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Isapres and maxillofacial surgery

Yeah. They provide coverage to all benefits that are codified by Fonasa

I invite you to VISIT THE COMPLETE ARTICLE WE HAVE ON THE SUBJECT

Do the isapres cover  maxillofacial surgery?

1.

Important clarification. Fonasa does not sell bonds for these procedures for the private system, andIt provides coverage but in public services.

 

Is orthognathic surgery an aesthetic procedure?
Orthognathic surgery is a procedure with functional bases whose main objective is to restore the functioning of the stomatognathic system.

2.

Restoring the bite allows you to improve chewing and pronunciation of words.

Restoring the position of the jaws allows adequate respiratory function both during the day and at night. A bad jaw position can cause severe breathing disorders, especially at night, generating snoring and a decrease in the amount of oxygen in our body, which can cause very severe cardio vascular disorders. A respiratory disturbance during the night generates a deterioration in the quality of sleep and this generates substantial alterations in the quality of life and can even predispose to daily accidents and concentration.

3.

Altered bite can cause destruction of teeth, bruxism, muscle pain in the face, head, and neck, and severe jaw joint problems.

4.

Everything mentioned only as a reference and concise summary that explains why it is a functional surgery and not aesthetic despite having surprising aesthetic results.

5.

Do the Isapres in Chile cover these surgeries?
The Isapres provide coverage for ambulatory and surgical procedures that are included in Fonasa's free-choice modality tariff. Said fee can be found on the Fonasa website. see link

6.

In this schedule, benefits for maxillofacial surgery are explicitly marked with a double *
The codes start with the number 14 or 15 in the listing. 

** THESE BENEFITS ARE AUTHORIZED TO DENTAL SURGEONS SPECIALISTS IN MAXILLOFACIAL SURGERY

7.

In the case of orthognathic surgery, the benefits are clearly defined in said tariff. The percentage of coverage will depend on the health plan they have contracted. There are plans with high percentages of coverage for care by free-choice professionals and there are plans with little coverage.

8

If you wish to have surgery with a private professional, we recommend having a health plan with good free-choice coverage and with high limits. In this way, you will be able to largely reimburse your surgical costs both from the professionals who treat you and from the expenses incurred in hospitalization and ward.

9

Remember that the isapres provide coverage for known declared pathologies
Can an isapre deny pre-existence coverage?
Yes, as long as the responsibility of the Sales Agent is not proven. The omission in the health declaration of a pre-existing disease or pathology at the time of signing a health contract with the Isapre -even if it has been recommended by the Sales Agent- must be proven during the processing of a claim.

The Superintendency recommends that Isapre affiliates report  all illnesses, surgeries or other morbid antecedents when filling out the respective Health Statement for themselves and their beneficiaries.

SOURCE: FONASA

Is the isapre coverage present when the procedure is performed by a Dentist or Maxillofacial Surgeon?
Yes, in Chile the university specialty is called "Oral and Maxillofacial Surgery and Traumatology" and it is a specialty for Dental Surgeons. Fonasa expressly states that these benefits are provided by dental surgeons, maxillofacial surgeons.

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