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Whether it’s for you or for a dependent, we know that getting braces can be a stressful event, for multiple reasons. This page is designed to make getting started with orthodontic care as simple as possible, so you can move on to the activities that make you smile.
Our Dental Plus Plan covers both child and adult orthodontia. Here are the highlights:
Deductible: $50 one-time per individual.
Coinsurance: 50%.
Lifetime maximum benefit per individual: $2,500 (separate from the annual maximum dental benefit).
You, your spouse/domestic partner, and your dependents are eligible for orthodontic services under the Dental Plus Plan. Please note that the Dental Basic Plan, available to retail employees only, does not cover orthodontia. If you are currently enrolled in this plan, consider switching to the Dental Plus Plan during the next Open Enrollment.
To get the most value for your orthodontia coverage, follow these steps:
Confirm your providers are in network: Check if your orthodontist is in network with Premera Blue Cross.
Request an estimate of your coverage: Your orthodontist will file a predetermination letter with Premera to determine what's covered and what you will need to pay.
Save money using pre-tax dollars: Use your Flexible Spending Account (FSA) or Health Savings Account (HSA) to pay for dental expenses that aren't fully covered by your group dental plan.
To begin your orthodontic journey, visit Premera to find in-network providers and schedule an appointment. You can also use your health insurance card to get an estimate of your coverage.
Set aside pre-tax dollars in your FSA or HSA to help cover your orthodontic expenses. You can set aside up to $3,200 in the Limited Purpose (Dental & Vision) FSA and carry over up to $640 at the end of the year. Alternatively, increase contributions to your HSA up to the IRS maximum limit to help cover your annual costs.
When paying for your treatment, the steps you take depend on whether your provider is in or out of network:
In-network providers: Your orthodontist will submit claims on your behalf.
Out-of-network providers: You will need to file the claim yourself. After your claim has been processed, your orthodontist will bill you directly.
If you have any questions or need assistance, please contact Premera, our dental plan provider. We are here to support you in achieving a healthy, beautiful smile!
Premera customer service: (800) 676-1411