Braces: Keeping cost down and insurance questions.

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Post Reply
User avatar
fortfun
Posts: 770
Joined: Tue Apr 19, 2016 7:31 pm

Braces: Keeping cost down and insurance questions.

Post by fortfun » Sat Jul 14, 2018 1:27 pm

Any advice on keeping the cost of braces to a minimum? I've got 2 kids that will need them in the next few years.

Also, my wife and I can both pay more for dental plans that cover $1,800-$2,000 of the cost. Is there any way for both of us to utilize our insurance, or is it one or another. I can't get a clear answer from anyone. I'd like to have my wife pay for extra insurance for the first half and then I'd pay for extra insurance for the second half. The orthodontist offices seem to indicate that this isn't possible.

Does the price vary greatly by region? I understand there are a lot of appointments but I'd be willing to travel 50 miles a few times to save a few grand.

User avatar
gasdoc
Posts: 1492
Joined: Mon Nov 03, 2014 8:26 am

Re: Braces: Keeping cost down and insurance questions.

Post by gasdoc » Sat Jul 14, 2018 1:32 pm

I can only answer the second part- I wouldn't go outside your general area, as there are LOTS of visits, and not everyone can have the slot right after school because all of the patients are students (well, the vast majority). Are you really going to take your kid out of school for the entire day instead of a couple of hours to drive them an hour each way in addition to the time in the office? I would stay local.

gasdoc
Last edited by gasdoc on Sat Jul 14, 2018 5:56 pm, edited 1 time in total.

User avatar
fortfun
Posts: 770
Joined: Tue Apr 19, 2016 7:31 pm

Re: Braces: Keeping cost down and insurance questions.

Post by fortfun » Sat Jul 14, 2018 1:47 pm

gasdoc wrote:
Sat Jul 14, 2018 1:32 pm
I can only answer the second part- I wouldn't go outside your general area, as there are LOTS of visits, and not everyone can have the slot right after school because all of the patients students (well, the vast majority). Are you really going to take your kid out of school for the entire day instead of a couple of hours to drive them an hour each way in addition to the time in the office? I would stay local.

gasdoc
Thanks Gasdoc. Probably not but I'm about 30 minutes to another state (bypassing the city). Sometimes the drive across the city, where the dentists are, takes thirty minutes. I guess if I could save 2k, I'd drive out of state. Since I'm not in the business, I don't know how rates change by region. I appreciate your input. In the end, I'm sure we will stay in town.

livesoft
Posts: 61944
Joined: Thu Mar 01, 2007 8:00 pm

Re: Braces: Keeping cost down and insurance questions.

Post by livesoft » Sat Jul 14, 2018 1:53 pm

One of our children got braces. We shopped orthodontists and found the following:

1. In wealthy areas, there are too many orthodontists, so the potential mouths per orthodontist are less than in an area with same population density with fewer orthodontists.

2. With less competition, the orthodontist can charge less to get the same standard of living because they get more mouths.

3. So we picked a well-recommended orthodontist not in our area, but about 20 miles away and saved some money.

4. We did not have "lots of visits." Also, dentists recommended pulling wisdom teeth and we did not have that done. The adult child often gets compliments on her smile / teeth, so those results speak for themselves.
Wiki This signature message sponsored by sscritic: Learn to fish.

Determined
Posts: 232
Joined: Sat Aug 12, 2017 7:43 pm

Re: Braces: Keeping cost down and insurance questions.

Post by Determined » Sat Jul 14, 2018 2:01 pm

One insurance is primary, the other can be secondary. You won't be able to switch and get the coverage twice. I have no experience with opting for a different coverage that pays more. My third child will get them next year. I have an HSA, but once I get the estimate next month, I will use a limited FSA in 2019 to cover the balance of the braces. This way I can keep the HSA as an investment account and use pre tax money for the orthodontics. I will pay for it all immediately on a 2% cash back credit card and receive a 5% discount for being paid in full. Then I will submit for reimbursement which should arrive before my credit card payment is due.

I could also open a new card with a bonus. I have done that a few times.

