Insurance Covering Cost for Adults

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#16 Post by Margie »

Unfortunately my insurance doesn't cover the cost of adult orthodontics. I was able to claim the amount I paid last year on my taxes, but considering how much I paid I didn't get a lot back, but some is better than nothing.

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#17 Post by fosterp »

i have washington dental service, pays 2000 of my orthodontics. My ortho basically chopped 2000 off my bill and I paid the other portion up front. How my insurance is paying my ortho I am not sure but I get monthly explanation of benefits statements showing my insurance paying the ortho a little bit each month.

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#18 Post by catfish »

Another Delta Dental subscriber here, and they paid $1500 of my bill. For a while I had dual coverage through my husband's employer, but they would only pay ortho for kids under 18. So I'm feeling lucky that I got any help at all.
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#19 Post by llehsal »

The insurance I have is with my office and it covers $2500. My entire procedure is costing $25, 000. So yeah. I have to pay first then claim.
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#20 Post by alimommy1 »

I'm looking into a discount plan that will save me about 25%, it's not ins but anything helps!

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#21 Post by Tovin »

I have insurance as a federal civil servant. It covered $0.

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#22 Post by Kei »

I've got very good dental insurance through my job. It pays $3000 lifetime cap for ortho for each person on my plan with no age limits or deductables. My total cost of treatment is around $3,996 and so I am paying the remainder off over the next ten months. I should be in braces for 24 to 26 months.

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#23 Post by RHOyally Braced »

I have Aetna DMO through my job, and they have an Orthodontics portion/clause/ thingy. I have a $2000 Copayment, which my Ortho has split up as $350 for my records, $910 when my brackets are installed, then the rest is paid over the remaining course of my treatment. They also cover my retainers, etc. I should be in braces for 2 years or so.
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#24 Post by PrincessKia »

Thanks for the replies.

Well I've contacted my insurer and they have to pay me directly b/c ortho doesn't accept payments from insurer.

So, they'll cover 50% of banding fee if invoice for claim is itemized. If not they take the total treatment cost times 20% and then that number by 50% and pay that. For me that would be $3200 then (x.20) $640 then (x.50) they'll pay $320.

Then, they pay $75 per month to me until I reach my maximum or by end of treatment.

So, my down payment is $800. So, I know up front I"ll at least be paying $480 for initial services.

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#25 Post by njsuburban »

I have Cigna DMO and they pay $2100 of my treatment. My part will be $2900 spread out in $100 payments after the $500 records fee. Cigna is paying a little to the ortho each month.
Braced Feb. 18, 2010.

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#26 Post by loradora »

I'm retired and have no dental insurance. When I did work I had Metlife dental and they did not cover orthodontia for adults.


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#27 Post by UGHBRACES »

PrincessKia wrote:If not they take the total treatment cost times 20% and then that number by 50% and pay that. For me that would be $3200 then (x.20) $640 then (x.50) they'll pay $320.
lol what a confusing way to say 10%.

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#28 Post by alimommy1 »

LOL!!! Right after I was reading that I thought the same thing. I have yet to get anything in writing from mine but when speaking with somebody, they state they pay 1500 lifetime max and there's not an age limit. However, they break it up into 3 payments, 50% immediately, then 25% after a few months, and then the remaining 25% after a year and/or when treatment is completed. I wonder why they don't pay it in one lump sum..

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#29 Post by drrick »

Since the longer they delay payment the more money they make.
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#30 Post by hal2me »

I have Delta Dental and they did not cover anything because it was considered a costmetic process.

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