Understanding Your Orthodontic Insurance

We know insurance can feel confusing, but here’s the good news: you don’t have to figure it out on your own. Once you give us your policy information, Raven and our team take it from there, verifying your benefits, filing claims, and following up with your insurance company so you don’t have to.

You focus on your smile. We’ll handle the paperwork.

We’re In-Network With

• Delta Dental
• Aetna
• United Concordia
• Premera

We work with patients across Shoreline, Lake Forest Park, Edmonds, and Mountlake Terrace, and many local employers offer plans through these providers, including Amazon, Microsoft, Boeing, Costco, T-Mobile, Google, CVS, area school districts, and first responders. If you work for one of these organizations, there’s a good chance we’re already in-network with your plan, but coverage varies by plan tier, so the best way to know for sure is to give us a call or bring in your card at your consultation and we’ll check for you.  Also, if you are choosing between different plans during an open enrollment period, we are more than happy to help you weigh different plans to help maximize your orthodontic benefit.

How Orthodontic Benefits Typically Work

Orthodontic coverage works a little differently than regular dental coverage. Regular dental benefits usually reset every year. Orthodontic benefits are usually a one-time lifetime maximum instead.

Here’s what that generally looks like:

• Most plans cover treatment at 50%, up to a lifetime maximum between $1,500 and $2,500.
• Rather than paying that amount all at once, insurance companies typically pay it out in installments over the course of your treatment.

Have two insurance plans? If you and a spouse both carry dental coverage, or your child is covered under both parents’ plans, you may be able to coordinate both policies and lower your out-of-pocket cost even further. Ask us about it and we’ll check.

To see what treatment might cost after insurance, take a look at our Invisalign and braces cost page, where you’ll find real numbers along with our payment plan options.

PPO vs. HMO Plans

Take a look at your insurance card. It will usually say either PPO or HMO.

• PPO plans give you the flexibility to choose your provider while still getting strong coverage. We accept many PPO plans.
• HMO plans typically restrict you to a specific list of network dentists and coverage for specialist care, like orthodontics, can be unpredictable. Because of this, we don’t participate in HMO plans at this time.

Out-of-Network? Don’t worry! You May Still Have Coverage

If we’re not listed as in-network with your specific PPO plan, don’t count yourself out. Many out-of-network PPO plans still offer solid orthodontic coverage, and we’ll handle the paperwork and file the claims either way, working to get you every dollar of benefit you’re entitled to.

Questions About Your Plan?

We know it can be intimidating to try and do this on your own so give us a call or send us a message before your first visit, and we’ll look into your specific benefits together.  Rest assured, we will walk you through the ever evolving insurance landscape.

Call or Text: (206) 693-3123  Or click to Schedule a Free Consultation