__NUXT_JSONP__("/understanding-your-orthodontic-insurance-coverage", (function(a,b,c,d,e,f,g,h,i,j,k,l,m,n,o,p,q,r,s,t,u,v,w,x){return {data:[{props:{title:d,slug:f,seo:{page_title:d,page_description:"Some dental insurance plans have orthodontic coverage that can help offset the overall cost of orthodontics. Below are some general points that can help you better understand your benefits.",page_keywords:e,additional_settings:true,social_meta:{og_meta:{title:e,description:e,image:"https:\u002F\u002Fd1bhomdc1zzbl0.cloudfront.net\u002Fblog\u002Fblog-9-hero.jpg"}}},blog:{title:d,date:"Feb 7, 2024",image:{src:"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fblog-9-hero.jpg",webp:"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fblog-9-hero.webp"},body:"Some dental insurance plans have orthodontic coverage that can help offset the overall cost of orthodontics. Below are some general points that can help you better understand your benefits.\r\n\r\n\u003Cb\u003EIn this article, you’ll learn:\u003C\u002Fb\u003E\r\n\u003Cul\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#eligibility\"\u003EEligibility & benefits\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#payments\"\u003EPayments\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#starting-date\"\u003EStarting date\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#mid-treatment\"\u003E Mid-treatment insurance changes\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#progress\"\u003EWork in progress\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#dual-coverage\"\u003EDual coverage\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#network-coverage\"\u003EIn and out of network coverage\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n \t\u003Cli aria-level=\"1\"\u003E\u003Ca href=\"#questions\"\u003EQuestions to ask when looking at orthodontic dental insurance coverage\u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n\u003C\u002Ful\u003E\r\n \r\n\u003Cfigure\u003E\u003Cimg decoding=\"async\" class=\"custom-blog-single__image\" style=\"object-position: center center;\" src=\"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fblog-9-hero.jpg\" alt=\"Happy family\" \u002F\u003E\u003C\u002Ffigure\u003E\r\n \r\n\u003Ch3\u003EEligibility & benefits\u003C\u002Fh3\u003E\r\n \r\n\r\nWhen we see you or your child for your initial consultation, we will verify your eligibility and benefits by contacting your dental insurance provider. Ideally, we hope to determine if the plan has any orthodontic coverage, if it is active, how much coverage is available, and how the insurance will pay out benefits. Unfortunately, sometimes this information is not available to us and occasionally the information can be inaccurate. \u003Cb\u003EWe recommend verifying your benefits directly with your dental insurance company or HR department to help make sure everything is clear.\u003C\u002Fb\u003E\r\n\r\n \r\n\u003Ch3\u003EPayments\u003C\u002Fh3\u003E\r\n \r\n\r\nInsurance companies can choose how to pay out their benefits, ranging from paying in full as soon as treatment starts, to yearly, quarterly, or monthly payments throughout treatment. \u003Cb\u003EIf insurance does not pay in full at the start of treatment, insurance coverage needs to remain active for the duration of treatment to receive full benefits.\u003C\u002Fb\u003E\r\n\r\n \r\n\u003Cfigure\u003E\u003Cimg decoding=\"async\" class=\"custom-blog-single__image--large\" style=\"object-position: center center;\" src=\"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fblog-9-1.jpg\" alt=\"infographic\" aria-hidden=\"true\" \u002F\u003E\u003C\u002Ffigure\u003E\r\n \r\n\u003Ch3\u003EStarting date\u003C\u002Fh3\u003E\r\n \r\n\r\nThe start date of treatment is when appliances are placed in the mouth, not when the initial diagnostic records are collected. Insurance companies use this date to process the claim. \u003Cb\u003EIf you are getting ready to start orthodontic treatment but are expecting a change in insurance, it’s best not to have appliances placed until you have confirmed your benefits are active\u003C\u002Fb\u003E, as some insurance plans will not provide coverage for treatment that began before the plan was effective.