Cost of SARPE/ palatal expansion/ maxillary expansion and does insurance cover it? Currently have capital Blue Cross

Question

Ive been doing tons of research on this, but i can't seem to find wether or not capital blue cross will cover this surgery. when i called to talk to a rep, i got two different answers. one said yea because it is medically necessary, although I've read that it is not medically necessary (I'm only recommended to get it in order to get braces). the other woman i spoke to had no idea what i was talking about. any info will help!

Ira Shapira, DDS · Answer

The best treatment would have been to expand your mouth prior to eight years of age.This would have avoided the need for surgery. As an adult there are a few choices available. Expansion not contraction is definitely the best course of action.There are two approaches available.  If you have sleep apnea you may get  some coverage  (defines your medical necessity) otherwise you will probably be out of pocket for surgery or DNA Appliance.1.The DNA Appliance and Epigenetic Orthodontics/ orthopedics2. Rapid Maxillary (palatal) Expansion with a Surgical Assist or SARPEThe decision between expansion and contraction is critical. Problems with contraction orthodontics include:TMJ disorders including locking, clicking and popping.snoringsleep apneamigraineschronic daily headachesfacial painoccipital headachespostural issuesSinus painsunken look to facecrowded tongue /deviate swallowThe mRNA version of the DNA appliance is FDA approved for treating Sleep Apnea and Snoring and there are a number of published case studies showing that they can cure patients with sleep apnea by growing the jaws orthopedically and the airway pneumopedically. There are no large prospective studies published as of this date but they are in progress.If you are already having these problems Expansion Orthodontics/orthopedics may relieve or eliminate symptoms.The DNA Appliance is worn 12-14 hours/day and gradually and virtually painlessly grows your bone orthopedically and allows teeth to position ideally.The SARPE procedure consists of cutting the upper jaw loose from mxilla (partially) and splitting the upper jaw on the midline.  This is done in conjunction with an expansion screw usually cemented or bonded to your teeth.  This is the followed by orthodontic treatment. Both are excellent procedures.  The DNA is far less expensive than the cost of SARPE plus ortho and entails more pain.The DNA Appliance is amazing in orthopedic growth and most tooth positioning but may require invisalign or other method of finishing for final tooth positioning.  This is not typical but some times required.The DNA Applince therapy requires visits every 2-3 months after first month and is ideal for long distance patients such as college students.  It was develped by Dr David Singh based on his work with the NIH (National Institute of Health)Ira L Shapira DDSCertified DNA ProviderDiplomate, American Board of Dental Sleep MedicineDiplomat, American Academy of Pain ManagementRegent and Fellow, International College of  CranioMandibular OrthopedicsChair, American Alliance of TMD Organizations

Cost of SARPE/ palatal expansion/ maxillary expansion and does insurance cover it? Currently have capital Blue Cross

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Cost of SARPE/ palatal expansion/ maxillary expansion and does insurance cover it? Currently have capital Blue Cross

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Everything you need to know about Braces

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