How Does Orthodontic Insurance in Worcester Work?

Navigating the financial aspects of orthodontic treatment can be a bit off-putting, especially if it’s your first venture into the field. Central Massachusetts Orthodontics Associates believes that everyone should have access to amazing treatment—which is why we make dealing with insurance a breeze. We’re going to go in-depth on how orthodontic insurance works in Worcester. 

Important Insurance Information

Under the interpretation of an expert team like ours, orthodontic insurance can significantly lower your out-of-pocket costs for all manners of treatment. There are some basic distinctions and guidelines that can be helpful to know from the get-go.

  • Targeted Coverage: Orthodontic insurance helps cover the cost of braces, clear aligners, and retainers, ensuring your smile stays healthy and aligned. It’s entirely distinct from general dental insurance.
  • Lifetime Maximums: It’s vital to know that most plans feature a one-time lifetime benefit per patient rather than an annual limit.
  • Age Restrictions: Some plans may provide better benefits for children and teens, though coverage for adult orthodontics is becoming more common as this treatment has become more mainstream.
  • Coverage Varies: Plans have individual differences. For example, some may not cover purely cosmetic treatments and will provide a condition only, including medically necessary appliances. 
  • Consultations and Diagnostics: Your various initial exams, X-rays, and other diagnostic procedures at Central Massachusetts Orthodontics Associates will be paid out-of-pocket—though we’ll include your insurance when we submit your initial treatment claim.

Generally speaking, your orthodontic insurance will cover one or more of the following:

  • Braces and Aligners: Many plans cover both traditional braces and clear aligners, particularly for younger patients.
  • Post-Treatment Retainers: Retainers are the star player of the retention phase (the period after active treatment concludes) and are usually included in the coverage.
How Does Orthodontic Insurance in Worcester Work?

Making the Most of Your Insurance at CMOA

Our teams at our three offices handle the brunt of your insurance process to make it a very easy experience for you. After all, we want you to be able to focus on your treatment and oral health without wrestling with finances.

Here are a few measures we take to make this possible:

  1. Insurance Verification: Before your first visit with Dr. Giarusso, Dr. Livanos, or Dr. Kotin, we verify your benefits and provide a clear breakdown of your coverage.
  2. Transparent Pricing: Your bespoke treatment plan will include a detailed breakdown of all costs, so there are no unpleasant surprises. We’ll be sure all of your questions are answered well before we initiate treatment.
  3. Claims Assistance: Our office will handle the filing of your insurance claims, so you don’t have to.
  4. Ongoing Support: If your insurance coverage changes for whatever reason, our team will help you update your information and navigate new benefits.

We are in-network with BCBS, Delta Dental, and Altus. If you aren’t covered, don’t let that prevent you from seeking treatment. Many times, orthodontic insurance covers the same costs in or out of network!

Additional Resources

We want to provide you with a few additional insurance tips to make your life a bit easier! Whether you, your spouse, or your children are undergoing treatment, keeping these points in mind will serve you well.

  • Bring Your Insurance Card: Always have your most up-to-date insurance information with you during your visit to avoid hiccups.
  • Inform Us of Changes: Let us know if your insurance coverage changes to ensure uninterrupted benefits.
  • Consider Early Intervention: Remember that many insurance plans emphasize early orthodontic care for children. They often cover medically necessary treatments such as space maintainers or appliances designed to address bite issues during developmental stages.
  • Understand Lifetime Maximums: Knowing your plan’s lifetime orthodontic benefit from the beginning can help you plan your finances without issue.
  • Utilize FSAs and HSAs: Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) can be used to cover out-of-pocket expenses with pre-tax dollars. These aren’t always taken advantage of in benefit plans, but we definitely recommend them!
  • Combine Plans: Dual coverage is a surefire way to reduce your out-of-pocket costs, so definitely opt for this option if it’s available to you or your family members.
How Does Orthodontic Insurance in Worcester Work?

The CMOA Difference

Our practice is aware that you have many options in choosing an orthodontic provider—and we are so fortunate to treat all of our patients here in Worcester, Auburn, and Spencer. Making sure that your treatment process isn’t a burden is one of our top priorities, and we’re confident you’ll notice this difference under our care. Come and see us soon!