Before even entering any type of medical office, many patients are already dreading dealing with financing and insurance options. A hallmark of good practice is making this process stress-free for their patients—which is what we try to do every day at Eastern Virginia Orthodontics. We’re going to explain how orthodontic insurance works in Norfolk.
Orthodontic Insurance Coverage
One thing we can say objectively is that not all insurance plans are alike—in fact, many of them will vary on certain points, which is why having a team like ours is so vital to assist you with your payment process. Generally speaking, coverage plans look like this:
- Diagnostic Tools and Assessments: Coverage often extends to initial consultations, X-rays, and diagnostic evaluations with Dr. Peluso or Dr. Savage before any orthodontic appliances are involved.
- Traditional Braces: Many plans include partial or full coverage for metal braces, particularly for younger patients—though adult patients can also be included.
- Clear Aligner Systems: Invisalign and similar aligner treatments are increasingly included in insurance policies these days, though the coverage amount may vary.
- Retention Devices: Retainers, vital for maintaining your post-treatment results, are almost always covered as part of your orthodontic plan.
In terms of exceptions to coverage, some instances are due to the motivation behind treatment. For example, if a treatment is purely cosmetic, it may not be covered. There are often coverage caps after a certain amount is spent, which should also be taken into consideration early on.
Boosting Your Benefits
Our team of professionals can play a significant role in how your insurance is integrated into your treatment. We strive to keep this as simple as we can for the sake of our patients. Your orthodontic treatment requires enough effort as it is!
- Flexible Payment Plans: For costs not covered by insurance, we offer flexible financing options tailored to your budget. You can also pay online through our website portal.
- Insurance Verification: Before your consultation, we’ll verify your insurance and provide a breakdown of your coverage so that you know exactly what to expect.
- Claims Assistance: Our team handles all claims and paperwork on your behalf, so you can focus on your treatment instead of administrative dysfunction!
- Personalized Support: If you have any questions along the way, you can ask our office team for additional guidance or investigation on an issue.
Saving More With Your Plan
- Get a Headstart: Many policies provide the best coverage for our youngest patients. This is part of why we say that interceptive treatment can save money in the long run.
- Additional Tip: Be sure to schedule a consultation at Eastern Virginia Orthodontics as soon as orthodontic concerns arise in children to determine if early treatment is necessary.
- Remain In-Network: Eastern Virginia Orthodontics partners with certain major insurance providers—but it’s important to know whether or not you are in-network at our practice to save you the most money.
- Additional Tip: Check with your provider routinely to confirm that your insurance remains in-network for your orthodontic care—this can occasionally change.
- Coordinate Benefits: If parents have separate insurance plans, combining dual coverage can lead to amazing savings on treatments for children and teenagers. This strategy is usually the best approach for reducing or eliminating gaps in coverage.
- Additional Tip: Ask your insurance providers how they handle dual coverage to avoid surprises.
FAQs
Let’s finish by covering some frequently asked questions about orthodontic insurance:
Q: What if my insurance changes during treatment?
A: If your insurance changes for whatever reason, let us know right away so we can get to work. We’ll assist you in navigating the transition and work to ensure your coverage remains intact as best as possible.
Q: Does insurance cover the full cost of braces?
A: Most plans do not cover the whole cost of braces—in fact, very, very few do. However, they often significantly reduce out-of-pocket expenses, sometimes by half or even more. Our team will provide a clear outline of your coverage before treatment begins to avoid any surprises.
Q: Do I need a referral from my dentist for orthodontic coverage?
A: This varies from plan to plan, but some do require a referral from your general dentist to allow you to qualify for orthodontic benefits. Be sure to check your policy details to confirm whether or not this condition is present.
A Helping Hand
Remember that we don’t expect you to have all the answers when you enter our practice—there is always a learning curve, and it’s nothing to be ashamed of! This is why we partner with you to find personalized answers and solutions. To get started, come see us in Norfolk, Virginia Beach, or Chesapeake.