Dental Insurance Orthodontics Coverage – There is a lot of confusion about health insurance, dental insurance and orthodontic insurance. The purpose of this site is to explain things in a way that will make sense to our patients. Understanding this information can help reduce the amount you pay out of pocket for braces or Invisalign. Most people have health insurance. Some people also have dental insurance. Of those with dental insurance, some have orthodontic insurance for themselves and their children. If you have dental insurance, we will take care of all the paperwork for you free of charge. We’ll also do what’s called “acceptance of benefits”, which means that instead of having the insurance company reimburse you after you’ve paid the full amount, we’ll talk directly to the insurance company to minimize your hassles and losses. out of pocket cost.
Garrett Orthodontics tries to make this as easy as possible and performs these tasks for you. There are several ways orthodontists can choose to participate in insurance companies and these ways are extremely important to understand.
Dental Insurance Orthodontics Coverage
In the following descriptions, we will use a situation in which a patient owes $5,500 for treatment and the patient’s insurance company offers a reimbursement of $1,000.
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No co-pays: Some orthodontic practices do not “claim” insurance or accept benefits. They bill the patient, and it is the patient’s responsibility to provide documentation and receive reimbursement. In this case, if the treatment cost $5,500 and your insurance copay was $1,000, the office would bill you $5,500, and you would be responsible for filing the paperwork and billing the insurance to pay its share.
Acceptance of assignment: This is when the orthodontic office agrees to be paid directly by the insurance company. This is easier for the patient as it frees them from having to worry about reimbursement. For example, if the treatment costs $5,500 as above, the office would bill you $4,500 and the office would be responsible for collecting $1,000 from the insurance company. The main benefit to the patient is that out-of-pocket costs are reduced by $1,000.
PPO Participation: When an orthodontist contracts with an insurance PPO and becomes a “preferred provider,” the orthodontist agrees to charge those patients less than the regular fee for that particular insurance. This is important because it can significantly reduce the cost of orthodontic treatment. If a patient’s treatment costs would otherwise be $5,500, then choosing a PPO orthodontist could reduce their fee to a lower total of, say, $4,800. They would still receive the full $1,000 in coverage, but the family’s total medical costs would drop to $3,800, saving the patient $700. To illustrate the differences in costs, we have prepared the following table as an example based on a simple orthodontic case. In the PPO example, the lower fee represents a discount offered to patients with that plan. Note that these figures are only estimates
That. We accept assignment of benefits for ALL insurance plans with orthodontic coverage and are PPO participants in many large plans. If you have questions about your specific benefits, we are able to explain your benefits to you as part of a free consultation. If you give us information about your plan over the phone, we will prepare all the information before your consultation so that you get the most accurate information.
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We’ll be happy to help you find out. With hundreds of plans available, the only way we can answer that is for you to call us and let us check your benefits for you. We can do this before your free consultation.
In most cases, yes, you will get the full benefit of Invisalign treatment. There are currently no PPO benefits for Invisalign treatment, but if you have $1,000 worth of orthodontic insurance, the full amount can be applied to your Invisalign treatment.
While all of these questions need to be answered on an individual basis, we can tell you that Garrett Orthodontics participates in many plans offered by the largest employers in Charleston and the surrounding area.
AT&T, Alcoa, Berkeley County Schools, Bi-Lo, Blackbaud, Boeing, Citadel, College of Charleston, Charleston County Schools, Coastal Center Department of Disabilities, Cummins Turbo, Dentien’s Shipyard, Dorchester County Schools, East Cooper Medical, Food Lion , Joint Base Charleston, Kapstone Paper, Kiawah Golf Resort, M.U.S.C., Robert Bosch Co., SAIC, SC Ports Authority, Trident Tech, Verizon, VA Hospital, Wal-Mart. Improperly positioned teeth pose a serious threat to oral health and can diminish the aesthetic potential of your smile. However, you may be hesitant to undergo orthodontic treatment due to concerns about cost. This is understandable, especially since braces or clear aligners usually cost thousands of dollars. Will your insurance increase to cover the cost of your care? If your insurance does not cover orthodontics, what other means can you use to get the treatment you need? Let us consider these important questions.
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If you’re looking to get braces for your child, there’s a good chance your dental insurance plan will cover a significant portion of their orthodontic care. However, plans often have very different details, so you need to check your specific policy to find out how it applies. MassHealth (Medicaid) dental benefits.
It is less common for dental plans to cover orthodontics for adults. If your policy does not cover braces, you may be able to purchase an add-on plan to help reduce the cost of your care. What if you want Invisalign or another alternative to traditional braces? If the dental policy states that it covers braces, but does not specifically mention clear aligners, it may still cover some of the cost of Invisalign. You may need to call your insurance provider to find out more about how you can use your adult orthodontic policy.
To receive the necessary treatment. Their team will do everything they can to help you understand how your insurance applies to your situation and how you can maximize your benefits.
In some cases, dental insurance will not pay anything to cover the cost of orthodontics. This can be the case if you have a basic, preventative plan. It is also likely true if your orthodontic treatment would only improve the aesthetics of your smile and not provide significant benefits to your oral or overall health.
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The unwillingness of your insurance policy to cover orthodontic treatment does not mean you should give up on achieving a more even smile. Most patients qualify for low-interest financing through a company like CareCredit. Can split the cost of braces or clear aligners into reasonable monthly payments.
Insurance is a wonderful source of dental care, and it could even help you afford a truer smile. Gather your policy details and contact the orthodontic office to find out how your insurance can help.
Ph.D. Reema Dhingra is our orthodontist at Children’s Dentistry and Orthodontics of New England. He has decades of experience in his field and uses that experience in the treatment of children and adults. Our office accepts almost all types of insurance, including Medicaid. To learn more about how we can help you or your child experience the benefits of orthodontic care, contact us at 508-832-6278. Your Dental Insurance Plan — Orthodontic Insurance | What are orthodontic services? | Orthodontic insurance for adults | Orthodontic insurance for a child | How to choose the right dental plan for orthodontic care? | Orthodontics specialists accept all major insurances
Health plans usually do not cover dental and orthodontic care, orthodontic health insurance is covered by supplemental dental insurance. If you want to get a good dental plan that will provide you with orthodontic insurance, there are a few things you should consider when choosing one. Shopping around and getting orthodontic insurance quotes is always a good way to save money, but you should also consider the fact that orthodontic insurance providers may have different orthodontic insurance coverage for adults and children.
Can I Get Orthodontic Insurance
Depending on your needs and the type of orthodontic care or services you are looking for, there are different orthodontic plans that will work best for you. But before you choose any, you need to know a few things. Read on to find out what those things are.
Orthodontic services would include different types of braces, clear aligners and some other specialized dental services and treatments. Not all dental insurance plans include coverage for orthodontic treatment, so before purchasing any dental plan, it’s important to read the plan materials carefully to see if it includes orthodontic services or if you need to purchase additional orthodontic coverage separately.
Dental insurance is usually included in an employee’s health care package, allowing the employer to decide on the plan and level of coverage. But not all dental plans include orthodontic treatment, and if they do, it’s limited to children under 18. Some employers may choose plans that have orthodontic coverage for adults as well.