In-Network vs. Out-of-Network Orthodontic Insurance

Finding out you or a family member needs orthodontic treatment can cause you to start thinking about ways to pay for it. Orthodontic treatment is an investment, but a very wise one, and finding the best way to make treatment attainable for you is often one of the first steps in the process. The great thing is there are so many ways to pay for orthodontic treatment, ranging from insurance to payment programs and everything in between.

If you’re thinking about using your dental insurance to help pay for your orthodontic treatment, you may have some questions, especially about in-network vs. out-of-network orthodontists. We’re here to help you sort it out.

About Orthodontic Insurance

Orthodontic insurance is actually dental insurance that covers part of the cost of treatment needed to make corrections to your smile. Treatment options typically covered by orthodontic insurance (to some extent, depending on the insurance) include:

Orthodontic insurance is usually obtained either through your employer if it is offered, or through self-pay insurance options. It’s important to note having dental insurance doesn’t necessarily mean orthodontic treatment is covered. That’s why taking a close look at your insurance policy is recommended. When looking for orthodontic insurance, you have the option of in-network and out-of-network coverage. Let’s discuss the difference between the two.

In-Network vs. Out-of-Network Orthodontic Insurance

Finding an orthodontist who is included in your network may mean their services are offered at a lower rate; however, this isn’t always the case. Just because an orthodontist is in your network, it’s not guaranteed you will be paying less for treatment. Some orthodontists raise their rates to cover the reduced rate paid to them by the insurance carrier.
If your insurance changes and suddenly your orthodontist is out of your network, you don’t have to immediately change to another practice. Look through the details of your insurance policy and speak with your orthodontist to get a better idea when it comes to the cost of your treatment. Many orthodontists accept most insurance plans, so the choice is yours to make.

Choosing the Right Orthodontist

In the end, finding the right orthodontist should be your priority. You want someone who understands you and has experience in the treatment method you prefer. The last thing you want to do is settle for an orthodontist just because they are in your network. Finding the right fit for you and your family is imperative to your outcome.

For example, if you’re looking for an orthodontist who specializes in Invisalign, don’t settle for one who doesn’t simply because they are in your network. The choice should depend on a number of things, with compatibility being at the top of the list.

Whether you choose an orthodontist who is in or out of your network will depend on what you want to get out of treatment. Do a little research before committing to an orthodontist, so you can be sure you’ve made the right choice.