Orthodontic Coverage with State-Sponsored Insurance Plans: What to Know
Insured through a state-sponsored plan? Let’s get your orthodontic coverage to work for you – and your smile!
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Your Insurance Questions Answered
Choosing a beautiful smile is easy – but insurance can be complicated! Don’t worry, Diamond Braces has you covered. We accept all orthodontic coverage insurance and are happy to answer all your questions. We’ll be here to help every step of the way on your journey towards smile joy.
- 1Does my dental insurance cover orthodontic treatment?
If you have dental insurance, your plan likely offers some kind of orthodontic coverage. Diamond Braces will help you verify your insurance information and work directly with your insurer to help secure coverage.
- 2Who does it cover?
State-sponsored insurance plans cover all individuals 21 years of age and younger.
- 3Will it cover treatment in full?
If your case – or your child’s case – is approved, your state-sponsored insurance plan will cover all necessary treatment costs.
- 4Will my case be approved?
If you change to another state-sponsored plan, your coverage generally remains the same and you can expect uninterrupted insurance coverage. If you change to a private insurance plan, your coverage will need to be approved under the guidelines of your new private plan. It is likely that your costs will change given the guidelines of private insurers.
- 5Will my case be approved?
State-sponsored orthodontic coverage is subject to a strict set of approval qualifications. Diamond Braces will take complimentary X-Rays and send them to your insurance provider for approval. After 20 years of experience, our orthodontists can generally tell you ahead of time whether you can expect to be approved.
- 6What is an HLD index?
It’s a clinical measurement tool to determine whether your orthodontic case is approved for coverage. Don’t ask what HLD stands for.
- 7What does HLD stand for?
HLD stands for Handicapping Labio-Lingual Deviation. We told you not to ask!
- 8Can I change my plan during treatment?
If you change to another state-sponsored plan, your coverage generally remains the same and you can expect uninterrupted insurance coverage. If you change to a private insurance plan, your coverage will need to be approved under the guidelines of your new private plan. It is likely that your costs will change given the guidelines of private insurers.
- 9What happens if I lose my insurance?
If you lose your insurance, and/or your new plan no longer covers orthodontic treatment, Diamond Braces will help you establish a flexible monthly payment plan that allows you to pay in manageable installments. All Diamond Braces payment plans are interest-free and require no up-front costs, and your costs will be pro-rated to include only the remaining balance.
- 10Does my plan cover Invisalign?
No. State-sponsored plans cover only standard metal braces.
- 11Does my plan cover clear braces?
No. No cosmetic upgrades are available.
- 12Can I upgrade by paying the extra cost myself?
No. Your insurance will only pay for treatment with standard metal braces.
- 13Do I need a referral?
No referral is necessary. You can schedule a complimentary consultation with Diamond Braces, and our team will take X-Rays to send to your insurance company for review.
- 14Is approval needed before I start treatment?
Yes – your insurance company will need to verify approval before your orthodontist begins treatment. This can take anywhere from one day to several weeks.
- 15Can I get treatment for multiple children?
Yes. State-sponsored plans treat everyone in your family as an individual policy member. Anyone under 21 whose diagnosis qualifies for treatment coverage can have their costs covered.
- 16Is Diamond Braces in my network?
Yes. Diamond Braces is accredited with all state-sponsored insurance plans.
Find out more about your state-sponsored dental insurance
Diamond Braces partners with these state-sponsored insurance providers:
