How Does Orthodontic Insurance Work?

It is completely understandable when patients approach orthodontic treatment with financial concerns at the top of their list of worries. An exceptional orthodontic practice like Clauss Orthodontics works closely with every patient on an individual basis to ensure finances aren’t an obstacle. We’ll be going over how orthodontic insurance in Burlington works. 

What Does My Plan Cover?

To provide you with a comprehensive explanation of orthodontic insurance and financial planning, we’re going to start by breaking down what is generally covered under most plans. One very important disclaimer we want to give is that plans and coverage can vary quite a bit from one patient to another—so it’s vital to gather accurate information ahead of treatment!

  • Diagnostic Procedures: Initial consultations, X-rays, and diagnostic records may also be partially or fully covered outside of the active treatment phase.
  • Braces: Almost all plans cover traditional metal braces for children and, in some cases, adults.
  • Clear Aligners: Treatments like Invisalign or other aligner systems are often at least partially covered.
  • Retainers: Post-treatment retainers, crucial for maintaining results, are frequently included in most plans.

In some cases, cosmetic-only or purely aesthetic treatments might not be covered. Orthodontic insurance can also come with “lifetime maximums,” meaning the total amount paid for treatment will be capped eventually.

Making the Most of Your Benefits

Even when you have insurance, there are steps your chosen practice can take to maximize them. Rest assured, our team at Clauss Orthodontics has your back! Here are a few ways we provide you with additional resources to help make your experience move along smoothly:

  1. Insurance Verification: Before your first consultation with Dr. Clauss, we’ll verify your benefits and provide a transparent, comprehensive breakdown of your coverage.
  2. Claims Assistance: You can let us handle filing claims and managing the necessary paperwork, so you don’t have to worry about it in the least.
  3. Flexible Payment Plans: For any uncovered costs, we’ll help you set up a payment plan that works best for you and your lifestyle.
  4. Treatment Coordinator Support: When you schedule a free consultation, our amazing in-house Treatment Coordinator will help you navigate your options and understand your benefits if you have any questions. Having this resource can be especially helpful if you or your child are undergoing a more complex, multi-leveled treatment plan.
How Does Orthodontic Insurance Work?

Insurance Tips

It’s fairly common for patients to learn that they may not be taking full advantage of their benefits, which is why we want to give you a few extra helpful tips!

  1. Stay In-Network: Clauss Orthodontics works with major insurance providers, including Delta, Cigna, and Anthem, to help you make the most of your coverage. It’s not that we can’t treat out-of-network patients, but you will likely find it means higher out-of-pocket costs.
  2. Coordinate Coverage: If both parents have insurance, combining benefits can significantly reduce out-of-pocket expenses for teens and kids.
  3. Start Early: Across the board, you’ll find that many plans provide better coverage for younger patients, so don’t delay beginning treatment if your child has shown signs of needing orthodontic care.
  4. Utilize FSAs or HSAs: Many plans offer Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs), which can cover out-of-pocket orthodontic costs with pre-tax dollars. You can learn more about these accounts through your provider.

Other Affordability Options

We’re also aware that not every patient has insurance—and that should never prevent them from getting the help they need from Dr. Clauss. Our team genuinely cares about securing an orthodontic treatment plan for you. We offer the following to our patients here in Watertown, and Middlebury:

  • 0% Interest Financing: You can opt to spread out your payments with no added interest for a manageable monthly cost.
  • Automatic Payment Options: Many patients set up convenient auto-draft payments from their bank or credit card to assist with staying on track. We know that many patients already have plenty of bills to pay—so this can be a huge asset.
  • Discounts: We offer a 5% discount for paid-in-full treatments and additional savings for multiple family members receiving care. Treating siblings and parents in the same family is a wonderful honor for our team!
  • No Pre-Approvals Needed: Our practice allows you to begin treatment without jumping through hoops or waiting for complicated approvals.
How Does Orthodontic Insurance Work?

A Helping Hand

Many people find the process of demystifying and unraveling insurance information to be a painful process, which is why you need someone in your corner to help you out! You can trust us for our unparalleled experience and quality of care. Get your orthodontic treatment started today by reaching out to our offices in Watertown or Middlebury soon!