\r\n\r\n \r\n\u003Ch3\u003EMid-treatment insurance changes\u003C\u002Fh3\u003E\r\n \r\n\r\nIf your insurance benefits change or terminate, often due to job changes\u002Floss, notify your provider immediately. You are responsible for any benefits not paid by your insurance.\r\n\r\n \r\n\u003Cfigure\u003E\u003Cimg decoding=\"async\" class=\"custom-blog-single__image--large\" style=\"object-position: center center;\" src=\"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fblog-9-2.jpg\" alt=\"Dental Insurance plans typically offer a lifetime benefit for orthodontics that will not renew annually like the standard dental benefits\" \u002F\u003E\u003C\u002Ffigure\u003E\r\n \r\n\u003Ch3\u003EWork in progress\u003C\u002Fh3\u003E\r\n \r\n\r\nIf your insurance company or coverage changes mid-treatment, your status is considered “work-in-progress” with your new insurance. Every plan is different – some may offer coverage for treatment that is in progress while others will not.\r\n\r\n \r\n\u003Ch3\u003EDual coverage\u003C\u002Fh3\u003E\r\n \r\n\r\nDual coverage is when you are actively covered under two dental plans. Some plans allow for a coordination of benefits which allows benefits from both plans to be used. Other plans have a non-duplication clause, allowing only the primary plan to provide coverage.\r\n\r\n \r\n\u003Ch3\u003EIn and out of network coverage\u003C\u002Fh3\u003E\r\nSome dental insurance plans offer different coverage for in and out-of-network providers. Ask your HR department or dental insurance company if coverage is different for in and out-of-network providers so you can determine if this will impact where you seek orthodontic treatment.\r\n\r\n \r\n\u003Ch3\u003EQuestions to ask when looking at orthodontic dental insurance coverage\u003C\u002Fh3\u003E\r\n\u003Cul\u003E\r\n \t\u003Cli\u003E\r\n\u003Cp style=\"margin: 0;\"\u003E\u003Cb\u003EWhat are the lifetime maximum benefits?\u003C\u002Fb\u003E\u003C\u002Fp\u003E\r\n\u003Cp class=\"custom-blog-single__text--small\"\u003EPlans typically offer a lifetime benefit for orthodontics that will not renew annually like standard dental benefits.\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n \t\u003Cli\u003E\r\n\u003Cp style=\"margin: 0;\"\u003E\u003Cb\u003EWhat percentage of treatment is covered?\u003C\u002Fb\u003E\u003C\u002Fp\u003E\r\n\u003Cp class=\"custom-blog-single__text--small\"\u003EIf your treatment plan costs $3000 and your insurance plan covers 50% up to a lifetime maximum of $2000, you will get $1500 of coverage ($3000 x 50% = $1500)\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n \t\u003Cli\u003E\r\n\u003Cp style=\"margin: 0;\"\u003E\u003Cb\u003EIs there an age limit on the plan?\u003C\u002Fb\u003E\u003C\u002Fp\u003E\r\n\u003Cp class=\"custom-blog-single__text--small\"\u003ESome plans exclude adults or will only cover children up to a certain age, while others have no age limits\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n \t\u003Cli\u003E\r\n\u003Cp style=\"margin: 0;\"\u003E\u003Cb\u003EIs there a waiting period to begin treatment?\u003C\u002Fb\u003E\u003C\u002Fp\u003E\r\n\u003Cp class=\"custom-blog-single__text--small\"\u003ESome plans require a 60 day\u002F90 day\u002F1 year waiting period before covering orthodontic benefits\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003C\u002Ful\u003E\r\n \r\n\u003Cfigure\u003E\u003Cimg decoding=\"async\" class=\"custom-blog-single__image--large\" style=\"object-position: center center;\" src=\"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fblog-9-3.jpg\" alt=\"insurance-infographic\" aria-hidden=\"true\" \u002F\u003E\u003C\u002Ffigure\u003E\r\n \r\n\u003Ch3\u003EThe Takeaway\u003C\u002Fh3\u003E\r\n \r\n\r\nBecause orthodontic insurance coverage works differently than standard dental or medical benefits, it can be difficult to understand how it applies to your treatment. At Garfinkle Orthodontics, we’re happy to help you through the process and answer your questions along the