Dental insurances are an important part of dental care. It can cover a range of dental services, such as regular cleanings, fillings, dental crowns, and dentures. Aside from these, a lot of people are also wondering if their dental insurance for braces and Invisalign can be used and claimed. In this blog, Our Orthodontist in New York will tell you about tips for using dental insurance for Invisalign & Braces.

How Do Dental Insurances Work?

Dental insurance is designed to help pay for dental care that would otherwise have to be paid out of pocket. It usually covers dental check-ups, dental treatments, and dental products such as dentures and crowns. A lot of dental plans come in different levels such as basic dental care, preventive dental care, and major dental care.

Dental Insurance for Braces & Invisalign

If you are wondering if dental insurance covers braces and Invisalign, the answer is it depends on various factors. You need to answer the following questions to be able to conclude if your insurance provider will cover braces and Invisalign treatment or not.

What type of dental plan do you have?

The type of dental plan you have will determine if dental insurance can cover braces and Invisalign or not. A dental HMO (health maintenance organization) plan may not cover braces and Invisalign while dental PPO (preferred provider organization) plans usually do.

Despite this, it’s important to know that most claims would only cover a certain percentage of the total orthodontic fees. For this reason, you still need to prepare for the cost that dental insurance may not cover. Also, they may have an annual limit for the dental expenses they cover, so you make sure to time your treatment accordingly.

What type of orthodontic treatment are you getting?

Different dental insurance plans may cover different types of orthodontic treatments. Some dental insurance providers may only cover metal braces while other dental insurance providers may cover traditional braces as well as Invisalign.

Is your braces/Invisalign provider in network with your dental insurance?

It’s important to check if your dental insurance provider has in-network orthodontic providers. Orthodontists who are in network with your dental insurance may often offer you discounted prices for dental treatments.

Is your orthodontic treatment medically necessary?

Some dental insurance plans may require patients to prove that their orthodontic treatment is not a cosmetic procedure. It must be medically necessary to qualify for dental insurance coverage. You can request a letter of medical necessity from your dental care provider or dentist to prove that you need orthodontic treatment.

Do you have FSA/HSA benefits?

FSA (flexible spending account) or HSA (health savings account) are health care benefits that allow you to use pre-tax income to pay dental and orthodontic costs. You can use it to cover the cost of dental treatments such as braces and Invisalign.

4 Tips for Using Your Dental Insurance for Braces or Invisalign

#1 – Review your current dental insurance plan or options.

First, you need to review the dental insurance for braces in New York that you are currently enrolled in. If you haven’t purchased one yet and are planning on getting orthodontic treatment, check out dental insurance plans that will cover the dental treatment.

Also, you need to know that orthodontic benefits under a dental insurance plan work differently. They don’t usually offer them from your annual out-of-pocket maximums. Instead, dental insurance plans usually have a separate benefit period and one annual maximum for orthodontic treatment.

#2 – Know your lifetime maximum benefits.

You need to be aware that most dental insurance for braces or Invisalign have set lifetime maximum benefits for orthodontic treatments. This means that the dental insurance for braces or Invisalign will only pay for these treatments up to the maximum benefit amount set by your dental insurance provider.

For instance, many will have a flat benefit amount (e.g., $3,000), while others will cover an unlimited amount of a certain percentage of the treatment (e.g., 50%). In some cases, you can combine these two to maximize your dental insurance for braces or Invisalign.

#3 – Consider using your FSA/HSA insurance benefits for braces or Invisalign.

If you have a Flexible Spending Account (FSA) or Health Savings Account (HSA), these can be used in place of dental insurance for braces and Invisalign. This is particularly beneficial if your dental insurance plan does not cover orthodontic treatment or has a low lifetime maximum benefit.

Using FSA/HSA insurance benefits for braces or your FSA/HSA insurance benefits for Invisalign can significantly reduce the cost of dental treatment. Plus, it is tax-free money so you can save even more by using it for dental expenses. Keep in mind that these benefits also have an annual maximum, so you need to plan your dental expenses accordingly.

#4 – Discover any additional payment options.

If dental insurance for braces or Invisalign does not cover all of the cost, you can look into your orthodontist’s payment plans. Ask them which providers and third-party financing institutions they are in network with to get the best dental treatment options and discounted rates.

In some cases, orthodontists may also offer discounts to their patients who can pay in full upfront or who have dental insurance plans that cover a majority of orthodontic fees. You can also consider using your HSA or FSA funds to cover dental expenses.

Consult Bracesetters Orthodontics in New York Today

To get an exact dental insurance quote for braces and Invisalign, contact Bracesetters Orthodontics in New York today. Our team can help you determine if your dental insurance for braces and Invisalign is possible and how much you’ll need to pay out of pocket.

Our offices are located in Middletown, Newburgh, Monroe, and Montecillo, NY. We house some of the most trusted board-certified orthodontists in the area. Our team of dentists and orthodontists have treated countless people in our area and are now treating third-generation patients.

At Bracesetters Orthodontics, you have a choice among various modern brace types such as Invisalign, metal braces, and ceramic braces. We also offer other orthodontic appliance options such as dental expanders, retainers, and the Herbst appliance.

With BraceSetters Orthodontics, you can trust that you’ll be in good hands. Contact us today to set up a FREE orthodontic appointment where our team will be able to help you determine if dental insurance for braces and Invisalign is possible! We look forward to meeting you and helping you get the dental treatment that you need!