orthodontic insurance

Choosing the right orthodontic insurance is an important decision. Many factors will affect your decision, including the type of plan you choose, the costs involved, and the limitations on coverage.


Depending on the type of dental insurance plan you have, orthodontic coverage may be limited or unavailable. However, there are several other options available, including discount plans. These plans can help you save a lot of money on orthodontic treatments. Choosing a plan is a matter of researching your options and choosing a plan that fits your needs.

The National Association of Dental Plans is a great resource for finding out which plans offer orthodontic coverage. They have information on several plans, and will even let you search for plans based on your state.

If you have an employer-sponsored health plan, your dental insurance plan is likely part of your healthcare package. Your employer’s benefits manager can help you find a plan that fits your needs. Depending on your plan, you may be required to pay a deductible, wait before getting certain services, or have a lifetime maximum.

If you are considering orthodontic coverage with a dental plan, check to see if your plan offers any type of co-pay or deductible. A deductible is a small fee you must pay up front for the services you are getting.

The best dental insurance plans for orthodontics will offer coverage for the cost of braces and other dental procedures. The deductible for these services is usually between $25 and $75 per person per year. The lifetime maximum will not renew like other dental services, but it does cover a certain amount each year.

If you have a spouse or domestic partner, they may have a separate health plan that covers their orthodontics. You may also have a health savings account. These accounts allow you to set pre-tax money aside for medical expenses. This money can then be used for dental bills. Using an HSA and discount plan together can save you a lot of money on orthodontic treatment and other dental work.

While orthodontic insurance coverage can be a great way to get dental work done, the price of coverage can vary widely. The more expensive plans can cost hundreds of dollars a month. A cheaper plan may only cover about one thousand dollars of orthodontic treatment.

Discount plans

Using discount orthodontic insurance plans can be a great way to get the care you need. However, you need to make sure you understand the coverage and limitations. You can find information on various plans on the National Association of Dental Plans website. You can also contact a human resources representative or benefits manager to learn more.

A Preferred Provider Organization, or PPO, is a dental insurance plan that is usually offered through an employer. It works much like health insurance. It will typically have a maximum spending limit for orthodontic services, as well as a deductible. Some plans have a waiting period, as well. The cost of orthodontic care can be expensive, but using a health savings account or discount orthodontic insurance plans can help you save money.

You can save money by using an HSA, which allows you to set aside pre-tax money for medical expenses. You can also use a flexible spending account to pay for dental services.

Some dental insurance plans will also offer discounts on braces and other orthodontic devices. The cost of orthodontic care can vary depending on where you live. You may also be able to find discounts by using a dental discount plan, which costs about $10 to $20 per month. These plans will typically pay up to 50% of the cost of orthodontic treatment.

Dental plans with orthodontic coverage often have low lifetime limits. This limit can range from $1,500 to $3,000. It can help you save money when you purchase a dental plan. However, if you need orthodontic work on a regular basis, you might need additional coverage.

If you are uninsured, you can apply for a discount orthodontic insurance plan. These plans work by negotiating discounted rates with orthodontists. You pay a monthly or annual fee, and your coverage will pay a reduced rate. These plans can be expensive, so you may want to shop around.

There are several plans offered by Humana, a Louisville, Kentucky-based insurer. You can use a phone quote to determine what plans will best suit your needs. Humana has an A- financial strength rating from AM Best.

Limitations on coverage

Whether you’re buying a plan through your employer or going it alone, be sure to check out the limitations. For example, you may not be able to get all of the teeth whitening treatments you want. Or, if you’re getting braces, you may not be able to get the full set of braces you want. Also, don’t forget about the dentist’s office fees. If you need to have additional cleanings done, you may have to pay for them yourself.

Most plans will restrict the number of services you can have performed in a calendar year. They also may not cover the latest in dental technology. Also, you may have to go to an orthodontist affiliated with the plan if you want to get the full benefit. You may also be required to have a preauthorization prior to starting any dental work.

Having dental insurance isn’t a given, but it’s something most people need to do to survive the recession. If you’re looking for dental insurance for yourself or your family, talk to a broker or insurance broker about your options. You may be able to find a full coverage plan for less than the cost of a single visit to the dentist. You can also find discount plans that can save you a bundle.

For example, a flexible spending account can help you pay for your dental bills without breaking the bank. You can also use the money you save in a health savings account to pay for things like orthodontics. Also, don’t forget about the dental deductible. If you don’t have insurance, you’ll have to pay out of pocket for things like teeth whitening and extra cleanings. You may also have to get a dental insurance quote to get the lowest price.

The most important point to remember is that dental insurance doesn’t cover everything. You’ll still have to pay out of pocket for things like plaque control, cosmetic procedures, and myofunctional therapy. Also, some plans don’t cover things like prescription fluoride and diagnostic photographs. Having dental insurance can be a real pain, so be sure to find a plan that suits your needs.

Filing a claim

Obtaining orthodontic insurance can be complicated. There are many factors that affect coverage. Some plans have restrictions based on age, length of validity, and dependent status.

Most dental plans pay only a portion of the orthodontic fee. The amount paid is usually split up over several months.

The most common percentage is 50%. The amount is based on the total cost of the treatment, the percentage of the patient’s coverage, and the number of months remaining on the plan. The benefit can be paid in one lump sum when the treatment begins, or it can be paid in quarterly or semi-annual installments over the course of the treatment.

If you are receiving orthodontic benefits under your employee’s plan, check the benefits section of the employee handbook for information on coordinating benefits. You may also need to inquire about supplemental insurance.

Orthodontic insurance benefits may also be prorated. When you first start treatment, you will be paid half the fee, and then the other half after the first year of treatment. You may also be required to pay a co-pay. Most co-pays are around $1,200.

Once you have received the orthodontic appliances, you will need to submit a claim to your insurance company. Some offices send predetermination forms to the insurance company. The predetermination contains a brief description of your orthodontic condition and your treatment plan. Your insurance company will then verify that the treatment was provided and payment was made according to the plan’s guidelines.

Most insurance companies make payments monthly, quarterly, or semi-annually. If you change employers or stop coverage, you will not receive your full benefit. Your new insurance will pick up payments where your previous insurance left off.

When you are submitting your claim, be sure to include your original EOB. This will verify the payment you received and help you correct any errors. If you have questions, you can always contact your insurance agent.

The Academy of Insurance Coordinators is a web-based educational program that teaches you how to submit accurate insurance claims. The program was developed in conjunction with Dr. Doug Depew and Jill Allen.