Orthodontic coverage is often a separate benefit in a dental insurance contract. Coverage for orthodontic treatment usually is at the 50% level up to a lifetime limit.
To determine your orthodontic coverage, it is suggested that you call your insurance carrier or speak with the plan administrator where you work and ask the following questions:
All payments are made to our office and then you will need to submit a claim to your insurance company
NOTE: IN THE PROVINCE OF ONTARIO, ORTHODONTICS IS A SPECIALTY AND THEREFORE, CAN’T ACCEPT ASSIGNMENTS AND RENDER ANYTHING OTHER THAN THE INSURANCE FORMS FOR SUBMISSION TO INSURANCE COMPANIES.
Your insurance carrier will advise you directly, in writing, how much the firm will cover. If you do not hear back from your carrier within two to three weeks, it is suggested that you give them a call.
In a situation where two parties both have orthodontic coverage, the person with the birth date earlier in the year is considered the primary or first subscriber (e.g., January birth date as opposed to August). The primary subscriber sends in the documents as outlined, and then sends the reply from the primary carrier to the secondary carrier for approval.