way.",tagline:"We're conveniently located in SW Portland, serving Beaverton, the Pearl District, Lake Oswego, and surrounding areas.",author:{image:{src:"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002FErin.jpg",webp:"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002FErin.webp"},description:"\u003Cspan style=\"font-weight: 600;\"\u003EErin Fortman\u003C\u002Fspan\u003E is a long-time employee of Garfinkle Orthodontics, working as our Marketing and Treatment Coordinator. She is a mother of two young children and a former patient of Dr. Garfinkle, which provides her with a unique and in-depth understanding of the orthodontic process as it relates to the concerns of our patients and their parents."},second_author:{image:{src:"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fkoreena-headshot.jpg",webp:"https:\u002F\u002Fd18hiuzzv9psyk.cloudfront.net\u002Fblog\u002Fkoreena-headshot.webp"},description:"\u003Cspan style=\"font-weight: 600;\"\u003EKoreena\u003C\u002Fspan\u003E is the clinical manager at Garfinkle Orthodontics, having worked on our team since 2018. Koreena has seen friends and family struggle with mental health and understands firsthand how much it can impact daily life. Koreena’s goal is to help create a positive and comfortable experience for patients through information and support."}}},global:{title:a,slug:a,phone:{number:b,href:c},email:g,company_name:h,address:{text:i,href:j},emergency_phone:{text:k,href:l},fax:m,hours:n,socials:[{icon:o,link:p},{icon:q,link:r},{icon:s,link:t},{icon:u,link:v},{icon:w,link:x}],google_phone:{href:c,number:b}},blogs:[{link:"\u002Fdr-garfinkle-the-best-orthodontist-in-portland",slug:"dr-garfinkle-the-best-orthodontist-in-portland"},{link:"\u002Faffordable-invisalign-in-portland-by-dr-garfinkle",slug:"affordable-invisalign-in-portland-by-dr-garfinkle"},{link:"\u002Ftooth-decay-and-oral-hygiene-during-orthodontic-treatment",slug:"tooth-decay-and-oral-hygiene-during-orthodontic-treatment"},{link:"\u002Funderstanding-your-orthodontic-insurance-coverage",slug:f},{link:"\u002Fclear-aligners-vs-traditional-metal-braces",slug:"clear-aligners-vs-traditional-metal-braces"},{link:"\u002Fmental-health-and-oral-hygiene",slug:"mental-health-and-oral-hygiene"},{link:"\u002Fmedical-and-dental-insurance-for-orthodontics",slug:"medical-and-dental-insurance-for-orthodontics"},{link:"\u002Fwhat-can-i-eat-with-braces-and-invisalign",slug:"what-can-i-eat-with-braces-and-invisalign"},{link:"\u002Fcrafting-smiles-that-elevate-the-spirit-a-chat-with-dr-judah",slug:"crafting-smiles-that-elevate-the-spirit-a-chat-with-dr-judah"},{link:"\u002Fhow-much-does-orthodontic-treatment-cost",slug:"how-much-does-orthodontic-treatment-cost"},{link:"\u002Fis-phase-i-and-phase-ii-orthodontic-treatment-necessary-for-everyone",slug:"is-phase-i-and-phase-ii-orthodontic-treatment-necessary-for-everyone"},{link:"\u002Fhow-old-do-you-need-to-be-to-start-braces",slug:"how-old-do-you-need-to-be-to-start-braces"}]}],fetch:{"0":{isMobile:false,props:{title:a,slug:a,phone:{number:b,href:c},email:g,company_name:h,address:{text:i,href:j},emergency_phone:{text:k,href:l},fax:m,hours:n,socials:[{icon:o,link:p},{icon:q,link:r},{icon:s,link:t},{icon:u,link:v},{icon:w,link:x}],google_phone:{href:c,number:b}},lastScrollPosition:0,debounceLastTimeout:null}},mutations:[]}}("global","503 • 246 • 9802","tel:+15032469802","Understanding your Orthodontic Insurance Coverage","","understanding-your-orthodontic-insurance-coverage","info@garfinkleortho.com","Garfinkle Orthodontics","1820 SW Vermont St., Suite O\u003Cbr\u003EPortland, OR 97219","https:\u002F\u002Fgoo.gl\u002Fmaps\u002FDqzyspobVrsGz6PD6","503 • 430 • 9207","tel:+15034309207","503 • 246 • 9995","M - Th: 8a - 5p","facebook","https:\u002F\u002Fwww.facebook.com\u002Fgarfinkleortho\u002F","instagram","https:\u002F\u002Fwww.instagram.com\u002Fgarfinkleortho\u002F","youtube","https:\u002F\u002Fwww.youtube.com\u002Fchannel\u002FUCYVVyUenl1jK8-RzPwS11Jw","google-simple","https:\u002F\u002Fg.page\u002Fr\u002FCePxl0rYtLT-EAE","tiktok","https:\u002F\u002Fwww.tiktok.com\u002F@garfinkleortho?lang=en")));