"I'm So Tired of Pain": TMJ Sufferers Lost in Insurance Gap

By: Jessica Zartler Email
By: Jessica Zartler Email

A jaw joint disorder that affects an estimate ten million people is often not covered by insurance and one local woman suffering from the pain it brings says she can't afford the surgery she needs and she doesn't know where to turn.

11 News Reporter Jessica Zartler has more on how a gap in coverage has many people suffering in silence.

"My biggest fear is that i can't handle the pain and I honestly might become suicidal," TMJ sufferer Jill Johnson tells 11 News.

Johnson says not a minute goes by that she isn't in pain. The Clifton resident suffers from a severe case of TMJ, a disorder of the jaw joint.

"I'm so tired of pain," said Johnson.

Pain across her face and jaw from a dislocated right TemporoMandibular join and a left joint that has completely disintegrated from arthrities.

"I just get more and more depressed and I feel desperate for some help."

Help she can't get from her Medicaid insurance.

That doesn't surprise Doctor James Kennedy, a dento–cranial expert who sees patients get rejected for coverage everyday.

"It's sad to see that they're not getting coverage. There are a lot of things in medicine that don't get covered also because they don't fit into the slots that insurance have created for people," Dr. Kennedy told 11 News on Tuesday.

Dr. Kennedy says dental insurance calls TMJ disorders a medical problem and medical says it's dental.

Meanwhile the patients that can't afford thousands of dollars in treatment are stuck with the pain.

"It's ridiculous, I mean they should have coverage," said Kennedy.

He says he tries to help patients with payment plans but some just plain can't pay--people like Jill Johnson.

"I don't have that, i don't have my bills paid," Johnson told 11 News.

She has written hundreds of emails and letters to congressmen and senators to try and change insurance laws.

But until she can get coverage she says she's afraid to eat and afraid to continue to suffer.

"I just really honestly don't want to live like this forever in pain. I'm hoping somebody will come through."

Dr. Kennedy says a proposal in Colorado congress in 2005 was set to address the insurance concern of Johnson and thousand of other TMJ sufferers but that bill died in the legislature and no one has tried to reintroduce the proposal.

He says states such as Minnesota and California have enacted similar measures to ensure coverage for people suffering from TMJ diseases and disorders.


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