Cost and Insurance

The complexity of treatment is the largest determining factor for the cost of orthodontic treatment. Other factors include the type of appliance used (removable, fixed or aesthetic) and the estimated length of treatment (months versus several years).

Your orthodontist, or a member of their staff, will be happy to discuss fees. Many orthodontic offices offer payment plans to help meet individual financial needs. In addition, many dental insurance plans now include orthodontic benefits for just a few dollars a month.

Will my insurance cover orthodontic treatment?

Orthodontic coverage is often a separate benefit in a dental insurance contract. Coverage for orthodontic treatment is often reimbursed at 50%, up to a maximum dollar amount.

To determine your orthodontic coverage, it is recommended that you call your insurance company or speak with the plan administrator where you work and ask the following questions:

  • Does the plan cover orthodontic treatment (braces)?
  • If so, at what percentage?
  • Are there any limitations to coverage (e.g., age, maximum dollar amount?

Most orthodontic specialists do not all bill insurance companies directly, but they will help you with the process to file your claim.

CAO Standard Information Form

Once you have established that you have orthodontic coverage, and after financial arrangements have been made with the Orthodontic Specialist, it is the obligation of the orthodontic office to provide you with a Canadian Association of Orthodontists (CAO) Certified Specialist in Orthodontics Standard Information Form. Send this form immediately to the insurance company. The carrier will write to you directly about your coverage. When you make a payment to the orthodontic office, you will be provided with a receipt. Attach this to one of your Dental Claim Forms (filled in by the subscriber) and submit both to your insurance company who will reimburse you directly.

It is not necessary for the Orthodontic Specialist to fill in the Dental Claim Form as no dental codes are required for orthodontic coverage.

Only one Certified Specialist in Orthodontics Standard Information Form is necessary to predetermine benefits, and once approved, no other insurance forms are necessary from the orthodontic office.

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