There you are, scanning the Byte website, admiring their convenience, reasonable prices, and innovative features. If there’s one thing that could potentially give you pause, it’s the price. Byte treatment is more affordable than traditional orthodontics like braces and Invisalign, but it’s still not cheap. And this often causes potential customers to hope for insurance coverage.
Aetna’s dental plans may or may not cover Byte aligners. It all depends on the specific plan and every plan is different. If you have an Aetna plan, you might be able to get discounts and coverage for part of your Byte treatment, and Byte will handle all the particulars. How? Read on. This guide contains all the information you need.
Pro tip: Let Byte’s insurance team do the research for you by getting a free coverage check.
Table of Contents
Does Aetna Cover Orthodontics?
Some of Aetna’s dental plans include orthodontic benefits and others don’t. If you have orthodontic benefits as part of your plan, you’ll most likely receive coverage for comprehensive orthodontic treatment, including braces, Invisalign, or potentially at-home aligners. Be aware though, that orthodontic benefits rarely cover 100% of your treatment costs, and they often come with certain restrictions.
For example, some plans only cover orthodontics for dependents up to age 19, not adults. And others have a lifetime spending maximum (usually somewhere around $1,000 or $2,000). You can find Aetna DMO and PPO plans that each include orthodontic benefits, but they can vary based on your location, employer, family size, and more. And most Aetna plans require you to get treatment from an in-network orthodontist to receive your coverage.
Does Aetna Cover Byte?
If you have a plan with orthodontic benefits, there’s a good chance that it might also cover your Byte treatment. Byte has recently announced a partnership that makes them a covered benefit with Aetna, so coverage is a lot more accessible.
Thanks to this partnership, you might get upfront discounts on your treatment. This would bring the price down to $1,695 for Byte’s standard aligners and $1,945 for their At-Night aligners. This discount is applied before orthodontic coverage. For example, if your plan covers 50% of treatment, your out-of-pocket cost will be just $847.50 for all day aligners and $972.50 for At-Night aligners.
But remember that not every plan includes orthodontic benefits. Before starting your treatment, enter your information on Byte’s insurance page to see if your aligners are covered.
How Much Does Byte Cost?
Orthodontic treatment comes at a variety of price points, but quality care is never cheap. Since Byte is remote treatment, it’s more affordable than most options, but its price tag of $1,999 for all-day treatment (or $2,399 for Byte At-Night) isn’t exactly pocket change.
If paying the full cost up front doesn’t work for you, don’t worry. BytePay is their in-house financing plan. No credit check is required so everyone qualifies. The terms are as follows:
- All-day treatment: $249 down payment, then $70 a month for 36 months
- At-Night treatment: $299 down payments, then $84 a month for 36 months
Like most payment plans, BytePay costs more than paying the cost of the aligners up front. However, it comes with the Byte Protection Plan, which includes new retainers every six months for five years plus two replacements in case you lose any. These retainers typically cost $129 per set, and since experts recommend wearing them at least overnight for life, you save money in the long run by choosing financing.
How Do Orthodontic Benefits Work?
The first step in utilizing your orthodontic benefits is actually having them. This means having a dental policy with orthodontic coverage — and not all dental policies include it.
Let’s assume you have a policy with orthodontic benefits. The next step is making sure you are covered. Not all policies will pay for orthodontic treatment in adults, and those that will might have a lifetime limit. If you’ve met this limit or your policy only covers children, you can’t use it to pay for treatment.
If you have adult orthodontic coverage and haven’t met your lifetime limit, you can get help paying for non-cosmetic treatments. This means braces and aligners like Invisalign should be covered. But always clarify the limits of your coverage before signing on for treatment.
Will Byte Help Me With Insurance?
Byte doesn’t just give you the information you need to fill out forms and file claims; they do all the heavy lifting with insurance for you. From running the preliminary coverage check to filing appeals if denied, Byte takes care of everything.
Byte goes further than any other at-home aligner company in getting insurance to cover treatment, but SmileDirectClub offers some help too. They’ll check your coverage limits, but leave the rest up to you.
