Contrary to what some people think, dental insurance isn’t a free pass to get any treatment you want. It covers a lot of procedures and preventative measures, but not everything. And adult orthodontia doesn’t always fall under the coverage umbrella. Getting coverage for your orthodontic treatment depends on a few different factors, primarily whether or not your benefits include Teledentistry coverage.
Of course, it all depends on your specific insurance provider and plan. You might receive reimbursement for 50% of your SnapCorrect price, or you might not get anything at all. But before you go sifting through piles of insurance paperwork to find out, read this guide. It’ll give you an in-depth look at the policies and procedures involved with benefit claims for at-home orthodontic treatment with SnapCorrect.
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Does Standard Health Insurance Cover Orthodontics?
In short: no, it doesn’t. And this is normally the case whether you’re considering a traditional orthodontic treatment option like braces, or an at-home option like SnapCorrect. Health insurance plans are separate from dental insurance plans, so they’ll usually only cover serious, medically-necessary procedures on the face and jaw. Standard health insurance does not cover routine cleanings, fillings, and orthodontic work.
And if routine dental care isn’t covered, at-home teeth straightening certainly isn’t. They’re often considered a cosmetic treatment, so if you just have standard health insurance, you’ll be stuck with the full bill.
What If I Have Dental Insurance?
Dental insurance can be paired with standard health insurance to cover preventative care (like semiannual cleanings) and other routine procedures (fillings, root canals, etc.).
Sometimes these plans will include orthodontic benefits as well, and that’s where you should focus. Orthodontic benefits often come with a lifetime coverage limit (rather than an annual limit). So, if your teeth require extensive or long-term treatment, you might run out. And there are a few other complications:
- On average, orthodontic benefits could cover 50% of the treatment cost up to your lifetime maximum, and a deductible could also apply.
- Some dental benefits have a waiting period, which means you’ll need to wait for a predetermined amount of time after enrolling with your plan before using them (this could be 3-6 months for minor procedures and 6-12 for major ones).
- Other plans have age restrictions. For example, some only cover orthodontic treatment for dependents up to age 19.
- You should be aware of the distinction between “in-network” and “out-of-network” coverage. Treatment by out-of-network providers can be subject to higher deductibles, and may also be covered at a lower rate. Home-based treatment options, when covered, are Teledentistry services that are usually considered out-of-network.
The moral of the story is that you shouldn’t simply assume that your dental insurance will cover SnapCorrect, or any orthodontic treatment, for that matter. Familiarize yourself with your plan’s details and contact your provider to see if you’re eligible for coverage.
Is SnapCorrect Covered Differently Than Braces or Invisalign?
Next scenario: you have dental insurance and orthodontic benefits. Will you receive coverage for SnapCorrect treatment? Surprisingly, not always.
With SnapCorrect, a dentist, orthodontist, or dental technician in your state will approve and supervise your care remotely, rather than in person. Some dental insurers treat SnapCorrect just like braces or Invisalign and provide coverage accordingly. However, because SnapCorrect does not involve regular, in-person check-ups, certain insurers consider SnapCorrect “do-it-yourself” treatment and routinely decline to provide coverage.
It’s important to distinguish between home aligners and the recent concerning trend of DIY orthodontics. The latter stems from online videos where people attempt to shift their own teeth using rubber bands and other crude materials, and it can be highly detrimental to your teeth. At-home treatment through a provider like SnapCorrect is designed and monitored by a licensed dentist or orthodontist, so it doesn’t present the same risks.
Some at-home aligner companies (like byte and SmileDirectClub) have established partnerships that make them “in-network” with certain insurers. SnapCorrect, however, doesn’t have any such relationships, so there’s no guarantee that any insurance provider will cover their treatment.
That said, some providers are friendlier toward remote orthodontics than others. These companies have partnerships with other at-home aligner companies (but not SnapCorrect) and might be more open to covering at-home treatment in general:
- Blue Cross Blue Shield
You might have a different provider, but your treatment could still be covered. Although there are other companies that aren’t as likely to cover at-home aligners. Even if your insurance provider isn’t typically open to at-home aligner treatments, it can’t hurt to check.
Note that this is a rapidly changing situation. Many insurers have recently updated or are currently updating their policy on coverage for home-based orthodontic treatment. We will continue to update this list as we learn about these changes.
How Do I Find Out Whether I Have Coverage?
SnapCorrect doesn’t communicate with insurance companies at all. So whether you want to check on your coverage, file a claim, or ask a question, you’ll have to do it yourself. While some at-home aligner companies have pages where you can enter your insurance details to find out if you’re covered, SnapCorrect doesn’t. Their insurance page provides a general overview of how your final price could look after reimbursement but gives no direction on how to file a claim.