User avatar
Summit111
Posts: 107
Joined: Sun Mar 17, 2013 6:32 pm

Re: Braces: Keeping cost down and insurance questions.

Post by Summit111 » Sat Jul 14, 2018 3:44 pm

I made a deal with the orthodontist for an upfront CASH payment of the total copayment of my kids treatment. He collected whatever the insurance payments were. Saved 30%....

Summit

Rupert
Posts: 3431
Joined: Fri Aug 17, 2012 12:01 pm

Re: Braces: Keeping cost down and insurance questions.

Post by Rupert » Sat Jul 14, 2018 4:04 pm

Do you and your wife both have dental coverage right now, or could you stack enrollment in your respective plans, i.e., enroll the family in your plan for a couple of years and then enroll the family in her plan for a couple of years? If the latter, then I think maybe you could get both plans to pay out the maximum benefit for orthodontia.

I think the number of visits depends on the exact treatment your kid is receiving. I know kids who go every week for months at a time, which would make the 50-mile trip a pain. I picked an orthodontist across the street from my kids' school for that very reason.

EHEngineer
Posts: 697
Joined: Sat Feb 28, 2015 4:35 pm

Re: Braces: Keeping cost down and insurance questions.

Post by EHEngineer » Sat Jul 14, 2018 4:21 pm

livesoft wrote:
Sat Jul 14, 2018 1:53 pm
One of our children got braces. We shopped orthodontists and found the following:

1. In wealthy areas, there are too many orthodontists, so the potential mouths per orthodontist are less than in an area with same population density with fewer orthodontists.

2. With less competition, the orthodontist can charge less to get the same standard of living because they get more mouths.
While I believe that orthodontists are more expensive in wealthy areas, your explanation that somehow the market is rationing mouths to orthos to ensure equal standards of living would be novel. Worthy of publication for sure. I suggest that rent and labor costs are higher in HCOL areas, price sensitivity is lower, and customer demands for posh facilities may also be higher.

back to thread subject

Edit to add: We chose the nearby ortho because it's convenient and everybody we spoke to loves him. We paid in full upfront for a substantial discount 20-30% from memory. They did warn us that if our insurance benefit is reduced during the treatment, we would need to pay for that.

about using two insurances. I had dual insurance for a while, I think they would both pay up to their cap. There would be a primary and secondary where the primary insurer is the insurance company of the older of the two primary insureds, ie you or your wife. The ortho would need to submit the claims twice, and sequentially, not simultaneously. As long as the costs exceed the benefit of the primary insurer, then the secondary should kick in up to its limit. That's how it worked for me. It was pretty messy, and the primary will keep asking you with emails and snail mail "Are you sure I'm the primary insurer? Please send us documentation of ....."
Last edited by EHEngineer on Sat Jul 14, 2018 4:48 pm, edited 2 times in total.
Or, you can ... decline to let me, a stranger on the Internet, egg you on to an exercise in time-wasting, and you could say "I'm probably OK and I don't care about it that much." -Nisiprius

Tanman4223
Posts: 4
Joined: Thu Jun 21, 2018 8:50 pm

Re: Braces: Keeping cost down and insurance questions.

Post by Tanman4223 » Sat Jul 14, 2018 4:32 pm

Fortfun,

If you do not have a HDHP for your insurance, I would suggest checking to see if your employer offers a healthcare FSA. This would allow you to pay for the entire amount without federal taxes, social security contributions and possibly state taxes. You’re money would stretch farther and realized income would be reduced. If you didn’t want to pay each fee in total upfront, you could ask if the orthodontist would split the payment in two and pay in two different years with the FSA to lighten the load.

drawpoker
Posts: 1837
Joined: Mon May 19, 2014 6:33 pm
Location: Delmarva

Re: Braces: Keeping cost down and insurance questions.

