Blue Cross Blue Shield is one of the largest insurance companies out there, with a sprawling network of subsidiaries and around 62 million members. If you have a BCBS dental insurance plan, you might get some help with your byte home aligners.
byte is a popular at-home aligner option because of their fast treatment times, reasonable prices, and excellent customer service. And they have partnerships with multiple dental insurance companies. So, if you’re pursuing byte treatment and you have Blue Cross Blue Shield insurance, you might get coverage for your aligners. But every dental plan is different, and this guide will help you know what to expect when getting BCBS coverage for your byte treatment.
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How Much Does byte Cost?
If traditional orthodontics take a bite out of your bank account, home aligners take a nibble. But that nibble is still significant. byte’s standard, all-day aligner treatment, for example, is $1,895. And if you choose their At-Night aligners (which you only need to wear for 10 hours a day), it’s $2,295. Those prices include all of your clear aligners, one set of aftercare retainers, and the HyperByte device (which empowers byte’s fast treatment times).
Do those prices look a little steep? You can spread them out over 29 months by enrolling in a bytepay financing plan. Since bytepay is an in-house payment plan, you don’t need a credit check to qualify. Here’s how they look:
- All-day treatment: $349 down payment, then $83 a month
- At-Night treatment: $449 down payments, then $99 a month
Add it all up and you’ll notice that these payment plans end up being more expensive than the sticker prices. That’s primarily because they include a subscription to byte’s Smile Protection Plan, which provides new aftercare retainers every six months (for five years) and will replace lost or stolen retainers twice. On their own, byte’s retainers cost $129, so it will save you money in the long run.
How Do Orthodontic Benefits Work?
Just because you have dental insurance, however, doesn’t mean your orthodontia is automatically covered. That’s where orthodontic benefits come in. The problem is, not every plan includes them. If you plan on getting orthodontic treatment at some point, you’ll want to enroll in a plan with orthodontic benefits when you choose one.
But as we’ve already mentioned, every insurance plan is different and their orthodontic benefits can vary too. They’ll typically cover traditional, in-office treatments like braces and Invisalign and some will cover remote treatment like byte too. Even so, orthodontic benefits aren’t all-inclusive. Most times, they’ll only cover a certain percentage of treatment. And they also often have restrictions like age limits, lifetime spending limits, and waiting periods.
Let’s say your treatment costs $3,000 and your orthodontic benefits cover 50%. If they have an age limit, it’ll probably only cover costs for patients up to age 19. And if they have a lifetime spending limit of $2,000, you’ll still have $1,000 in out-of-pocket expenses. That’s why it’s important to understand the particulars of your dental plan before you begin your treatment.
Does Blue Cross Blue Shield Cover Orthodontics?
Blue Cross Blue Shield is more like an umbrella that encompasses “36 independent, community-based and locally operated Blue Cross Blue Shield companies.” Each one of these companies operates in different locations and has different plan variations. So there are a lot of different plans with different policies on orthodontia.
Regardless of your location and subsidiary, the most basic BCBS plans don’t often provide coverage for adult orthodontics (sometimes they cover treatment for patients under age 19), while their more expensive plans usually do. Some BCBS companies even allow you to add orthodontic benefits to plans that don’t initially include them. Normally, these benefits will cover braces and Invisalign. They may also cover byte and other at-home aligners, but that’s slightly less common.
Does Blue Cross Blue Shield Cover byte?
Sometimes, but it all depends on your specific plan. Some plans label at-home clear aligners as a cosmetic treatment and, consequently, won’t cover it. Other plans will cover part of your byte treatment. Anthem and Empire, two large companies under the BCBS umbrella, have partnerships with byte that bring the home aligner company in-network. This doesn’t mean that every Anthem plan includes home aligners, but they could be more likely to provide coverage.
Even when a plan covers byte, it typically won’t cover the entire cost, just a percentage of the price or up to a lifetime maximum. So, you’ll still probably have to pay some out of pocket.
Will byte Help Me With Insurance?
They’ll do more than help you. They’ll take care of everything. At the outset, they’ll do a preliminary check to determine whether you might have coverage. Then, after you proceed with treatment, they’ll complete and submit your claim paperwork. And if your claim is denied, they’ll find out why and look for ways to correct it, whether that means contacting the provider directly or filing an appeal.
byte is the only at-home aligner company that goes this far to help you navigate your insurance processes. Some competitors, like Candid and SmileDirectClub, will do a preliminary check for you, but they won’t handle any paperwork or communications after that.
How Do I Use My Orthodontic Benefits?
If you have an Anthem or Empire plan, it might consider byte an in-network treatment and provide coverage for your treatment. In these cases, your coverage might be deducted directly from your overall bill. In other cases, you would need to pay the whole amount at once (or enroll in a financing plan) then file a claim form to get a reimbursement. The good news is that byte will do it all for you.
Just contact your byte advisor. They will put you in touch with the insurance team, who will walk you through the whole process. They’ll even fill out your claim paperwork for you to ensure accuracy and timeliness. They’ll tell you where to sign on the dotted line, then you can sit back and wait for your reimbursement.
What If I’m Not Covered?
Even though BCBS has a standing partnership with byte, not every one of their plans covers at-home aligner treatment. 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 also options. These accounts allow you to use your pre-tax income to pay for medical and dental expenses, and byte accepts HSA/FSA payments, which can save some money. You’ll just need to make sure that your HSA or FSA considers at-home clear aligners a qualifying expense.
And if $1,895 or $2,295 is looking like too much for a lump-sum payment, you can break it up into more manageable chunks by enrolling in bytepay, byte’s in-house financing plan. These plans require a $349 or $449 down payment, followed by 29 monthly payments of $83 or $99. The best part is that there’s no credit check involved, so everyone qualifies.
byte already offers affordable treatment, and orthodontic benefits can make it even more manageable. Their standing partnerships with Anthem and Empire make coverage from certain Blue Cross Blue Shield plans a lot easier. And the best part is that byte will take care of all your insurance paperwork and communications. Just get in touch with them and you’ll have a dedicated partner for the entire process.