Do I need dental insurance for orthodontic treatment?
No, you do not need dental insurance to start orthodontic treatment. In fact, less than 50% of our patients have dental insurance. Also, some dental insurances don’t have orthodontic coverage. The most important thing when it comes to dental insurance is to check with the carrier’s coverage policies.
What should I look for in my carrier’s coverage policies?
There are a few things to check for:
- Waiting period – You may have to wait several months before you are covered for dental care beyond routine hygiene check-ups and cleanings with your dentist.
- Age limit
- “Medically necessary” clause – some dental insurance plans only pay out for orthodontic treatment when it’s medically necessary
- If it makes financial sense – Take the waiting period into consideration. See if the benefits outweigh the premium. Remember, your dental insurance must be active for the entire duration of the orthodontic treatment to receive the full benefit.
- Assignment of benefits – insurance may either pay us directly or send the benefit to you depending on the plan. This will change your patient responsibility amount.
What procedures are not covered?
Replacement retainers (beyond the first set we provide), teeth whitening, and anything cosmetic would not be covered by insurance.
Can I drop my insurance once I start treatment?
It is not recommended. Insurance plans do not reimburse orthodontic treatment in one lump sum. If you discontinue your insurance, your benefit will not be paid out, and you will be responsible for that amount.
What happens if I switch my insurance mid treatment?
Before you choose your new insurance plan, be sure to check for “Treatment in Progress” or “orthodontic in progress” as a policy feature. This ensures that any current orthodontic treatments underway will continue with the new policy. If you switch insurances, let us know as soon as possible. Most insurance plans have a once in a lifetime clause, but we will help you make this transition as seamless as possible.
Can I buy insurance after orthodontic treatment has already started?
It is most likely that your plan will not cover orthodontic treatment after it has started.
I have 2 insurances. How will the benefits work?
In most cases, your insurance benefits will not stack. Your insurance will be classified into primary and secondary insurance. Primary insurance processes your claim first, and then your secondary insurance will process the rest of the claim based on how your plan is written. All patients are encouraged to contact their insurance carrier. Insurance carriers determine the benefit.
We do all insurance work for you so you can focus on taking care of your teeth. We also have an automatic monthly payment system for your convenience. If you have no insurance, no problem. We have 0% financing and extended payment plans for you.