Guide to Finding Orthodontic Insurance

Many patients ask if there’s such a thing as orthodontic insurance coverage for adults. The short answer is yes! We put together the following information with everything you need to know about shopping for insurance plans that cover orthodontic treatment.

In the United States, the average cost of orthodontic treatment for adults is usually between $4,000 – $8,000. For many patients, having a perfect smile is priceless, but it’s nice to have options that will offset the cost. Purchasing an insurance plan that covers orthodontia is good to consider as this makes treatment more affordable for many patients.

Getting started

Orthodontic coverage is often included within dental insurance policies. Therefore, you’ll need to begin the process by first selecting a dental insurance plan. (Note: If you already have dental coverage, check your policy to see if orthodontia is included.)

Here are a few ways to purchase dental insurance:

  • Check with your employer – Many employers offer dental coverage in addition to health coverage. Check with your employer to see if they offer group dental plans that include orthodontic treatment and if you’re eligible to enroll. We recommend exploring this option first as group plans are often less expensive than individual dental plans.
  • Shop individual plans – If you don’t have dental coverage through your employer, another option to consider is purchasing an individual plan directly from an insurance company. Reputable companies like Aetna, MetLife, and Delta Dental offer individual dental plans that may include orthodontic treatment.

What to consider when selecting orthodontic insurance for adults

The best dental insurance for braces or Invisalign varies for each patient and depends on many different factors. Here’s what to look out for when shopping for a plan.

  1. When comparing dental plans, make sure the plan covers orthodontic treatment.
  2. Adult coverage – Some plans only offer orthodontic coverage for children, and exclude coverage for the subscriber and spouse. If you’re an adult, make sure coverage applies to you.
  3. Premium – Pay attention to the insurance premium. The premium is the total payment or monthly installment you agree to pay for coverage. It’s important to make sure the benefits included in the plan justify the cost of the premium.
  4. Deductible – Sometimes, an insurance company pays for treatment after the patient has paid the deductible. A deductible is the predetermined amount that must be paid by the patient before the insurance policy pays toward your treatment.
  5. Waiting period – Some plans require a waiting period between the date you purchase the policy and when you can begin using the plan for orthodontic treatment. You may have to pay the insurance premium for up to a year or longer before an orthodontic claim can be filed.
  6. Treatment in progress – Does the insurance plan cover orthodontic treatment that’s already in progress? The insurance plan may not cover orthodontic treatment if you’ve already started treatment. If you’re currently an orthodontic patient, it’s important to find an insurance policy that covers treatment in progress.

Spillers Orthodontics is NOT in network with any insurance companies. However, MOST orthodontic benefits are the same whether you choose a provider that is “in” or “out” of network. Orthodontic coverage is TYPICALLY a Lifetime Maximum Benefit for each dependent under the policy that will be paid regardless of the network.

Other options

If you’ve missed the open enrollment period or if a dental insurance plan is not a good option for you at this time, there are a couple of other options to consider.

Payment plans

Many orthodontists offer affordable monthly payment plans that can be arranged depending on the down payment and the length of treatment. This can lessen the financial pressure by spreading out payments in monthly increments over a period of time.

Spillers Orthodontics offers no interest, in-house payment plans to our patients. These payments will auto draft from your checking account monthly to make it easy for you. Since we handle this billing in house, you can call to speak with one of our friendly team members any time you have questions about your account.

Personal loan/third-party financing
Another option is to apply for a personal loan through your bank, credit union or an online lender. Some financial institutions offer medical loans, which might be a good option to consider.

Spillers Orthodontics works with online lenders Care Credit and Lending Point for our patients seeking outside financing.

Special Discounts
Some orthodontists offer special discounts. Spillers Orthodontics offers a 5% discount when paying in full at the beginning of treatment by cash or check.

We also offer a family discount. If more than one family member begins treatment with us, each additional family member receives 5% off their treatment fee. If the family discount is applied, an extra 2% discount is added for paying in full.

Take the next step toward a perfect smile

We understand that evaluating insurance and financial options can be overwhelming. But don’t let this stop you from getting the smile you’ve always dreamed of. We want to help!

At Spillers Orthodontics we accept most insurance plans and we can explain what benefits are available to you. We will also file your insurance as a courtesy to you and work with your Flexible Spending Account to maximize benefits.

Call us at 478-953-2700 to schedule a free orthodontic exam in one of our offices in Warner Robins and Macon, GA. After the exam, we’ll also discuss your financial options in detail. Don’t wait another day, schedule your visit today.