Payment Options | Pond Orthodontics

Insurance

We are happy to work with you and your insurance company to receive the maximum benefit possible under your policy. We have found that the more you know about your individual policy, the easier it is to process your claim. To assist us both in this endeavor, we have established the following answers to the most commonly asked questions.

Please keep in mind that our primary financial relationship is with our patients and their families. We realize that understanding your orthodontic insurance can be difficult and we welcome any questions you have.

How does orthodontic insurance work?

There are many different agreements between insurance carriers and their subscribers, and each contract provides a different benefit. For example: some programs pay monthly, others quarterly. Some programs cover adults and others cover only children. There may be other qualifications such as being with the program a year or longer before any benefits are available. Orthodontic insurance generally differs from regular medical insurance in that it rarely pays for orthodontic treatment in full. Each insured individual usually has a lifetime maximum benefit for orthodontic services. This benefit is generally spread out over the length of the orthodontic treatment. Please be aware that termination of any insurance policy before payment is received will also stop the insurance payments. Charges for lost or broken appliances are also not covered by insurance.

How will our office assist you with your insurance?

We will submit an insurance form that describes the orthodontic problems, the required treatment, the length of treatment time and the financial arrangements. They will then send information to the office stating the benefit amount and method of payment. We will follow up with the insurance payments once treatment is started.

How can you maximize your benefit?

Call your insurance company to learn as much as possible about your program. Ask how often it pays, lifetime maximum age limitation (when applicable), whether payment will start immediately when treatment is started or whether there is a waiting period. Get the name of the person you speak with. We will do the same for you prior to your exam. Chances are that if the information agrees, we can depend on it! Please be aware that if your policy changes during the time in treatment, benefits will also change and any money not received in the overall transition will be added to your balance, continuing your payments at the end of treatment. We pledge to help you achieve your full insurance benefit to the best of our ability.