Want to know if your insurer will reimburse you for SnapCorrect? Give them a call. Make sure you explain the type of treatment you’re getting and that it’s directed by a licensed dentist or orthodontist.
An insurer may initially promise reimbursement but then deny your claim later on. There could be from something as small as a mistake on your claim form to something more significant like a re-evaluation of SnapCorrect’s services. Just remember that a “yes” on your preliminary check doesn’t always equate to coverage.
How Do I Claim My Insurance Benefits?
Let’s say your insurance provider covers at-home aligners. Great! Now it’s time for the tough stuff: filing a claim. It’s not overly complicated, but it’s more time-consuming than checking on your coverage.
Even if you’re completing your claim form as an individual, you’ll need to provide information about your treating dentist. And you won’t get an assigned dentist for your SnapCorrect treatment until you’ve submitted an impression kit. Before you move forward with your claim, send in your impressions and wait for SnapCorrect to provide a treatment plan with info about your supervising dentist.
Now you can go ahead with the claim. First, you need to access and print a claim form. You should be able to download one from your insurance provider’s website. Even though you probably want to get it in the mail ASAP, don’t rush! Even a small mistake is enough for an insurer to deny your claim, so make sure you complete every section with the correct information. While SnapCorrect won’t complete the form for you (like byte or SmileDirectClub), they will provide an electronic document with information on your case and treatment, an approval from your assigned dentist, and that dentist’s licensure information.
When you’re finished, mail the claim to the address provided on the provider’s website or in your insurance paperwork. Depending on the company and the time of year, it could take a couple of months to process your form and send a response. Since SnapCorrect isn’t in-network for any providers, your coverage will come in the form of a reimbursement check. You’ll need to pay the full price upfront (or get on a payment plan), then wait for your check to arrive. It may come in one lump sum, or it might be dispersed throughout your treatment.
What If My Insurance Company Denies My Benefits?
This isn’t the ideal scenario, but it’s a very possible one. Occasionally, insurance providers will deny coverage even if a customer should receive it (or thinks they should receive it). Confusing? Yes. Rectifiable? Sometimes.
In some cases, a claim denial is the direct result of a paperwork mistake. You included the wrong code for your treatment or filled out a section incorrectly, and consequently, the provider denied your claim. Sometimes, you can rectify the situation by talking with the insurance company or making corrections to your form. Other times, you might need to resubmit your claim. And with certain providers, you might be out of luck.
Other times, your plan might simply not cover any remote treatments. In this situation, you can either drop it or file an appeal. According to Healthcare.gov, you have the right to request an internal appeal (a re-review by the insurer) within 180 days or an external appeal (a review by the state) within four months. Appeals, however, are often complicated, and SnapCorrect doesn’t openly offer help with the process.
If your appeal fails, you’ll have to live with the full price. Fortunately, SnapCorrect offers financing that can break that price into easier monthly payments.
If that doesn’t work, you might consider enrolling in SnapCorrect’s financing plan, SmilePay, to help make your payments more manageable. Or, you can apply for CareCredit, a line of credit with flexible payment plans specifically intended for medical expenses.
If you believe you’re eligible for orthodontic coverage, but feel overwhelmed by the process of claiming benefits, you may wish to consider one of SnapCorrect’s competitors – byte. In our opinion, byte has the most supportive, knowledgeable, and genuinely helpful insurance experts in the industry. Plus, they handle all of the paperwork for you!
What About HSA and FSA?
Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) both allow you to contribute pretax income to your medical expenses. They’re an option for many employer health plans (HSAs require a higher-deductible plan, though), and they’re also a viable payment option for your SnapCorrect treatment. Whether or not you’re eligible for insurance coverage, this can be a great way to help cover the cost of your treatment.
You can use funds from most FSA and HSA accounts to pay for your SnapCorrect treatment. But every account has different rules, so you’ll want to double-check with your provider before doing so. You can use an HSA or FSA debit card the same way you would any other debit or credit card. Just provide the card info when you pay for your treatment.
If you have an FSA, remember that they have a time limit, since you can’t roll over funds from year to year like you can with an HSA. Make sure to use your funds before they expire!
Bottom line: It might take some work on your end, but it’s totally possible to get insurance coverage for your SnapCorrect treatment. Just remember that it all depends on your specific provider and plan, so you should touch base with your insurer before you dive into treatment. At best, you’ll get reimbursed for part of your aligner price. At worst, you’ll pay full price. But you won’t know until you ask! Once you’ve got your insurance squared away, you’ll have a better sense of your total SnapCorrect price and one step closer to beginning your smile journey.