Before making any changes to your dental/orthodontic insurance during open enrollment, please confirm with your provider or your insurance company that they have paid the orthodontic lifetime maximum in full. Insurance companies are smart and do not pay the full benefit up front when treatment begins. Instead, they spread payments out over as much as two years. Therefore, if you cancel or change your policy mid-treatment, you will likely lose part of the orthodontic benefit that we were expecting and you will be responsible for this unpaid portion.
If your insurance has not paid the maximum benefit in full and you are changing policies, please ensure that your new policy covers “treatment in progress”. If the new policy does not cover “treatment in progress,” it will not pay for continuing treatment and the unpaid insurance balance will then become your responsibility.
Age limits and waiting periods can also affect payments. Please make sure your new policy does not have a waiting period or any age limit restrictions.
In addition, before adding a secondary dental policy, please make sure your primary policy and your new policy have a coordination of benefits clause. If either policy does not have a coordination of benefits clause, they will not pay for treatment if there is another active policy making payments.
Please ask questions and do your research. Your old and new insurance companies are great resources and should be able to answer most of your questions. Orthodontic insurance is a contract between you and the insurance company – we do not know the details of your policy. If you have any additional questions, we are happy to help, though your insurance company will be your best resource.