The complaint has been investigated and
resolved to the customer's satisfactionResolved Aetna Health Insurance — Denied me upper and lower jaw surgery
resolved to the customer's satisfaction
Aetna Health Insurance has approved me part of my surgery but denied me the upper and lower jaw surgery of my surgery. I have an underdeveloped upper and lower jaw (hypoplasia), non union of jawbone, decreased airway at 4mm (normal is 11mm), decreased ROM at 5mm (normal is 40mm), misaligned jaws, pain, headaches. It was determined by a world renowned surgeon that I needed joint surgery combined with jaw surgeries to completely correct my problems. They denied me on the grounds they feel the jaw surgeries are cosmetic despite the fact that six different doctors have written letters to Aetna stating the medical necessity of my surgery. My surgeon even stated my airway is not increased could be life threatening and my non-union of bone could cause infection or eventually loss of bone. Despite this Aetna continues to deny the jaw surgeries. My surgeon even wrote a letter to Aetna stating I have a 4mm transverse deficiency which falls under their guidelines to cover Orthographic surgery.