You may be wondering if your dental insurance covers orthodontics for your teenager or yourself. Does it cover Invisalign clear aligners or only braces? How much does it cover, and how much should you be prepared to pay on your own?
We often get asked these questions during consultations with patients, and thought it would be helpful to give some general information.
Everyone’s coverage and plans are different, however there are some standard coverage amounts and ways to pay for orthodontics. Keep reading to find out more about insurance, FSA and other ways to finance orthodontic treatment.
As always, we’re here to answer your specific questions about insurance and financing – don’t hesitate to contact us anytime!
Insurance Coverage for Orthodontics
Some – but not all – dental insurances have an orthodontic coverage benefit. Right now is a perfect time of year to review your coverage, and plan if you want to change it for next year.
Many people will opt to change their dental insurance during open enrollment if they’re planning to seek orthodontic care in the following calendar year. For most companies, open enrollment happens in late October or early November. Now is a perfect time to start doing your research to find out if you want to update your insurance plan.
If a dental insurance plan offers orthodontic coverage, it is usually in the amount of $1500 or $2000 towards orthodontic treatment – this typically represents between 20-30% of the total cost of orthodontic treatment depending on the complexity of your case. This means that most patients even with insurance will be self-funding the majority of their orthodontic care.
The orthodontic insurance benefit is usually a one-time benefit per person on your plan. Contact our office if you have questions about dual coverage with another insurance as well.
Orthodontic insurance benefits are applicable to either Invisalign clear aligners or traditional braces and the coverage amount is the same for either. Fortunately for our patients, unlike other offices we always charge the same for Invisalign and braces so you can get the appliance you prefer!
Flexible Spending Accounts (FSA) for Orthodontics
Another popular option to pay for orthodontic treatment is using a Flexible Spending Account (FSA) to pay for your care. You can use FSA money whether or not you have dental insurance with an orthodontic benefit. In nearly all cases, orthodontic care is reimbursable under FSA’s.
Many employers offer an FSA benefit. An FSA works by allowing you to contribute pre-tax dollars from your earnings into a medical health savings account. You elect a total yearly contribution amount during your open enrollment before the calendar year starts, and this amount is taken out in small increments during each paycheck.
A very important note on FSA accounts is that typically you must spend all the money in the account during the calendar year or you’ll lose the money.
Currently the maximum benefit patients can put towards an FSA account is $2600 per calendar year. It’s a great time right now to start planning to set aside money in an FSA if you’re thinking of starting orthodontic treatment in 2018.
Also, if you’ve set money aside in 2017 and need to use it up before the end of the year – give us a call to start your orthodontic treatment in 2017! Another great way to use your FSA money is to get Vivera retainers if you’ve already had orthodontic treatment – this is the best system on the market for lifetime retention!
Making Orthodontics Affordable For You
At Boschken Orthodontics, we will work with you to maximize your insurance benefits and help you plan your coverage. We’re experts in making the cost of orthodontic care work for all of our patients and their lifestyles.
In addition to orthodontic insurance and FSA accounts, we also have creative ways for patients to pay for their orthodontic care – even for patients with no coverage at all! It’s our goal to find a payment system that works for you with a reasonable down-payment and comfortable monthly payments.
Another option some patients take advantage of is 3rd party financing, which is often at 0% interest to patients and can allow you to pay over time.
We never want finances to get in the way of the care you need, and we work with each family individually to find a solution that works for them.
Paying for Orthodontic Care
There’s many ways to pay for orthodontic care including insurance coverage, FSA and other financing options. Orthodontic treatment is likely more affordable than you may think!
We evaluate each patient individually during our complementary consultations, as each case is different in complexity. Based on that, we will work with you to find a financial solution that’s comfortable for your lifestyle.
Remember, now is the perfect time to review your insurance benefits and FSA to plan for 2018 and use up any unused insurance benefits or FSA money for 2017!
Call us today and we can help you maximize your coverage! Schedule your complimentary consultation today to learn more about your orthodontic case, financing and benefits.
