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Understanding Your Orthodontic Insurance

October 22nd, 2020

Understanding Your Orthodontic Insurance
Orthodontic insurance is very different from medical insurance! Our insurance specialists here at Green Orthodontics have gathered up some common questions about navigating orthodontic insurance. If you have any questions that were not discussed in this blog, please feel free to call us at 931-542-9940 any time and a friendly insurance specialist will be glad to assist!

Do You Accept My Insurance?
Green Orthodontics accepts ALL insurances! We can verify your insurance prior to the consultation to ensure we are maximizing benefits.

Do I Have to Have Insurance to Schedule a Consultation?
Nope! Patients are not required to have insurance in order to be seen. We offer 100% complimentary consultations. There are no charges for this visit and even the x-rays are free!

What is a DPO or HMO insurance?
In some rare cases, a workplace may be contracted out with specific orthodontists within a certain radius. In this case, even though we accept payments from the main insurance company, the “group” may not be willing to pay benefits. If you have an insurance policy like this, we encourage you to contact your insurance company for more information on specific coverage. You are always welcome to come by our office for a complimentary consultation, regardless of the type of insurance!

What Are My Benefits?
Every insurance company offers different benefits. Medical, dental, and orthodontic insurance are all considered different benefits. In most cases, orthodontic insurance has a “one-time use” benefit, called a lifetime maximum. Your insurance company may pay up to this amount towards braces.

Should I Purchase a Second Insurance Plan for Braces?
This is a tough question!  There are hundreds of policies with many exclusions. Policies and coverage may change on a daily basis. We recommend that you first contact the HR department at work, or a representative for the insurance company to get a layout of their plans. Please be aware that secondary insurance may sometimes have fine print that they will not pay if there is a primary insurance. It is important when contacting an HR representative or an insurance company representative that this question is specifically addressed so you can rest assured the secondary insurance will provide coverage.

What is a Lifetime Maximum?
Unlike other dental benefits, most orthodontic benefits do not renew each year. Insurance companies call this a lifetime maximum. This means the orthodontic benefit can only be used once per duration of having that insurance.

Does My Insurance Company Pay for Each Appointment?
It is important to remember that orthodontic benefits are typically paid over the course of treatment in monthly, quarterly, or even yearly installments. This is why it is very important to keep your coverage throughout the course of treatment in order to receive the full benefit.

How Do I Check My Eligibility?
Some employers offer orthodontic coverage, but they have rules about who may or may not receive those benefits. Some policies require you to work a minimum number of hours per week, or there may be a waiting period for new employees. Our insurance specialists will verify your orthodontic benefits before your free consultation to let you know if you are eligible for orthodontic benefits!

Work in Progress
If you get a new insurance company while in treatment, or if you transfer to our office from another location to continue treatment, your new insurance company will consider the braces as a “work in progress”. Most insurance companies will prorate your benefit based on what the prior coverage paid and/or the remaining treatment time. Not all plans allow for work in progress. Every insurance company has their own little formula that they use to determine how much they will pay for a work in progress claim. We can help you navigate that tricky slope!

Primary vs. Secondary Insurance
When a patient is enrolled in two active insurances, this is called “dual coverage.” Our office will do our best to help determine how much each policy will pay towards braces. Some insurances have special rules or exclusions on the policy that may make it impossible to collect the maximum amount on both insurances.

The plans determine which insurance is primary and which is secondary; we as providers and you as the patients are not able to determine or choose which is primary. Sometimes they use a “birthday rule.” This means the parent whose birthday comes first in the calendar year may be considered to be your child’s primary coverage. Since each insurance has their own set of rules, it is important to have a knowledgeable insurance specialist to help navigate the systems!

Additional Procedures
If extractions or other dental work is needed throughout orthodontic treatment, your policy may charge your “dental benefits” or your “orthodontic benefits”. These are typically separate benefits and each insurance company has their own rules about which one will apply.

 

Foods you Can and Can’t Eat With Braces

August 25th, 2020

Are you wondering what kinds of food you can eat while you’re in braces? Can you still have pizza? What about gum? Are you only going to be eating soft foods for the next two years? What do you avoid completely with braces? These are all great questions to think about if considering braces in the future!

The good news is you do not have to stick to a completely soft diet for the next two years. There are plenty of good foods you can still have while you have your braces on. Awareness of “good” and “bad” food is very important so you are able to take care of your braces throughout treatment and have the best results.

Why certain foods need to be avoided with braces
Your braces may have brackets, bands, and arch wires that can all be damaged by certain foods. Avoiding very hard or sticky food is a big priority. Along with avoiding certain foods, having proper hygiene is essential to making sure cavities do not form around the braces. If the teeth and braces are not properly cleaned of food debris, tartar and plaque can accumulate which can cause white spots on the surfaces of the teeth.

Foods you can’t eat with braces
Crunchy and sticky foods such as nuts and bubble gum, hard candies like lollipops and candy canes can loosen brackets and wires which may cause delays in treatment. Foods to avoid with your braces are:

  • Nuts
  • Potato chips
  • Popcorn
  • Crunchy veggies
  • Hard candies (such as jolly ranchers or lollipops)
  • Gum (Sugar-free gum is okay)
  • Sticky candies (like laffy-taffy or gummy bears)
  • Corn on the cob
  • Apples
  • Beef jerky
  • Pizza crust

It’s not just hard foods can break the appliances in your mouth! Other items and habits to avoid that could damage brackets are:

  • Pen chewing
  • Pencil chewing
  • Nail biting
  • Toothpicks
  • Straw Chewing

It is important to not chew on any hard objects!

