The cost of braces and Invisalign

What do braces cost? Because almost everyone’s bite problem is different and unique, the cost of orthodontic treatment is based on the complexity of the problem, the specific type of procedures involved, and the timing in a patient’s life when they start treatment.

Almost all the fees we quote are all-inclusive, which means that you will be charged only one fee which includes all the braces (or other orthodontic appliances), office visits, retainers after treatment, and follow-up appointments.

When you consider the long term benefits and problems that orthodontic treatment can help you avoid, the cost of braces is actually quite a good investment in a smile that will last you a lifetime along with making sure that the bite, the jaw joints, and the jaw muscles all work together properly.

At your first appointment, we will answer questions about the typical cost of braces, the payment options we provide, along with the advantages of choosing an orthodontic specialist like Dr. Tom. Because straightening teeth is all we do, the amount of time spent in braces will be minimized, and we’ll do our best to help avoid the need to do any additional orthodontic treatment in the future.

A few payment options for braces to consider:

• Pay In Full Families who pay in full at the beginning of treatment receive a bookkeeping courtesy so please inquire with our Treatment Coordinator if this is an option for you.
• Payment Plans We understand that some families prefer to pay for braces over the course of treatment. Our office provides interest-free, monthly payments for braces and orthodontic treatment in order to help you obtain a payment amount within your budget.
• Flex Spending Accounts Set up through your employer, a Flex Spending Account allows you to set aside pre-tax dollars for medical/dental expenses. If you don’t already have one, inquire with your employer about setting up a Flex Spending Account now so the funds will be there when you need them.
• Loans A loan from family members, or a financial institution (home equity line of credit, for example) can be a comfortable way of affording the orthodontic treatment you or your child needs.

Orthodontic insurance is always beneficial, but the entire cost of braces is not usually covered by most insurance plans. Not all employers offer insurance benefits so we are happy to help you with financing. The amount of your out of pocket investment depends upon the type of orthodontic procedure required, the length of time required, along with the complexity of the treatment, and the specifics of your insurance plan.

Will My Insurance Cover Braces?

If you already have Dental / Orthodontic Insurance:
Orthodontic insurance is almost always an optional, separate benefit within your dental insurance, just as dental insurance is different from medical insurance. Therefore, just because you may already have dental insurance, you may or may not have orthodontic insurance.

Most orthodontic insurance policies cover some of the cost of your orthodontic treatment, but it depends upon your specific policy. The typical policy is structured to cover 50% of the cost of orthodontic treatment up to a once-in-a-lifetime-maximum. This means that your policy will usually contain two significant restrictions:

1. It will only pay up to the maximum one time during the lifetime of the patient— so this benefit will not renew with a new deductible every year as with standard medical or dental insurance, and
2. Your policy will usually not pay half of the cost of treatment, but will instead pay half only up to your maximum. For example, with a $1500 maximum it would pay $1500 if the cost of braces is $6000, but only $1000 if the braces cost $2000.

If you plan to purchase Orthodontic Insurance outside of your employer:
The best advice is to speak with your insurance agent to determine exactly what your policy covers:

• The type of orthodontic treatment (braces, Invisalign, etc.)
• The length of treatment (6 months, 12 months, etc.)
• The cause of the problem being treated (naturally developed problem, a problem caused by an accident, congenital problem, etc.)
• Whether the problem to be treated is strictly cosmetic or a functional/anatomical problem.
• The premium that will need to be paid over the course of treatment compared to the financial benefit received.

WE CAN HELP!

The good news is that the insurance experts at Dr. Tom’s can tell you exactly how much will be covered by your orthodontic insurance at your very first visit. Here’s what we need:

• Your insurance company’s name and telephone number
• The insured’s name
• The insured’s I.D. Number on your insurance card, or the insured’s social security number
• Your employer’s name that provides the insurance
• If Delta Dental Insurance, we must know in which particular state the insurance company is located (I.e., Delta Dental of Arkansas, etc.)

Many orthodontists do not accept assignment of your insurance benefits, which means that your out of pocket costs is higher. But we are here to help you, and will do all the paperwork for you in order to file your insurance on your behalf. And because we will accepts the assignment of your benefits, your out of pocket cost will be less.

Common Insurance Questions

Must I file my own insurance claims?
No, we will file all insurance claims for you. We will also verify your benefits prior to starting treatment.

How will my insurance company pay?
Insurance companies almost never pay in full when treatment begins. Instead, they pay monthly over the entire course of your treatment.

I have two insurance plans. Can I use both to pay for my orthodontic treatment?
Yes! Generally you will receive ALL of your benefits from your primary insurance, while your secondary insurance will pay a percentage (typically 50% up to the lifetime maximum).

What happens if I get new insurance during my orthodontic treatment?
Simply inform us and we will verify your benefits and file your claim for you.

What happens if I change jobs during my orthodontic treatment?
If you lose your job, your benefits will stop and any remaining balance not paid by your insurance company becomes your responsibility. We will work with you to get this balance paid. If your new job offers orthodontic insurance, we will file a claim when you become eligible to receive your benefits.

Does your office accept Medicaid?
Unfortunately, South Carolina Medicaid does not pay for orthodontic treatment. We are happy to work with each patient on an individual basis with payment arrangements.