Orthodontic Coverage with Private Health Insurance: What to Know

Do you have dental insurance through your employer? Learn more about how you can use your orthodontic treatment to get your dream smile!

Your Insurance Questions Answered

If you have dental insurance, your plan may also offer orthodontic coverage. Diamond Braces will help you verify your insurance information and will work directly with your insurer to help secure coverage.

Private insurance plans vary widely, but many plans cover anyone listed in the policy, including adults. Depending on the plan, coverage may extend to multiple individuals, or allow you to use the fixed amount of coverage for each individual on the policy. Diamond Braces teams members will assist you to review and understand your plan’s available benefits.

Some plans will cover treatment in full, however most private insurances provide a fixed benefit amount, which covers a portion of treatment, not the full amount. Those are once per lifetime benefits. When you visit Diamond Braces for your initial consultation, we will discuss any available insurance information and what portion of the treatment may be covered.

No. For most plans, if you have verified that your dental insurance includes orthodontic coverage, Diamond Braces can begin your treatment and bill your insurance provider immediately.

Because private insurance varies so widely with orthodontic coverage, we generally recommend that you try to stay on the same plan for the duration of your treatment. If your plan does change for any reason, please notify us as soon as possible. Diamond Braces team members will assist you with verifying any updated benefit information that may affect your treatment.

If you do lose your insurance, and/or your new insurance plan does not include orthodontic coverage, Diamond Braces will help you establish a flexible monthly payment plan that allows you to pay in manageable installments. Diamond Braces offers customizable options to fit your budget including extended, zero down payment and no interest plans. You will only be responsible for the portion of your treatment that was not covered by insurance.

Most insurance plans allow members and their dependents to upgrade to elective treatment options such as Invisalign or other clear aligners. For many insurance plans, coverage is the same or similar to traditional braces. A Diamond Braces team member will review your estimated financial commitment for Invisalign treatment at your consultation.

Like clear aligners, clear braces are considered an elective treatment option. Most insurance plans will allow you to select your preferred option – see above.

The good news, you do not need a referral to see an orthodontist. No referral is necessary to be evaluated for orthodontic treatment; you can schedule a consultation with Diamond Braces and begin treatment right away. Our administrative staff will assist you with verifying and understanding your insurance benefits. 

We recommend you check with your insurance carrier prior to your first visit. Diamond Braces participates with most insurance plans, and we will always work with you to understand insurance coverage and establish flexible payment terms when applicable.

Questions About Your Private Insurance Plan? We Have Answers!

Disclaimer

” Starts as low at $2800 “: All Diamond Braces final treatment plans are devised based on a review of x-rays and an in-person examination of the patient’s dentition performed by a licensed doctor. Plans discussed via virtual consultations and appointments are not final and will require an in-office visit and additional diagnostic records such as x rays or 3D scans before they are considered final.

” Starts as low at $2800 “: The cost associated with comprehensive orthodontic treatment with Diamond Braces are for terms up to 24 months. Extending a patient’s term due to poor compliance or other factors, such as case complexity and tooth movement variations, may result in additional fees.

” Lifetime Smile Guarantee “: Only Diamond Braces cases completed by the Practice and placed on retention are backed by our Lifetime Smile Maintenance Guarantee. Terms and conditions apply. Visit /lifetime-warranty/ for more details.

” 30% less than the national average “: Claim comes from calculations comparing an average treatment plan from Diamond Braces to the national average calculated by the American Dental Association’s Survey of Dental Fees.

“As low as $104 per month “: Monthly payments are calculated by dividing the patient’s final treatment price by a number of months. Prices may vary based on the patient’s age, case severity, treatment type, insurance coverage and more.

” 0 down”, “0% financing”, “flexible monthly payment plans “: Alternate financing options are only available to qualified applicants based on a financial review and available insurance coverage.

” Starts as low at $2800 “: Costs associated with Invisalign clear aligners for comprehensive and SMILIFY Expedited Invisalign treatment, including the full prescribed set of upper and lower aligners, are covered by the stated price for up to 24 months (for comprehensive) and up to 12 months (for SMILIFY) or until the originally prescribed term is completed.

” Up to 24 months “: Term lengths are calculated based on the patient’s medical status and may vary based on factors such as age, case severity, patient needs, and chief complaint.

” SMILIFY Expedited Invisalign Treatment “: SMILIFY Expedited Invisalign treatment is only available for qualified patients based on x-rays and medical examinations performed by a licensed doctor. Not all applicants may qualify.

” SMILIFY Expedited Invisalign Treatment “: Savings associated with SMILIFY Expedited Invisalign treatment cannot be combined with other promotions offered by Diamond Braces unless explicitly stated otherwise.