Post by drawpoker » Sat Jul 14, 2018 4:39 pm

Be very, very cautious with dealing with childrens orthodontists and dental insurance plans.
When I had dental coverage at work it offered orthodontists benefit but you had to stay within network. At the initial visit for the in-network one with an office nearby was told the kid would need two teeth (not wisdom) pulled. Explanation being that the braces would not fully do the trick without this teeth pulling.
Did a little checking, and sure enough, found out some orthodontists pull this on unsuspecting parents with certain insurance plans. Apparently pulling teeth first makes the whole job of applying braces much easier, less time and effort.
Evidently this one was not satisfied with the payment rates he was getting from the insurer so he was looking for any short cuts he could.
Naturally, I consulted another orthodontist (not in network) who said absolutely not, we have no reason to pull healthy teeth prior to putting on braces.
Then I had to battle with the insurance company to approve allowing me to go out-of-network for services.
It was a hassle, but it was finally granted. Probably because I had some rather damning documentation of just how their in-network orthodontists were doing business.

livesoft
Posts: 61944
Joined: Thu Mar 01, 2007 8:00 pm

Re: Braces: Keeping cost down and insurance questions.

Post by livesoft » Sat Jul 14, 2018 5:12 pm

EHEngineer wrote:
Sat Jul 14, 2018 4:21 pm
While I believe that orthodontists are more expensive in wealthy areas, your explanation that somehow the market is rationing mouths to orthos to ensure equal standards of living would be novel. Worthy of publication for sure. I suggest that rent and labor costs are higher in HCOL areas, price sensitivity is lower, and customer demands for posh facilities may also be higher.
This article supports your view: https://orthopundit.com/orthodontics-is ... -is-right/
Wiki This signature message sponsored by sscritic: Learn to fish.

User avatar
gasdoc
Posts: 1492
Joined: Mon Nov 03, 2014 8:26 am

Re: Braces: Keeping cost down and insurance questions.

Post by gasdoc » Sat Jul 14, 2018 5:59 pm

Rupert wrote:
Sat Jul 14, 2018 4:04 pm
Do you and your wife both have dental coverage right now, or could you stack enrollment in your respective plans, i.e., enroll the family in your plan for a couple of years and then enroll the family in her plan for a couple of years? If the latter, then I think maybe you could get both plans to pay out the maximum benefit for orthodontia.

I think the number of visits depends on the exact treatment your kid is receiving. I know kids who go every week for months at a time, which would make the 50-mile trip a pain. I picked an orthodontist across the street from my kids' school for that very reason.
Yes, that was our experience. And if your kid has after-school activities and/or challenging classes, it can be rough.

gasdoc

AlphaLess
Posts: 342
Joined: Fri Sep 29, 2017 11:38 pm

Re: Braces: Keeping cost down and insurance questions.

Post by AlphaLess » Sat Jul 14, 2018 6:06 pm

drawpoker wrote:
Sat Jul 14, 2018 4:39 pm
Naturally, I consulted another orthodontist (not in network) who said absolutely not, we have no reason to pull healthy teeth prior to putting on braces.
Anybody who would suggest pulling healthy teeth out needs to have some neurons pulled from their brains.

User avatar
fortfun
Posts: 770
Joined: Tue Apr 19, 2016 7:31 pm

Re: Braces: Keeping cost down and insurance questions.

Post by fortfun » Sat Jul 14, 2018 7:47 pm

Thanks for the helpful suggestions everyone!

Hillview
Posts: 297
Joined: Fri Feb 02, 2018 7:27 am

Re: Braces: Keeping cost down and insurance questions.

Post by Hillview » Sun Jul 15, 2018 7:32 am

Ask around for a good orthodontist. Get 2 opinions and 2 estimates (3 if you can). We used FSA funds and our ortho provides a payment plan without any interest. We paid son #2's off entirely with the FSA and son #1's with some of the FSA and the rest is on a payment plan of 180 a month for a year. Our kids don't need weekly checks but some kids around us at same ortho do need weekly checks so it does vary. Good luck!

User avatar
grabiner
Advisory Board
Posts: 22341
Joined: Tue Feb 20, 2007 11:58 pm
Location: Columbia, MD

Re: Braces: Keeping cost down and insurance questions.

