Insurance can save you a whole lot of money on your dental expenses, covering all or part of your preventative care, basic treatments, and even more complicated procedures like bridges and crowns. But what about Byte’s at-home aligners? Since online aligner services are still newcomers to the orthodontic game, dental insurance companies have various policies on them.
If you have a Cigna dental plan, you might get partial coverage for Byte treatment. Or you might not. Every plan is slightly different, but Byte will help you check on your coverage and navigate the claim process. By the end of this guide, you’ll know what to expect from your Cigna plan when it comes to Byte treatment.
Pro tip: Let Byte’s insurance team do the research for you by getting a free coverage check.
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Does Cigna Cover Orthodontics?
Cigna has six main dental insurance plans, but the only one that includes orthodontic benefits is the Cigna Dental 1500. These benefits include orthodontics and after you meet your deductible, they will cover 50% of the provider’s contracted fee. However, there’s a $1,000 lifetime maximum per person and a twelve-month waiting period before you can access your benefit.
These plans can vary based on your location, your employer, and the size of your family. Some plans might also have an age restriction, only covering treatment for dependents up to age 19. There might also be a waiting period after you enroll and before you can use your orthodontic benefits.
Some Cigna plans will also offer discounted treatment if you go to an in-network dentist or orthodontist. If you’re considering an in-office treatment like braces or Invisalign, it could be significantly cheaper if you go to an in-network dentist.
Does Cigna Cover Byte?
Most of the time, if your Cigna plan has orthodontic benefits, it likely covers traditional treatments like braces and Invisalign. But will they cover at-home aligner services like Byte? It’s unclear.
Cigna hasn’t come out and said whether they will cover at-home aligners like Byte, but customers who purchased at-home aligners have reported that Cigna will not cover them. Byte adheres to the ADA’s guidelines for teledentistry, but that doesn’t always mean they’re covered. There’s only one way to know for sure, and that’s to check with Cigna. Fortunately, Byte will do that for you. Just enter your information on Byte’s insurance page and they’ll let you know if your plan will cover their treatment.
How Much Does Byte Cost?
Some orthodontic treatments are more affordable than others, but one thing is for sure: quality orthodontic care isn’t cheap. Byte is an at-home aligner system, putting it on the more affordable end of the spectrum. Still, it costs $1,999 for all-day treatment and $2,399 for Byte At-Night. We don’t know what your budget is like, but for us, that’s more than pocket change — even if Byte delivers great value for the price.
Paying the full cost up front might not work for you. In that case, you can opt for BytePay. This is their in-house financing plan and 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
As is the case with most payment plans, this does cost more than just paying in full. But unlike most payment plans, Byte includes bonuses that increase the value and actually save money when you factor in aftercare. Financing comes with the Byte Protection Plan, giving you new retainers every six months plus two replacements in case you lose a few.
How Do Orthodontic Benefits Work?
First, you need to get a dental insurance policy. But even if you have one, that doesn’t guarantee you’ll have orthodontic coverage. Not every policy includes it.
Assuming you have a dental policy with orthodontic benefits, most in-office treatments will be covered. So if you are interested in braces, Invisalign, or 3M Clarity, you could get help from your insurance provider.
But notice we said “could.” That’s because many insurance policies only offer orthodontic coverage to those aged 18 and under. If yours offers orthodontic coverage to adults, expect there to be a lifetime limit or set percentage that they will pay. Clarify the limits of your coverage and how everything works with your budget before starting treatment.
Will Byte Help Me With Insurance?
Byte doesn’t just assist with the insurance claims process; they are the one at-home aligner company that handles everything from start to finish. They run the preliminary check, file for reimbursement, and if the claim is denied, file your appeal.
Byte excels in helping their customers afford their treatment, though they aren’t the only one offering assistance. SmileDirectClub also runs the preliminary check, but the rest is up to you.
How Do I Use My Orthodontic Benefits?
Even if you have coverage through your Cigna dental plan, Byte will usually be considered an out-of-network treatment provider, which means you’ll need to submit claim paperwork for reimbursement. If you’ve never dealt with insurance claims before, this might seem like an intimidating prospect. But as we’ve mentioned, Byte will handle the paperwork for you. They’ll fill out your claim form quickly and accurately, so you just have to sign it.
Just pay for your aligners up front, or enroll in a payment plan, then contact your Byte advisor to get the ball rolling on your claim. They’ll send in your form and communicate with Cigna on your behalf. If for some reason, your claim is denied, Byte can even submit an appeal for you.
What If I’m Not Covered?
Cigna might not be open to covering at-home clear aligners 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 great for fitting aligners into your budget. These accounts hold pre-tax income, allowing you to apply the funds to qualifying medical and dental expenses. Byte accepts HSA and FSA payments, but you need to make sure your account administrator considers them a qualifying expense, otherwise, your purchase might be subject to penalties.
If the cost of Byte is too much to handle at once, you can enroll in BytePay to break it up into manageable chunks. 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.
Final Thoughts
If you’re considering Byte treatment, start poring over your Cigna insurance benefits because you might receive some coverage, making your aligners even more affordable. Cigna doesn’t have specific partnerships with any home aligner companies, but there’s a chance that you’ll still have orthodontic benefits. Insurance information might seem murky, but Byte will handle every aspect of your claim process, so you can have a smooth ride to an affordable, transformed smile.
Frequently Asked Questions
Why are dental and health insurance separate?
These two fields developed separately, with their own training schools, professional associations, and standards. Insurance just followed suit.
Will dental insurance always include orthodontic coverage?
No, only some policies include orthodontic coverage.
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 general, insurance companies are hesitant to cover newer forms of treatment. They also worry about potential complications that can only be detected in person, but since these are rare, more and more providers are opening up coverage.
If my policy covers orthodontics, will they cover them in full?
In most cases, policies cover a percentage of treatment. Some opt for a lifetime limit instead. It is possible for your treatment to cost less than your lifetime limit, in which case you would have full coverage.
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, you are free to use insurance, FSA, and HSA funds to pay for the same treatment, so long as you don’t double-bill. So whatever insurance doesn’t cover, start by paying down the balance with FSA money so it doesn’t expire. If anything is left, use your HSA to pay.
What is the easiest way to find a policy with orthodontic coverage?
Either through your employer or an insurance broker. Brokers will look at hundreds of policies, narrow things down to just a few options, then let you choose the ideal policy for you.
Do I need to wait to use my benefits?
If your policy has a waiting period, yes. Most require you to wait three months to two years to use orthodontic benefits. The exact time frame varies.
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