Braces and Insurance

[LaDonna]

Quick ? I switched dental insurance companies and their orthdontics I only have to pay a $500 copay, downside is I only have one ortho in the area I can choose from. So the Estimate sheet with the treatment plan and everything listed states I have a $500 copay(and wow says normal estimate is $6500), and I did double check and ask if that was the absolute only amount of money I would have to pay, and the staff reassured me yes, but I was just wondering if there was any way they "could" say I owed more? I did ask how come it was such a low payment and she said it was just something they did with the particular company my husband works for So I don't know I guess I'm just untrustworthy of docs and such because I figure they are just trying to get more money, maybe I shouldn't think like that. But although the staff and doc were really nice and I got a good vibe from them, the office was very rundown and small and in an almost abandoned strip mall, so that made me a lil' leary. The place was packed w/ kids though so I don't know if that is a good sign or not. And then another part of me thinks well it is only $500 even if I do have to switch and pay out of pocket I won't be losing a whole heck of a lot in the grand scheme of things.
I don't know what do you think? And can they come back and say I owe something else?

 

[juliebean]

Orthodontics are one of those things that are hard to switch midstream - most of the cost is in the hardware, so switching may not resolve anything owed, if that were to happen.

I would try to find someone who used the plan, and if possible that plan with that orth, and just make sure it's all good. If it is, great! You spend a ton of time at that office over the years, so advance investigation and getting recommendations are really worth it.

 

[mommasita]

I got 3 opinions for my son's braces. Is this your first? Personally, I was not comfortable with only one. Do you have any history on this doc?

If you are comfortable, and this does sound off to me, but I hope it is all you owe , I would get it in writing. It should be already in writing, or mine were. I would ask them to draw it up, so you have written proof that 500$ is all you owe.

 

[princessnoelly]

A lot of the insurance companies only cover "life time max". For dd7 it is a $1,000 out of pocket max. Yes, we are paying all but the $1,000 out of pocket (that's just under $3,000 for phase 1). Phase 2 will be about the same and NO insurance.
We knew we wanted to use this ortho because she did my braces as an adult (wear your retainer!) and I knew if I could trust her with my mouth there wasn't a question about the mouth of my offspring!

I know the owner of the company DH and I work for (my dad) looked into better ortho coverage for employees several years back (over 15 employees were gearing up for braces for their kids) and the out of pocket expense for the other employees was just too high. You are lucky to have such great ortho coverage- maybe the owners kids are getting braces and he wanted the extra coverage? It's hard to tell when working with the insurance companies.

I agree with PP- too hard to change midway as each ortho is a little different. I would ask the ortho office what happens if the dental coverage changes- come Jan 1st? Our ortho explained it to us that they claim a percentage of the appliances each time something is done with the insurance company, as the treatment needs can change midway. Also, we just found out DD might need oral surgery to get her laterals down- find out if that it is covered- it's not for us.