A little mystery can be fun sometimes— but not so much where finances are concerned. Patients want and deserve a totally transparent financial process when they’re seeking orthodontic treatment. Brodsky Orthodontics is going to cover how orthodontic insurance works here in Lakewood and how we make the best of it.
The Question of Coverage
To begin, let’s discuss a few of the most important aspects of orthodontic insurance. This information is a good starting point for new patients before they meet Dr. Joel, Dr. Charles, or Dr. Vistica and connect with our expert office team.
Factors That Influence Coverage
- Age Restrictions: Orthodontic insurance plans sometimes provide greater coverage for children and teens compared to adults. This is because orthodontic treatment during younger years is more common and may be considered medically necessary to correct developmental issues.
- Treatment Type: The amount of coverage might vary based on the type of treatment we choose. Cosmetic-only treatments may not always be covered (especially if a company requires pre-authorization). We’ll help you check the fine print in your policy to see which treatments are included and discuss options to find the best balance between your needs and your budget.
- Out-of-Network Providers: Costs can be higher if our office is out-of-network with your insurance company—though orthodontic insurance is a little different in the sense that in-network and out-of-network costs can be virtually the same in some cases.
Covered Treatments
- Diagnostics: Your consultations, X-rays, and diagnostic records to begin your treatment are usually covered, first and foremost.
- Braces and Aligners: Coverage will usually apply to traditional metal braces, clear braces, and clear aligners like Invisalign. They can also cover lingual braces, though we won’t know the extent of coverage until we take a closer look.
- Additional Treatments: We also offer Diode Laser Treatment and advanced 3D imaging, which may or may not be included under your policy
- Retention Devices: Post-treatment retainers (your first set only) are typically covered to help you maintain your results.
- Surgical Orthodontics: Severe or complex cases requiring surgical corrections in a separate hospital setting outside of our office may have partial coverage under some plans.
A Complete Insurance Solution
Utilizing insurance can be a multi-layered process, all of which is handled by our team on your behalf. From start to finish, we’ll be the main intercessor between you and your insurance company to make sure everything is running smoothly and fairly.
Insurance Verification
Before your initial consultation, our office team will:
- Carefully examine and verify your insurance benefits.
- Provide an itemized breakdown of everything covered under your insurance plan.
- Help clarify and explain any expected out-of-pocket costs.
Claim Assistance
We take the frustration out of filing claims by doing the following for you:
- Submitting claims directly to your insurance provider from our desk.
- Maximizing your benefits in any way we can.
- Keeping you informed about any changes along the way.
Helpful Online Tools
There are other measures you can opt into that can enhance your financial process with us, all through our online portal:
- Easily review your payment history and answer any questions you might have.
- Print out flex spending reimbursement and tax receipts in a few simple steps.
Myths About Orthodontic Insurance
Finally, we want to demystify your insurance even further by debunking some misconceptions that get passed around from time to time. Brodsky Orthodontics wants to make sure your questions are answered and that those answers are factual!
MYTH: Orthodontic Coverage is Included in All Dental Insurance Plans
Not all dental insurance policies will include orthodontic benefits by default. You may have to take extra steps to opt into orthodontic coverage or choose a premium tier plan. This will be one part of the process you should take care of independently before your first consultation—though again, we can help with any clarifications you may need.
MYTH: Orthodontic Insurance Covers All Costs
Many patients initially believe their orthodontic insurance will fully cover treatments like braces or aligners. In reality, most plans only cover a portion of the cost.
MYTH: Financing Orthodontic Treatment is Too Much Trouble
It really shouldn’t be—and this is where having the right provider matters! Brodsky Orthodontics strives to make your payment plan experience easy for you. We even offer flexible options like interest-free monthly payments to help make costs more manageable.
The Best of Brodsky Orthodontics
We believe that our local patients shouldn’t have to struggle to receive the treatment they need. We care about your results, but we also care about how you’re able to get them—and it should never be a process that causes you undue stress. Our Lakewood office team can’t wait to meet you!