Our goal at Becker and Scott Orthodontics is to make orthodontic treatment affordable for everyone. Drs. Becker and Scott offer a variety of payment options to meet your needs, including:
- Full-payment discount
- No-interest financing with a low down payment and low monthly payments
- Multiple family member discounts
Patients often ask us how orthodontic insurance works. Nowadays, there are several different agreements between insurance companies and their subscribers. Each contract provides a different benefit.
With orthodontic insurance, each insured family member usually has a lifetime maximum benefit. The benefit is paid as a percentage of the fee, until the maximum benefit is reached.
Each policy maintains its own formula for calculating the amount to be paid toward the initial fee for appliance placement or subsequent monthly fees. Insurance companies do not pay out orthodontic benefits in a lump sum at the beginning of treatment. They spread out the payments over the course of the estimated treatment time. Generally, insurance companies pay a percentage of the total fee up to the lifetime maximum. Your policy may also have a yearly deductible.
If you have more than one orthodontic insurance policy, the carriers will decide which plan is the primary policy. This is typically determined based on the birthdates of the insured parties. However, this method of determination is not universal. The secondary insurance carrier will not make any payments until the primary carrier has determined what services will be covered.
Typically, the secondary carrier requests written confirmation from the primary carrier detailing what benefits will be covered. The secondary carrier will then determine what benefit is applicable. Having a secondary insurance is not a guarantee that you will have no out-of-pocket costs.
Flexible Benefit Plans
Flexible Benefit Plans are also known as Flexible Spending Plans. These have become a very popular way of projecting “pre-tax” dollars that will be spent during the next plan year. You must declare this amount before the beginning of the plan year. The plan year for the policy may not be a calendar year.
You may wish to confirm the beginning of the plan year with your employer. Utilizing this method, you stand to receive the greatest benefit, since you are planning in advance how orthodontic treatment will fit into your family’s plan for that year.
Once we receive your insurance information, we will bill your carrier directly. All insurance benefits will be assigned to our office. We do not provide service on the assumption that the charges will be paid by your insurance carrier.
If the insurance company pays less than estimated, denies a claim, or stops payments, you are responsible for paying any remaining fees. If the insurance pays more than estimated, any refunds owed will be paid out when treatment is complete.