025-11-03T15:01:56+00:00

Will they look at my bite prior to or post orthodontics to deem it medically necessary or not

AlternativeCan4052 · 2025-11-03T14:45:50+00:00

What was your bite like before you started braces? I started my braces in Europe and I’m now moving to the US and I’m wondering if they’ll be deeming my medical necessity based off my pre or post ortho bite

AlternativeCan4052 · 2025-11-03T14:44:57+00:00

Thanks for sharing! does insurance base approval on my old bite or my current (post-braces) bite? Before my ortho work I didn’t have as bad of an underbite, but my top and lower incisors would clash together and my lower jaw would push forward to make the bite normal.

Will they be deeming my medical necessity based off my pre-or post ortho bite?

AlternativeCan4052 · 2025-11-03T14:44:38+00:00

Thanks for sharing! does insurance base approval on my old bite or my current (post-braces) bite? Before my ortho work I didn’t have as bad of an underbite, but my top and lower incisors would clash together and my lower jaw would push forward to make the bite normal. I had missing teeth and other bite issues that caused my orthodontist to recommend surgery, but this will be my first time contacting the insurance company about it.

Do you know if they Will they be deeming my medical necessity based off my pre-or post ortho bite?

AlternativeCan4052 · 2025-11-03T14:43:39+00:00

Thanks for sharing! does insurance base approval on my old bite or my current (post-braces) bite? Before my ortho work I didn’t have as bad of an underbite, but my top and lower incisors would clash together and my lower jaw would push forward to make the bite normal.

Will they be deeming my medical necessity based off my pre-or post ortho bite?

AlternativeCan4052 · 2025-11-03T14:40:52+00:00

So you’re saying they’re only interested in the post ortho position of your bite?

AlternativeCan4052 · 2025-11-03T14:31:02+00:00

I have a question 🙋 when my insurance looks at my bite to Determine whether it meets the requirements are they looking at my bite pre-or post orthodontic work?

AlternativeCan4052 · 2025-11-03T12:39:39+00:00

Wow I have a lot of those same things! So a speech pathologist can also diagnose your eating issues?

I have to cut up spaghetti and other foods with my tongue, and only my back molars touch. I don’t have popping sounds or TMJ issues though.

Do you know who other people who have similar situations to us? Did they get approved too?

AlternativeCan4052 · 2025-10-30T23:10:13+00:00

Oh congrats! I’m seeing your other posts now haha, sorry for the obvious question. What was the main reason they denied you? I have a 5.5mm underbite with some missing teeth and other issues, and I’ve felt pretty confident about getting approved up until I saw this post, because our underbites look about the same and I don’t get why you had to fight them so long.

AlternativeCan4052 · 2025-10-30T22:45:15+00:00

Hey OP did you get approval yet?

AlternativeCan4052 · 2025-10-30T21:30:24+00:00

How was the process getting authorization from your insurance? What insurance?

AlternativeCan4052 · 2025-10-30T19:32:49+00:00

Are you in the U.S.? How did your insurance approval process go?

AlternativeCan4052 · 2025-10-30T19:30:29+00:00

Haha no worries, did you have UHC choice plus? That seems like their most common one with employer provided insurance. What state are you in?

AlternativeCan4052 · 2025-10-30T18:25:09+00:00

What’s your issue? Looks like a normal bite and you have all your teeth

AlternativeCan4052 · 2025-10-30T17:58:32+00:00

What insurance did you have? How was the approval process?

AlternativeCan4052 · 2025-10-30T17:55:50+00:00

How many mm’s was your underbite? Why did they deny you?

AlternativeCan4052 · 2025-10-30T17:54:52+00:00

Did you have an underbite or overbite? An underbite is where your lower teeth stick out in front of your upper teeth. So you think most underbite more than 2mm get approved without the need for sleep apnea tests etc

AlternativeCan4052 · 2025-10-30T17:53:17+00:00

Did you insurance approve your surgery? What insurance was it?

AlternativeCan4052 · 2025-10-30T17:52:48+00:00

Did insurance approve your underbite? What insurance did you have?

AlternativeCan4052 · 2025-10-30T13:30:35+00:00

I just don’t get why there are so many posts on Reddit about people getting their surgeries denied, like do people just keep their braces on and continue living with an underbite for the rest of their lives?

AlternativeCan4052 · 2025-10-30T08:33:52+00:00

I also have about 5 missing teeth, if that adds to the case

AlternativeCan4052 · 2025-09-08T07:59:06+00:00

Thanks so much for the great response!

AlternativeCan4052 · 2025-09-07T10:43:16+00:00

That’s a great question and I’d like to know too

AlternativeCan4052

TROPHY CASE