We hope the following information will help you understand your orthodontic insurance benefits.
- Orthodontic insurance differs from general dentistry insurance
- Orthodontic insurance is added on to some dental plans as an additional benefit
- Having dental insurance does not guarantee that you have orthodontic coverage
If you have orthodontic benefits, or do not know if you do, please do the following:
- Provide us with the insurance company’s information
- be sure that it includes the insurance company’s name, address and phone number
- Provide us with the subscriber’s necessary information
- Social Security or ID number, birth date, address, phone numbers, and employer
Provided with the above information, we will be happy to verify your insurance benefits with your insurance company. Dr. Phillips accepts assignment of benefits for all insurance companies.
- Benefits from your insurance plan will come directly to our office and will be applied to your separate insurance account
- We will handle all of the insurance billings
- We will work to maximize your benefits and resolve any issues that may arise
- If benefits are sent to you in error, please endorse the check payable to Dr. Phillips and turn it over to our office to be applied to your insurance account.
- Please notify our office of any changes in insurance coverage throughout treatment
- Many insurance companies will allow benefits even if treatment is already in progress
- Should you gain new insurance coverage once a patient is in treatment, please provide us with the necessary information so we may check on benefits for you.
Possible Insurance benefit limitations:
- Can be limited to dependent children (adults exempt)
- Can be subject to a waiting period
- May have an age limit for dependent children
- May include a yearly deductible
- May limit benefits specified by your plan’s contracted amounts
- Some insurance plans do not pay the full benefit amount at the start of treatment
- Some plans disperse the benefit as the treatment is rendered
- Benefits are available to you while you are insured
- Should you lose coverage:
- We will make sure your benefits have been maximized
- Any benefit left unpaid will revert to your personal responsibility
If you have any further questions or concerns, our front office staff will be happy to assist you.
Flexible Spending and Health Savings Accounts
- Many employers now offer Flexible Spending Accounts (also known as Cafeteria or 125 Plans) or Health Savings Accounts
- These plans are designed to assist families in paying for out-of-pocket medical and dental expenses including orthodontic services
- Employees are allowed to set aside pre-tax dollars to help pay for expenses that are not covered by insurance
- These plans are federally regulated with strict guidelines that must be followed and can vary in their format and requirements
To determine if your employer offers a Flexible Spending or Health Savings Account, please do one of the following:
- Read the benefits booklet supplied by your employer
- Check with your employer’s Human Resources or Benefits Department
If you have a Flexible Spending or Health Savings Account, please be aware of the following:
- Eligibility and enrollment requirements
When the enrollment deadline is, and what period of time the plan covers (i.e. January to January, July to July, or indefinitely etc.)
- Know the maximum amount per year that your plan allows you to set aside for non-reimbursed health expenses
- Know what documentation the plan requires you to submit to receive your funds (i.e. a required form, copy of your contract, receipts, verification of treatment, etc.)
- Know how your funds will be disbursed to you (i.e. in one lump sum, quarterly or monthly)
- Plan requirements can change from year-to-year, and should be reviewed each new benefit period
When determining what amount to put into your Flexible Spending or Health Savings Account to be used for orthodontic services:
- The plans are for non-reimbursed health expenses
- Any insurance benefits that you may receive during the benefit period will be deducted from any charges you plan to pay with the pre-tax dollars
- Choose your treatment starting dates carefully so that planned funds will be available to you
- Flexible Spending Account funds
- Must be used during the current benefit period
- Are not allowed to accrue
- Any leftover funds will revert to your employer
- Health Savings Account funds
- May accrue
- Do not expire if not used during the benefit year
- Pre--treatment observation appointments are excellent opportunities to plan ahead for your enrollment period
- Make your appointments well in advance of your enrollment deadline so we may assist you with your planning
- Once treatment begins, our staff will provide you with any necessary documentation you may require, such as receipts for payments, copies of financial agreements, and verification of treatment
Please let our administrative staff know if you have any questions, or how we may assist you in understanding your Flexible Spending or Health Savings Account.
Accepted Forms of Payment
It is our mission to provide you with affordable, high-quality treatment that fits your budget! We offer a variety of payment options to meet your needs. For your convenience, we accept Visa, MasterCard, American Express and Discover.
We offer third party financing through the Springstone Patient Financing and CareCredit as well as in-house financing with flexible monthly or quarterly payment options spread over the course of treatment. In addition, we offer discounts for payment in full at the start of treatment and for multiple family members in treatment. We thoroughly explain your options so that we can accommodate your needs.