When you begin any sort of orthodontic treatment – whether it’s Invisalign or traditional braces in Rochester – it’s important to ask, “Will my care be covered by insurance?” Each dental plan is different; some offer orthodontic benefits while others don’t. It’s important to have a firm grasp on whether or not you can expect help from your dental insurance provider to help pay for a straighter, healthier smile. Below are some important things you’ll need to know about your dental insurance before you schedule your first consultation with the orthodontist.
How Will You Know if Your Plan Offers Orthodontic Benefits?
Since each plan is different, the best way to know for sure what benefits are available is to call your dental insurance provider directly. Tell them exactly what kind of treatment you’re considering; they should be able to quickly confirm whether or not it falls under your current plan. If you’re not completely sure about the kind of coverage you’re entitled to, you can also talk with your orthodontics team; they’re used to working with insurance companies and can explain the process to you in easy-to-understand terms.
How Much Will Insurance Cover?
It’s important to note that orthodontic benefits aren’t like regular dental benefits. Most dental plans have an annual maximum that is renewed each year. Orthodontic benefits, on the other hand, are usually limited by lifetime maximums. Essentially, once you’ve used these benefits, they’re gone and they won’t be renewed. As such, if you’re undergoing an orthodontic treatment that is completed in multiple phases, any benefit that was used during the first phase will reduce the amount of coverage you can receive during the second phase. (For example, insurance will usually pay less for a retainer than for full braces simply because there’s less money available.)
How Much Will My Orthodontic Treatment Cost?
That depends on many different factors, including:
- The kind of service you need, whether it’s traditional braces, Invisalign, a specialized oral appliance, or dentofacial orthopedics.
- The complexity of the issue and how long it will take to correct. Some patients will only need a six-month Invisalign treatment while others will have to wear braces for two years or more.
- Any unforeseen complications that might occur. For example, if braces break and aren’t repaired in a timely manner, overall treatment time could be affected.
Your orthodontist will go over the different factors that will affect the overall cost of your orthodontic care. They’ll also take the time to explain your insurance benefits so that you know ahead of time what you can expect to pay out of pocket.
Don’t be afraid to contact your insurance provider if you have any other questions regarding your dental insurance plan. Orthodontic care can make a big difference in your life, but you should only begin your treatment when you’re fully confident that you understand your financial situation.
About the Author
Dr. Stan Drabik has spent over two decades improving smiles with orthodontic care. He completed his orthodontic certificate at Boston University’s Henry M. Goldman School of Dental Medicine, and today he is a proud member of the American Association of Orthodontists. If you would like to schedule a consultation at Drabik Orthodontics or have a question about using dental insurance to pay for braces, get in touch with Dr. Drabik through his website or by calling (585) 730-7700.