How Do I Use My Orthodontic Benefits?
Thanks to Byte’s partnership with Aetna, accessing your benefits is pretty simple. Because they now include Byte as an in-network treatment provider, Aetna will apply their discount right away and you’ll pay the remainder. Other insurance companies require you to pay upfront, then file for reimbursement later on. No matter how the discount is applied, Byte will handle the entire process for you. And if there are any unforeseen complications, they’ll work with Aetna to get them smoothed over.
Just get in touch with your Byte advisor. They will connect you with the insurance team, who will walk you through the whole process. They’ll even fill out any necessary paperwork for you to ensure accuracy and timeliness. All you’ll need to do is sign.
What If I’m Not Covered?
Aetna and Byte might have a partnership, but that doesn’t mean every Aetna plan covers at-home aligners. If your plan doesn’t include orthodontic benefits, your Byte treatment probably won’t be covered. But don’t worry, there are still ways to manage your expenses. You could switch providers and/or plans, but you can only do that during open enrollment periods or if you have a qualifying life event. And if you have insurance through your employer, they might not offer plans from other providers.
If so, you could enroll in an individual plan to supplement your employer-provided one. But that means you’ll be paying more in premiums, so you’ll have to make sure the savings are worth it.
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are another great way to pay for treatment. These accounts hold pre-tax income that you can apply to qualified medical and dental purchases. Byte accepts payment from both of these account types, but you need to make sure your account administrator considers Byte to be a qualifying medical expense.
If $1,999 is too much to pay up front, you can opt for BytePay to break it up into smaller chunks and get aftercare retainers, all for a great price. This plan requires a $249 down payment, followed by 36 monthly payments of $70. The best part is that there’s no credit check involved, so everyone qualifies.
At-home aligner companies like Byte have made teeth-straightening treatment more affordable than ever. And as Aetna and other insurance providers continue modifying and extending their orthodontic coverage, clear aligners are only getting more accessible.
Byte treatment and Aetna dental insurance is an ideal combination, but as we’ve mentioned, every insurance plan is different, so be sure to talk with Byte — their insurance team will help you navigate the details of your plan and facilitate a smooth process every step of the way.
Frequently Asked Questions
Why are dental and health insurance separate?
These two medical fields (dental and general health) developed separately, establishing their own schools, standards, and associations. Insurance providers simply followed their lead and kept things separate.
Will dental insurance always include orthodontic coverage?
No, not all policies have orthodontic coverage. Those that do often have restrictions that prevent coverage from applying to everyone on the policy.
What are common limits on orthodontics when covered?
- Lifetime Limits: Paying a set dollar amount towards orthodontics per lifetime
- Age Limits: Covering orthodontics in those aged 18 and younger but not in adults
- Percentage Limits: Only covering a set percentage of the cost of treatment
- Medical Only: Not paying for orthodontics if treating a cosmetic case
Why are some insurance companies hesitant to cover at-home and hybrid treatments?
In addition to the fact that this approach to treatment is fairly new, there are rare complications that can’t easily be spotted remotely. Insurance companies can feel hesitant due to this even if the risk is very low.
If my policy covers orthodontics, will they cover them in full?
Only if they use lifetime limits rather than percentages and the cost of your treatment is below the limit. Otherwise, expect to pay at least some out of pocket.
What fees should I keep in mind when setting my budget for treatment?
- Your deductible and how much you have already paid towards it this year
- Your copay and/or coinsurance for treatment and office visits
- The percentage of treatment you will be responsible for
Can I use HSA and FSA funds in addition to insurance?
Yes! Start with insurance, then use your FSA funds to cover the remaining balance. If this doesn’t cover in full, move on to HSA funds. Since FSA funds expire and HSA funds roll over, always spend FSA money first.
What is the easiest way to find a policy with orthodontic coverage?
Either through your employer or an insurance broker. Brokers will go over hundreds of options, narrowing it down to a few that will work for you, then help you select the perfect policy.
Do I need to wait to use my benefits?
Yes, in most cases. How long you need to wait varies by policy. This is typically somewhere between 3 and 24 months.