Understanding the ins and outs of orthodontic benefits can be more confusing than traditional dental or medical insurance coverage. Dr. Harris is committed to providing affordable care for all our patients and part of that promise is helping your understand your insurance coverage. Check out a few FAQ’s that will get your started on understanding your benefits.
Does Dental Insurance Include Orthodontic Benefits?
Some do, and some don’t. It just depends on your policy. Be sure to ask if your plan covers general dentistry AND orthodontics. Another important question to ask is if orthodontic coverage is just for children/teens or if you have adult ortho coverage as well.
Does Orthodontic Insurance Cost More in Premiums?
Again – it depends on your plan. Different policies and insurance companies have higher premiums for orthodontic coverage, but often there isn’t an additional charge. Make sure that if you are paying more specifically for orthodontic coverage that your premiums aren’t more than the cost of treatment. Our team can help you figure that out if you’re not sure.
What Does Orthodontic Insurance Typically Cover?
We hate to be a broken record, but every policy is different. Here are some basics that tend to be a good rule of thumb:
- Usually, orthodontic coverage has a Lifetime Maximum Benefit (LMT) that will pay out 50% of the total case fee. (Some may pay less.)
- Most policies only pay for braces one time.
- Out of pocket expenses vary from policy to policy, and whether you choose an in-network provider.
Do Orthodontic Benefits Pay Out All at Once?
No, not typically. Generally orthodontic benefits pay out throughout treatment. The insurance company will pay an initial payment when the braces are first put on and then in monthly, quarterly or annual installments.
Is There a Waiting Period for Orthodontic Coverage?
Some plans do require a waiting period, but it’s not guaranteed that all will. Be sure to ask your insurance company if there is a waiting period before braces are covered.
Is it Possible to Have Dual Coverage for Braces?
In most cases, yes! There are some specific rules that insurance companies have to follow for primary vs. secondary insurances. You need to check to see if your plan allows for standard coordination of benefits.
What Resources Does Our Office Offer to Help with Expenses?
We offer low down payments with convenient monthly payment plans, with zero % financing. We also offer an auto-draft option as a monthly payment and we accept MasterCard, Visa, Discover and Care Credit.
We’re Here to Help!
Our entire team wants to help you and your child through the journey to their perfect smile. That means helping you understand the cost of treatment and your insurance benefits. It also means reassuring you that you’ll never pay hidden fees or unnecessary expenses. Contact us today if you have any questions!