Your dental insurance has likely saved you money on routine procedures like cleanings, oral exams, and fillings. But when something bigger comes up—like orthodontic treatment—it could be a different process, because certain plans might not cover it. The big question is: does your plan?
If you’re looking into byte’s at-home aligner treatment, you’ve likely wondered if your dental insurance might cover it. And if you have Guardian, there’s good news. Guardian plans with orthodontic benefits often cover byte treatment and give byte customers an in-network discount. Read on to find out how you can take advantage and learn more about your Guardian plan.
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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 Guardian Cover Orthodontics?
Sometimes. It’s different for every plan, which may vary based on your location, age, employer, household size, and more. Guardian’s basic HMO and PPO plans don’t usually cover orthodontics, but some of their more comprehensive and expensive plans do. Make sure you read the plan’s details carefully because some have age limits (only cover treatment for dependents under age 19) and/or lifetime spending maximums (usually around $1,000 to $2,000).
For example, according to Guardian’s website, “Guardian Direct’s Managed DentalGuard DHMO plans in New York, Florida, Illinois, and Texas cover $2,800 towards braces for adults 19 and over with no waiting period.” And you could find similar plans in other states.
Does Guardian Cover byte?
Guardian and byte have a partnership that brings byte into their dental network. This means that their orthodontic benefits extend to byte as well. On top of that, byte customers with Guardian insurance will get an additional $200 “Guardian Network Discount.” So, if your plan includes orthodontic benefits, you might get a discount and insurance coverage.
byte’s standard, all-day aligner treatment costs $1,895. Take that $200 discount off the top and you’re at $1,695. Then, let’s say your orthodontic benefits cover 50% of your treatment. You might only end up paying $847.50. Of course, this all depends on the particulars of your plan. Contact byte if you have questions. They will communicate with Guardian to check on your coverage and iron out the details. And you can visit this page on byte’s website for more information on their partnership with Guardian.
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?
The byte/Guardian partnership makes it pretty simple. Because Guardian considers byte an in-network treatment provider, they can apply their coverage and discounted rate to the initial price, and you’ll pay the remainder. With other insurance companies you need to pay the entire cost upfront, then file a claim for reimbursement later. The nice part is that you won’t need to worry about navigating the process on your own. 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 any necessary paperwork for you to ensure accuracy and timeliness. All you’ll need to do is sign.
What If I’m Not Covered?
Even though Guardian and byte have a partnership that makes insurance coverage simpler, not every Guardian plan includes orthodontic benefits. So, there’s still a chance that you won’t receive coverage. 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.
If you have Guardian dental insurance with orthodontic benefits, you’re in good shape to get coverage on your byte treatment. Their partnership makes byte’s costs a lot more manageable for customers and helps to streamline insurance procedures.
Plus, byte’s insurance team makes it incredibly easy to navigate the process, handling your questions, claims, discounts, and paperwork along the way. If you’re ready to get started with treatment and insurance, contact your byte advisor and they can get the ball rolling.