BRACES QUESTION

[SandyinMonterey]

My daughter started braces end of August 2015. She started Phase I which I was told would take 16 to 18 months. The total cost came out to just over $4000 BUT minus a $1500 lifetime max from dental insurance, so our responsibility was about $3000. Went on the monthly plan of $160 for 20 months (3% interest). Recent events will have us moving probably in June, husband already took new job in GA (my daughter and I remain in California till end of school year). So, when husband quit old job, of course old dental insurance stopped paying. They did not pay out the $1500 lifetime max up front, instead making payments which totaled $560. So, now the orthodontist says we're responsible for what dental insurance didn't finish paying and payment in full by the time we move. My question is: does that sound correct to you? Come June, we will not even been in this process for a year and this Phase 1 was to be a 16 to 18 month process. I'm not trying to get out of paying what I don't owe, if this is the norm and correct, so be it, but it just doesn't sound right to me. Thanks everyone!

 

[havaneselover]

My company just hired a woman full time who lost her orthodontics coverage for her dd when she took our dental insurance. She didn't realize we didn't have any (she had $1200) so she's now responsible for what they didn't pay. It stinks because she's a single mom and her ex isn't paying child support.

 

[starry_solo]

Get a copy of the dental insurance policy to see how they handle braces. Since you elected to pay monthly, that might have allowed the dental insurance company to pay monthly as well until their $1500 was paid off. If you had paid it in full, then maybe they would have paid it in full.

 

[Belle0101]

As for what the dental insurance is responsible for, like a PP mentioned, you'll need to contact them and ask specifically how the policy reads. We had Delta Dental and our specific policy is $1250 lifetime max, towards orthodontics. How they pay that to the dentist is $625 when the braces are placed on (they called it "the front) and the other $625 when they braces are finished (they called that "the back").

Delta Dental paid the front $625 and then 6 months later DH switched employers so we no longer have Delta Dental. Per the contract with the orthodontist, we are responsible for what our insurance doesn't pay so the other $625 is due by us. I knew that going into it, I had called Delta Dental to make sure I understood how it would all be handled, and our ortho spelled it out very clearly in the contract.

As for the other, your ortho asking everything to be paid off before you move ... I'd read through the contract. I've never know anyone who needed to switch orthos so I wouldn't even have a guess as to how that is handled. Sorry.

 

[Tigerlulu]

We have MetLife dental and paid our portion all up front, so no monthly payments. MetLife makes quarterly payments to the ortho for their part. So I'd imagine it is what it is. :-/

 

[JohnDaleswife]

Ya, this is pretty crappy the way dental insurance companies do this. My oldest daughter had to have her braces on for longer than normal. Thank goodness my husband didn't change jobs during this time.

We are fixin to go through this now with our younger daughter. I am going to check this out myself and see if we pay up front our portion, If they would do the same. Personally, I think this practice should be illegal.

 

[havaneselover]

Ya, this is pretty crappy the way dental insurance companies do this. My oldest daughter had to have her braces on for longer than normal. Thank goodness my husband didn't change jobs during this time.

We are fixin to go through this now with our younger daughter. I am going to check this out myself and see if we pay up front our portion, If they would do the same. Personally, I think this practice should be illegal.

Well if you are the insurance company and someone gets a policy, get braces on their child, then switch jobs the next month, the insurance company just lost a lot of money that they have to pass on to others.

Neither my ex nor I have ortho coverage on our policies so we are looking at $6,500 for dd. Still getting more estimates but it stinks. Thankfully I have an hsa.

 

[4HppyCamprs]

My daughter started braces end of August 2015. She started Phase I which I was told would take 16 to 18 months. The total cost came out to just over $4000 BUT minus a $1500 lifetime max from dental insurance, so our responsibility was about $3000. Went on the monthly plan of $160 for 20 months (3% interest). Recent events will have us moving probably in June, husband already took new job in GA (my daughter and I remain in California till end of school year). So, when husband quit old job, of course old dental insurance stopped paying. They did not pay out the $1500 lifetime max up front, instead making payments which totaled $560. So, now the orthodontist says we're responsible for what dental insurance didn't finish paying and payment in full by the time we move. My question is: does that sound correct to you? Come June, we will not even been in this process for a year and this Phase 1 was to be a 16 to 18 month process. I'm not trying to get out of paying what I don't owe, if this is the norm and correct, so be it, but it just doesn't sound right to me. Thanks everyone!

My son just got braces on in Novembee and they stressed that our quote included our 2000.00 ortho. Coverage but that we should be aware that if the insurance changed or DH changed jobs the remainder of the balance would fall on us. They also said that insurance does not pay out lump sum but like yours doles out portions throughout the year.

 

[4HppyCamprs]

We paid in full and our insurance still pays out in smaller increments.

Get a copy of the dental insurance policy to see how they handle braces. Since you elected to pay monthly, that might have allowed the dental insurance company to pay monthly as well until their $1500 was paid off. If you had paid it in full, then maybe they would have paid it in full.

