The OrthoCare Orthodontic Discount Program is a program for orthodontic care. When using a contracted OrthoCare Orthodontist, you could save up to 20% on the services performed. This results in meaningful savings when compared to the Usual and Customary (UCR) fees charged by Orthodontists.
HIGHLIGHTS
- No Deductibles
- No Waiting Periods
- No Claim Forms
- No Prior Authorization Required
- Affordable Rates
- Coverage for Children and Adults
ELIGIBILITY
The OrthoCare program has been designed to offer orthodontic benefits
to both individuals and families, providing benefits for the routine
orthodontic treatment for children and adults. Children who are
dependents are covered under the family plan up to their 23rd
birthday. OrthoCare has no waiting periods before the benefits begin.
QUESTIONS & ANSWERS ABOUT THE ORTHOCARE PROGRAM
1. I LIKE MY CURRENT FAMILY DENTIST. DO I HAVE TO SELECT A NEW
GENERAL DENTIST?
No, you do not need to change general dentists. You can continue to
see your general dentist. When you join the OrthoCare program, you
select an Orthodontic specialist from the list of OrthoCare providers.
2. DO ALL FAMILY MEMBERS NEED TO GO TO THE SAME ORTHOCARE
PROVIDER?
Family members can choose their own OrthoCare Provider.
3. IS THE ORTHOCARE PROGRAM AN INSURANCE PRODUCT?
No, the OrthoCare program is a reduced fee program where the OrthoCare
providers have agreed to provide orthodontic benefits to OrthoCare
members for a reduced fee. This results in meaningful member savings
in comparison to the normal (UCR) fees typically charged by
orthodontists.
4. DO I NEED TO REMAIN A MEMBER DURING MY ORTHODONTIC
TREATMENT?
Yes, you must continue to be a member of the OrthoCare program
throughout your entire orthodontic treatment to receive the reduced
fees for services provided by the OrthoCare provider.
5. I AM CURRENTLY HAVING ORTHODONTIC TREATMENT DONE, CAN I
BENEFIT FROM THE ORTHOCARE PROGRAM?
No, the OrthoCare program would not be a benefit to you if you are
currently receiving orthodontic treatment.
6. HOW CAN I FIND A LISTING OF PARTICIPATING ORTHODONTISTS?
Visit the OrthoCare
Provider Search website.
EXCLUSIONS FROM THE ORTHODONTIC DISCOUNT PROGRAM:
1. Orthodontic treatment for the alteration of vertical face height,
or treatment of temporomandibular joint dysfunction (TMD).
2. Additional costs due to frequently missed appointments.
3. Cost for lost or broken appliances and retainers.
4. Changes in treatment plan or additional services necessitated by an
accident or trauma.
5. Follow-up visits (retention therapy) that extends beyond twelve
(12) months after active appliances are removed.
6. Personalized special appliances such as “clear” or
“invisible” braces, colored brackets, Invisalign System and
similar special braces. Discount will apply to the routine orthodontic
appliance portion of services.
7. Services that are performed by a dentist or orthodontic provider
who is not an OrthoCare Orthodontist.
8. Orthodontic services in process.
9. Any orthodontic services rendered after a member becomes ineligible
due to dependent age (23 or over) or any other change in eligibility.
The discount will apply only for the portion of treatment rendered
while eligible.
10. This Discount may not be used in conjunction with other
orthodontic discounts, fee schedule plans or DHMO plans.
11. Dental providers are independent contractors and solely
responsible for all treatment provided. American Dental Professional
Services, LLC makes no expressed or implied warranties regarding
services received and disclaim all liability for any and all services
performed by contracted providers and their associates.
*The optional OrthoCare Program is not an insurance benefit, nor is
it affiliated with Standard Security Life Insurance Company of New
York or a part of the Secure DentalOne insurance plan.