What if you have found an orthodontist outside of your network? Will your insurance cover the cost of braces or other orthodontic treatment? If you have found a orthodontist that is out of network, there are some things you need to know.
There are many things to know before considering orthodontic treatment but knowing if your insurance will help cover the cost is top priority for many patients. Here is some more information about insurance plans and if you can cover the cost of an orthodontist outside of your network.
Payments For Orthodontic Care
Cost for braces, Invisalign, or other appliances will depend on your needs and what treatment plan we divise for you. Our team will help you discuss financing options and each payment plan so you can make the best choice for your oral health.
Fees can vary from orthodontist to orthodontist and can depend on the material and severity of your correction. Some orthodontists offer payment plans or accept fees from flexible spending accounts (FSAs) to be used toward orthodontic treatment.
We want your care to come easily and fit in your budget so we work to accept most insurance plans and major credit cards. Our office staff is also always available to help you with insurance claims and paperwork.
What Does Out Of Network Mean?
Out of network means that the doctor or orthodontist does not have a contract with your dental insurance plan provider. Sometimes this means higher prices for you as the patient and some dental plans will not cover the care of out of network providers at all.
Out of network providers have not signed any agreement with your insurance provider. These providers may still be able to do a balance bill for those patients who need to pay the remainder of what the insurance will not cover.
Should I Even Consider A Provider That Is Out Of Network?
If Bailey Orthodontics is not listed as an “in-network” provider on your orthodontic insurance plan that doesn’t necessarily mean that you won’t receive payment from your insurance for your treatment here. Often there is no difference between in and out of network contributions with specialized dental treatment like orthodontics. We are happy to check your benefits for you.
Orthodontic benefits are unique in the fact that the benefit is generally still available outside of your insurance network. If you have found a provider that is convenient for you but is out of network, this does not mean you should write them off entirely. Just because your insurance doesn’t cover all the costs of treatment does not mean that they won’t pay anything.
You may also want to check that your plan does not have coverage limits, even if the orthodontist is in your network. These limits could prevent you from spending so much in a year, or could have a waiting period between dental treatments.
There are some insurance plans that may cover orthodontic care for children and not for adults. Some will only cover certain services. It is always best to understand the orthodontic benefit that is available to you and any limitations that may apply.
As a service to our clients we help you to file insurance claims. Policies can vary and different benefits come with different plans but we can help you figure out estimated costs that you may have to pay. If you do leave your insurance plan, or switch plans, any cost not covered by the insurance company will be the patient’s responsibility.
Please notify us if there are any changes in your coverage or carrier as soon as possible so that we may identify how it affects your contract.
Bailey Orthodontics
Our office covers many insurance plans and is happy to help assist you in any way we can. Our website has a FAQ page about insurance that is specific to our office.
With offices in both Bountiful and Farmington, we can serve patients with our high quality services and friendly service. Our team looks forward to meeting with you and you can schedule a consultation to chat before even thinking about treatment.
From the moment you enter our practice, we want you to feel comfortable and appreciated. We are efficient with your time and money and make the most of the time that you are here. We know that busy schedules are important and we won’t waste your time. Come into our office and meet our two orthodontists, Dr. Grant Bailey and Dr. Andrew Welling and our support dog, Ralphie. Contact us today!