 

[tvguy]

This is a very very very broad statement, but based on my experience, orthodontic insurance is a joke. My then employer added orthodontic coverage when my kids had braces.
1) Maximum benefit, $1,500 (no matter how many kids you had)
2) Requirement that you pay premiums for 36 months.
3 ) Premiums = $41.66 a month (no matter how many kids you had).
4) $41.66 X 36 = $1,500.
Thanks for nothing.

 

[4HppyCamprs]

Wow that is terrible. I am definitely grateful for our coverage.

This is a very very very broad statement, but based on my experience, orthodontic insurance is a joke. My then employer added orthodontic coverage when my kids had braces.
1) Maximum benefit, $1,500 (no matter how many kids you had)
2) Requirement that you pay premiums for 36 months.
3 ) Premiums = $41.66 a month (no matter how many kids you had).
4) $41.66 X 36 = $1,500.
Thanks for nothing.

hat

 

[Music City Mama]

This is interesting to read how the insurance company pays the Ortho. My older DS will be getting braces this year. I plan on paying in cash to get a 10% discount and then getting my FSA to reimburse me (instead of using the FSA debit card and not getting the cash discount). I guess I assumed that the insurance company would just pay their $1,250 since I paid in full, but I guess it makes sense that they pay in installments in case you leave your job/lose your insurance.

 

[NinaBella]

Here is the other part to consider.

My DD did Phase I while I was active duty under that insurance plan. That plan paid $1500 for ortho. So I retired from active duty and we are now with my husband's employer for dental. Both my DD and my DS were ready for braces again 6 months ago. They just got them in January because DH insurance won't cover ortho until after 12 months from the plan effective date. But they do pay out $2500, so since it is a different company, although the previous company paid $1500 for Phase I, we now get an additional $2500 to go toward her Phase II. DS they are doing in one shot. No Phase I & II like DD. So previous insurance didn't pay anything for him.

 

[SandyinMonterey]

I'm not questioning amount (so much), it's that my daughter has only had braces on for 7 months. She's in Phase 1 which I was told would take 16 to 18 months. Do I have to pay for 16 to 18 months of treatments? When we move (probably in June), she'll have only 10 months out of the 16 to 18 month of phase 1. The earliest phase 1 would be done is February 2017, that would be 16 months.

 

[ajasmom]

I'm not questioning amount (so much), it's that my daughter has only had braces on for 7 months. She's in Phase 1 which I was told would take 16 to 18 months. Do I have to pay for 16 to 18 months of treatments? When we move (probably in June), she'll have only 10 months out of the 16 to 18 month of phase 1. The earliest phase 1 would be done is February 2017, that would be 16 months.

From what I understand you should only pay the larger first installment when the braces went on and your monthly payment for the number of months that your child was being treated. Just be aware not all braces are the same there are different makes and styles when u find a new orthodontist do t be surprised if they remove all the braces and replace them with the type the new office uses. the wires and attachments may not be interchangeable. I used to work for an orthodontist and this is how we handled the situation when switching doctors

 

[NinaBella]

I'm not questioning amount (so much), it's that my daughter has only had braces on for 7 months. She's in Phase 1 which I was told would take 16 to 18 months. Do I have to pay for 16 to 18 months of treatments? When we move (probably in June), she'll have only 10 months out of the 16 to 18 month of phase 1. The earliest phase 1 would be done is February 2017, that would be 16 months.

You should have received the contract and payment plan BEFORE her braces were put on. You basically sign a contract. Within that contract, mine says if my insurance doesn't pay, I pay. So to answer your question, yes, you would be responsible for both your portion and the insurance portion if the insurance does not pay. You would need to pay your portion and the insurance portion for the duration that you are having treatments.

Our paperwork also says braces will not be removed until payment is made in full (entire contract). I am not sure why you are asking if you have to pay for each month of treatments... of course you do! Are you expecting the orthodontist to continue treatments without payments? This situation is not the orthodontist issue. He made a contract with you in good faith expecting to receive xxx monthly payment.

 

[shoney]

Our orthodontist did not have any incentives for paying upfront. There was no interest on the payment plan.
We were told upfront that the insurance will cover $1200 and that will be paid over time and that if we lost the insurance we would be responsible.

For me it worked opposite, my coverage increased to $3000. They wouldn't retro it, but paid double on the remaining payments.

 

[NinaBella]

This is our QUOTE sheet that we were provided. We also signed additional information after agreeing to the quote. I suggest you get a copy.

 

[kidshop]

I think OP is asking if she has to pay orthodontist 1 the full 18 months treatment if she moves in month 10 of treatment.

Honestly I have the same question. We are military, and I have 2 kids that need braces. What if I move in the middle? Do I pay twice for once set of braces if I move?

 

[shoney]

But I think she thought that the insurance paid their 1500.00 upfront and they do not. They pay it over time, so they won't cover the whole 1500.00.