Foods that you can eat with braces
Now that you know what you can’t have with braces, we can talk about all the good things that you can have! Though there are many things that must be avoided with braces, there are many yummy things that can still be enjoyed. For example, you can still enjoy:

  • Pastas
  • Mashed potatoes
  • Meats with no bones
  • Soft veggies
  • Fruits
  • Soups
  • Dairy products
  • Soft breads and sandwiches
  • Casseroles
  • Pizza (without the crust)

Even with braces, we can still enjoy the good things in life! At every visit, Dr. Green and your dental assistant will evaluate the braces for damage to brackets or plaque build-up. All of our patients receive a short class after braces are placed to review how to best care for your appliances to ensure they stay in top shape throughout treatment. Remembering the “do’s” and “don’ts” can have a big impact on your treatment outcome and will help to get the beautiful smile you have always dreamed of!

Green Orthodontics Newsletter!

February 24th, 2020

Check out the newest edition of the Green Orthodontics Newsletter!

Retainers – Choosing the right one for you!

February 24th, 2020

Once you get your braces off, you will have three options for retainers. A retainer is an appliance that keeps your teeth from shifting back to their original location. Each retainer has pros and cons! Dr. Green and your dental assistant can help you decide which option will be best for you.

Option 1: Clear Essix Retainers (Removable)
Made of a clear plastic.

Pros:

  • Cannot be seen while wearing.
  • Holds your teeth the best as it forms around each tooth on all surfaces.
  • Lasts anywhere between 9 months to 10 years. This depends on the tendency to “chew” or “grind” your teeth as well as how well the retainer is cared for.
    • If you are a grinder, please notify your assistant! We can use a thicker material. It is bulkier than the regular material, but will last longer.

Cons:

  • Not as durable as the wire Hawley retainer.
  • It cannot be adjusted. If teeth move because the retainer has not been worn, it will no longer fit and will need to be replaced.
  • Needs to be replaced periodically.

Option 2: Wire Hawley Retainers (Removable)
Made of hard acrylic and wire.

Pros:

  • Most durable retainer. It lasts a long time and with proper care, it can last up to 40 years!
  • Ideal for night time “grinders” as a special plate can be added to it. Please notify your dental assistant if you would like this added.
  • This is the best option for a back-up retainer.

Cons:

  • The wires may get bent and need periodic adjustments.
  • The Hawley retainer does not hold the position of your front teeth as well as the clear type of retainer, because it does not form around each individual tooth.

Option 3: Fixed Retainers (Not Removable)
A fixed retainer is more maintenance than removable retainers, but they are a great way to keep the teeth in place as they are worn all the time.

Pros:

  • They stay in your mouth 24/7, meaning you won’t lose them!

Cons:

  • This is often the most expensive type of retainer.
  • Wearing a clear essix retainer at least one night per week to check for unwanted tooth movement is highly recommended.
  • They require excellent brushing, flossing, and using mouth rinses. If the teeth are not kept clean, it may affect the health and longevity of your teeth.
  • Breakage can occur due to the fact that the retainers are in while eating. Each person eats differently and applies forces at different locations.
  • Due to breakage, it is recommended you avoid biting into hard and sticky foods such as apples, carrots, hard breads, steak, taffy, etc. and cut all food and chew on the back teeth.
  • This retainer needs replaced most often. It typically lasts between 6 months – 3 years.

 

Dr. Green recommends wearing your retainer every night for 6 months, then as often as needed to keep your teeth in their current position. Many of our orthodontic patients are able to maintain straight teeth by wearing their retainers once a week at night. Your dental assistant will have further instructions regarding retainer wear as some patients need to wear it more often.

Never wrap your retainer in a paper towel or tissue! Many people do this while eating and it gets thrown away.

Make sure you store your retainer only in its case! Remember that little brothers and sisters are very curious. Pets, especially dogs, also love to eat them.

How often do I need to replace my retainers?

Retainers are like eyeglasses and need to be replaced and adjusted periodically. Some people are able to keep the same glasses for 10 years, some last less than a year. It is the same with retainers!

My retainer feels tight!

This means your teeth are starting to shift. You should increase the amount of time you are wearing your retainers to get them back to the original position.

My retainers won’t fit!

Give us a call at 931-542-9940 as soon as possible! This means your teeth have shifted and there are two options. We can make a new set of retainers that will hold the current position or we can discuss retreatment options to get that perfect smile again.

How should I clean my retainers?

Take your retainer out and hold it in the palm of your hand. Use your toothbrush to carefully brush the retainer with toothpaste. Rinse it with water. Avoid soaking in hot water! You can also drop it in some mouth wash for 5 minutes.

One thing about orthodontic treatment is certain and that is – if you don’t wear your retainer as prescribed, your teeth WILL shift. Make sure you always wear your retainer to keep your teeth straight!

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