Insurance

How orthodontic coverage works

Orthodontic benefits work differently from general dental benefits. Most plans that include orthodontics apply a lifetime maximum rather than an annual one. That is a fixed dollar amount the plan will pay toward orthodontic treatment for that person, ever. The amount varies by plan.

Once the lifetime maximum is used, the plan pays nothing further toward orthodontics for that patient, even in a later year or with a different provider.

Plans typically pay orthodontic benefits in installments over the course of treatment rather than in one payment at the start.

Common plan terms

Age limits. Some plans cover orthodontics only for dependents under a certain age, often 19. Adult coverage is less common.

Waiting periods. Some plans require you to be enrolled for six or twelve months before orthodontic benefits become available.

Medically necessary clause. A small number of plans cover orthodontics only when it meets a specific clinical threshold rather than for alignment alone.

What CDZ Ortho does

We verify your coverage before treatment starts and tell you what the plan is expected to pay and what your portion will be. We file claims for you.

Bring your insurance card to the initial consult.

If you do not have coverage

Payment plans are available and are covered on the financial information page.