If you are looking for high-quality orthodontic treatment (like braces or Invisalign®) for you or your child, you may want to know if your dental insurance covers orthodontics! So if you’re asking yourself “is orthodontic insurance worth it”, you’ll be happy to know that orthodontic coverage can make a beautiful smile even more affordable!
At GO Orthodontics, our friendly team is committed to helping you get the most out of your orthodontic benefits, because the smile of your dreams doesn’t have to come with a financial burden. Our practice accepts most dental insurance!
What does orthodontic insurance cover?
If you have dental insurance, it’s a good idea to call the customer service number for your insurance company. Usually this can be found on the back of your dental insurance card or online if you haven’t received a card. Be sure to ask them for a “Summary of Benefits” to see if your plan covers orthodontic treatment. Just because you have dental insurance doesn’t necessarily mean your treatment is covered. You can find out what is covered and how much orthodontic-wise by looking for a section titled “orthodontia” (we’ll talk more on this soon).
Is orthodontic insurance worth it?
Having orthodontic insurance for you and your children can reduce your overall orthodontic care costs significantly! There are a ton of different insurance options to choose from, so here are a few things to consider when deciding on an insurance policy:
- • Don’t wait until the last minute – The sooner you are covered, the better!
- • The waiting period of your coverage – Ask if a waiting period may apply.
- • Be careful with cheap plans – Cheap doesn’t mean the best option.
- • Deductibles and Copays – Determine whether the deductibles/copays are reasonable for your budget.
To determine what your current insurance covers, schedule your complimentary consultation with us! We will discuss everything you need to know about payment and insurance coverage at your first visit to any of our 5 convenient locations in Mississippi and Tennessee.
What are disadvantages of dual dental insurance?
There’s a reality to secondary dental coverage most people aren’t aware of! It’s not uncommon for new patients to believe that having dual dental insurance coverage means that their orthodontic treatment will be completely covered and free of cost. However, that’s not the case! But wait, why? Isn’t that the point of having 2 insurances?
Because the world of insurance can be confusing, it’s a good idea to review the terms and benefits of both your dental insurances to help gain a better understanding of how they’ll work together (typically this is called a “coordination of benefits, or COB”).
Check out this fictional scenario for a quick explanation of how dual dental insurance can work:
Let’s say Sarah has two jobs that both provide her with dental insurance policies: Plan A will be designated her primary insurance (as this is one that has covered her for longer) and Plan B as her secondary insurance. Sarah decides to undergo orthodontic treatment, which costs a total of $6,000.
With Plan A (Sarah’s primary insurance), she discovers that orthodontic treatment is covered at 50% after the deductible is met. The deductible is $1,000, which means Sarah needs to pay this amount out of pocket before her insurance coverage kicks in. After the deductible, Plan A covers 50% of the remaining $5,000, leaving Sarah responsible for the other 50%.
Now, Sarah turns to her secondary insurance, Plan B, hoping it will cover the remaining 50% of the cost. However, Plan B has its own set of coverage rules. Let’s say Plan B covers orthodontic treatment at 30% after the deductible, with a deductible of $1,500. Sarah would need to meet this deductible with Plan B before any coverage is provided.
Once the deductible is met, Plan B would cover 30% of the remaining $1,000, leaving Sarah responsible for the remaining 70%. This means that even with secondary dental insurance coverage, Sarah would still have a significant out-of-pocket expense for her orthodontic treatment (a total of $2,200).
So you see a little how dual insurance coverage can work. Just remember it’s meant to supplement, not compound on your primary insurance coverage. Our friendly insurance coordinators will also go over your expected costs and eligible payment plans with you at your complimentary consultation so you’ll know the exact cost of braces or Invisalign with us!
Insurance payment plans
At GO Orthodontics, we accept most insurance plans! Some of the most popular plans we accept are Cigna, GEHA, and Delta Dental insurance. Orthodontic insurance companies work in several ways. Here are a few examples:
- • Percentage with a lifetime maximum: Some companies offer a rate with a lifetime maximum; for example, payable at 50% with a lifetime maximum of $3000 per person. This means that the insurance will cover 50% of the treatment (including the down payment) until it reaches the limit of $3000. If your treatment lasts for 24 months and you reach your limit on the 15th month, you’ll be responsible for the remaining cost.
- • A fixed copay: This option is much simpler. In this case, the insurance company will charge a fixed copay (amount varies) and pay the rest of your treatment. So, if your treatment costs $5,000, you would pay $1000 in co-pay, and the insurance company will take care of the rest.
- • Cover a percentage: Some companies cover at a rate or percentage. For example, if the insurance company covers 60% of your orthodontic treatment, you will be responsible for the remaining 40%. It all depends on the type of coverage you get.
If you still have questions or concerns about the various financing options or coverage for your orthodontic treatment, our team would be more than happy to speak with you!
Are you ready to transform your smile with high-quality, affordable orthodontic care? Schedule your first appointment with an experienced orthodontist in Saltillo, Corinth, Collierville, Southaven or Oxford.