Post by grabiner » Sun Jul 15, 2018 9:39 am

Tanman4223 wrote:
Sat Jul 14, 2018 4:32 pm
If you do not have a HDHP for your insurance, I would suggest checking to see if your employer offers a healthcare FSA.
Even if you do have a HDHP, check whether you have a limited-purpose FSA, usable for only dental and vision; this would allow you to put in $2500 towards braces or other dental costs tax-free, and keep the HSA for other current or future medical expenses.
Wiki David Grabiner

User avatar
fortfun
Posts: 770
Joined: Tue Apr 19, 2016 7:31 pm

Re: Braces: Keeping cost down and insurance questions.

Post by fortfun » Mon Jul 16, 2018 8:57 am

grabiner wrote:
Sun Jul 15, 2018 9:39 am
Tanman4223 wrote:
Sat Jul 14, 2018 4:32 pm
If you do not have a HDHP for your insurance, I would suggest checking to see if your employer offers a healthcare FSA.
Even if you do have a HDHP, check whether you have a limited-purpose FSA, usable for only dental and vision; this would allow you to put in $2500 towards braces or other dental costs tax-free, and keep the HSA for other current or future medical expenses.
Thanks Grabiner. Neither of our insurances indicates anything about a limited-purpose FSA, they only mention FSA. We are on a HDHP plan (HSA). Is there any way to get our employers to offer a limited use FSA?
Thanks!
Fortfun

User avatar
grabiner
Advisory Board
Posts: 22341
Joined: Tue Feb 20, 2007 11:58 pm
Location: Columbia, MD

Re: Braces: Keeping cost down and insurance questions.

Post by grabiner » Mon Jul 16, 2018 7:46 pm

fortfun wrote:
Mon Jul 16, 2018 8:57 am
grabiner wrote:
Sun Jul 15, 2018 9:39 am
Tanman4223 wrote:
Sat Jul 14, 2018 4:32 pm
If you do not have a HDHP for your insurance, I would suggest checking to see if your employer offers a healthcare FSA.
Even if you do have a HDHP, check whether you have a limited-purpose FSA, usable for only dental and vision; this would allow you to put in $2500 towards braces or other dental costs tax-free, and keep the HSA for other current or future medical expenses.
Thanks Grabiner. Neither of our insurances indicates anything about a limited-purpose FSA, they only mention FSA. We are on a HDHP plan (HSA). Is there any way to get our employers to offer a limited use FSA?
Thanks!
Fortfun
You have to ask your employer; there is some extra administrative work to set it up. The benefit isn't usually that great since you can't anticipate that much in medical and dental expenses. (However, it is possible to take advantage of this as you are planning to do, and I have also done this, opening an FSA in December because I knew I would have dental work done in January or February of the next year.)
Wiki David Grabiner

User avatar
fortfun
Posts: 770
Joined: Tue Apr 19, 2016 7:31 pm

Re: Braces: Keeping cost down and insurance questions.

Post by fortfun » Mon Jul 16, 2018 7:59 pm

grabiner wrote:
Mon Jul 16, 2018 7:46 pm
fortfun wrote:
Mon Jul 16, 2018 8:57 am
grabiner wrote:
Sun Jul 15, 2018 9:39 am
Tanman4223 wrote:
Sat Jul 14, 2018 4:32 pm
If you do not have a HDHP for your insurance, I would suggest checking to see if your employer offers a healthcare FSA.
Even if you do have a HDHP, check whether you have a limited-purpose FSA, usable for only dental and vision; this would allow you to put in $2500 towards braces or other dental costs tax-free, and keep the HSA for other current or future medical expenses.
Thanks Grabiner. Neither of our insurances indicates anything about a limited-purpose FSA, they only mention FSA. We are on a HDHP plan (HSA). Is there any way to get our employers to offer a limited use FSA?
Thanks!
Fortfun
You have to ask your employer; there is some extra administrative work to set it up. The benefit isn't usually that great since you can't anticipate that much in medical and dental expenses. (However, it is possible to take advantage of this as you are planning to do, and I have also done this, opening an FSA in December because I knew I would have dental work done in January or February of the next year.)
Sadly, neither of our employers offers, or plans to offer in the future... You would think a University that is pushing the HDHP HSA plan would offer such a plan....

Post Reply