Insurance PoliciesAt Chapman Orthodontics, we accept most major insurance. If we have your insurance information prior to your complimentary initial exam, our staff will research your coverage and provide an estimate of your orthodontic benefit at your exam.
If you have orthodontic insurance, we are happy to help determine your available coverage and file your insurance for you. We'll do our best to answer any of your questions, however, coverage does vary by carrier and by individual policy, so when questions arise about your coverage, it's usually best for you to contact your insurance carrier directly or talk with your employer.
There are many different agreements between insurance carriers and their subscribers, and each contract provides a different benefit. Orthodontic insurance generally differs from regular dental insurance in that:
- Each insured member of the family usually has a lifetime maximum benefit for orthodontic services.
- There are often age limitations.
- It rarely—if ever—pays for orthodontic treatment in full.
- The benefit is paid as a percentage of the orthodontic professional fee until the maximum has been reached.
- Each insured individual usually has a lifetime maximum benefit for orthodontic treatment. This benefit may vary from as little as $500 to more than $1,500, depending on the type of insurance policy.
- Insurance payments are usually paid out over the course of treatment—not in one lump sum, so your coverage must continue throughout treatment.
- If your plan says 'covered at 50%,' it usually has a maximum amount—it does not mean your insurance will pay 50% of the fee for treatment.
- Double check the effective date of coverage. Some insurance plans require a waiting period before your coverage becomes effective.
- Check on any benefits already paid out for previous orthodontic treatment and/or dental benefits. Find out from your insurance carrier whether or not that amount will be deducted.
- Unfortunately, fees for lost or broken orthodontic appliances are rarely covered by insurance.