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Are braces elective?

Started by FireFighterDAD, Feb 18, 2011, 09:53:58 AM

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FireFighterDAD

I am dealing with a visitation order violation issue with my ex wife so she is already very upset with me.

She sent me a note today stating that she took our son to the orthodontist and gave me a number (over a thousand dollars) that I will be responsible for since, according to her "orthodontist falls under dental".

If I had the money to pay for braces for my son I would go for it but my salary is not high and I have zero dental coverage myself so I can't get any help from that.

I had always thought that braces were an elective/cosmetic procedure, at least in most cases.  My son's teeth are not straight but there isn't a problem with chewing, etc.

If I'm required to pay then I'm required to pay and I can go apply for a loan.  If I'm not required to pay and she wants to go forward with it I can always contribute what I can even if it's not all that she wants.

I am interested to know if anyone has dealt with this issue before and if braces are required to be covered in the same way that dental expenses are?

FFD

Kitty C.

I work at a dental college, so I know 'just enough to be dangerous'..........take this for what it's worth.........

Braces CAN be medically necessary, but it all depends on your son's situation.  Your son's teeth may not be straight, but you have no idea whether he chews okay.  Have you gone to any of your son's appts. and talked to the orthodontist personally?  One valid concern is occlusion...how the teeth meet together.  You don't say how old your son is, but if he's still in his teens, his teeth will still be moving.  And if his wisdom teeth come in sideways (as they often can do), it will wreak havoc on his alignment and occlusion.  And a mis-aligned occlusion can certainly cause problems down the road....TMJ is just one possibility and that is VERY difficult to get treated.  That one I know personally because I work directly with the pathologists who see TMJ pts.

If she is asking for ONLY $1000, you're getting off dirt cheap.  SS was able to go through the orthodontic program here and I was also able to get him the 'employee's family' rate, but the total cost was still between $2000-3000.  Around here, going to a private orthodontist it would cost up to $10,000 for braces.  Here we can set up a payment plan with the college and pay a set fee per month towards the contract until it's fulfilled, so between DH and BM, they traded off paying every other month.

I recommend going to your son's next orthodontic appt. and talk to the DDS personally, so that you have all the facts.  If your BM won't allow you to do this for whatever reason, demand to see a copy of the DDS's notes outlining the reasons for the need for orthodontics before you'll agree to anything.  You can also shop around..........if you have a dental college somewhere near you, I'd certainly take advantage of that.  Student fees here can be anywhere from 1/3 to 1/2 less than a private DDS and they do EXCELLENT, thorough work..........I can vouch for that, at least from this college!
Handle every stressful situation like a dog........if you can't play with it or eat it, pee on it and walk away.......

gemini3

We went through this a year or so ago.  SD1 needed braced, according to 3 different orthodontists.  BM is supposed to split medical costs 50/50.  Long story short - she didn't have to pay.

FireFighterDAD

Sorry, I wasn't clear--she is asking for $2,400 from me total, but over $1 k to start with.

I looked over my order and there is not specifically concerning orthodontia, just dental.

I will call the orthodontist and ask for the specific reasons for needing braces -- if it's purely cosmetic or not.  My ex is required by the order to provide me with the name of the medical professional and the order entitles me access to all information so that shouldn't be a problem.  We have joint custody and I can bring the order with me.

My son is almost 14.

Thanks so much for all of the help!  You guys are great!

ocean

Yes, dealing with it now BUT this is what we did:
Sent dentist a letter and asked for medically necessity. They then refused to put on braces for about a year...then it was.

Your dental insurance usually has some coverage. Ask them who is in network, you save some that way.

Call the orthodontist. Here they can set up your own account and have bills send directly to you once a month. They also have a dental credit...basically a dental charge card if needed BUT two dentists we have dealt with took the total amount and divided by 2 years and that is what we paid. Ask them for a payment plan.

If you split 50/50 that number is high even with NO insurance. Here is NY it is $4500 total. (so are they asking for $4800?).

My advice:deal with the separate but make sure they deduct any insurance first before you sign any agreement....

Kitty C.

Quote from: FireFighterDAD on Feb 18, 2011, 11:54:12 AM
Sorry, I wasn't clear--she is asking for $2,400 from me total, but over $1 k to start with.

I looked over my order and there is not specifically concerning orthodontia, just dental.

I will call the orthodontist and ask for the specific reasons for needing braces -- if it's purely cosmetic or not.  My ex is required by the order to provide me with the name of the medical professional and the order entitles me access to all information so that shouldn't be a problem.  We have joint custody and I can bring the order with me.

My son is almost 14.

Thanks so much for all of the help!  You guys are great!

I know that many think that braces are mostly cosmetic, but since working in a dental college, I've come to learn just how important it is to have teeth aligned properly, because it can severely affect the way you eat.  If teeth are not 'meshing' together the way they are supposed to, it can cause all kinds of problems down the road.

If she is splitting the cost 50/50, $4800 is still very reasonable with a private orthodontist, from what I've seen.  But I would venture to say that the court will probably see orthodontics as dental, and for the most part, rightly so.  If dental codes are used, only dental ins. will cover it, medical ins. will not.  I also recommend asking about a payment plan.

You can get braces for $4500 in NY with a private orthodontist, ocean?  That's incredible!  When DS needed them, I priced it here with private and it was $7000....and that was 7 years ago!  Thank God for the dental college or I'd still be paying for it!
Handle every stressful situation like a dog........if you can't play with it or eat it, pee on it and walk away.......

ocean

OMG...$7000???

Yes, we are paying on my daughter who just started last august and SD. Since PB went out of network it was $4500 for 2 year plan. My daughter I went in network and they can not charge more than $2800. Then we both thankfully have dental insurance. Dental insurance here is not great...but it helps! Each of them pay $1000. Thankfully we split with PB 50/50 too so that helps.

MixedBag

great advice...

yes, see if you can make monthly payments and get a separate account lined up.

And yes, my MD cost about $7K too....tremendous work done over several several years.

All three of my kids have had braces -- and yes, it fell under the large umbrella of dental.

FireFighterDAD

Thank you all for the great advice (again)!  I will contact the orthodontist to see if this is necessary but even if it's not if they can make a payment plan low enough for me to manage each month I will find a way to swing it so that my son can get his teeth straightened.

I like the idea of having my account separate from my ex wife largely because she is notorious for making late (or missing) payments and I have spent to past 5 years trying to dig myself out of a lousy credit rating due to those actions on her part and I really don't want her dragging my credit back down again.

I'm thinking that if my account is separate from hers that even though both accounts are going toward the same patient's braces if she is late in making payment it wont affect my rating.  I hope that's the case.

Thanks again everyone!

FFD

ocean

Just do not sign anything that is over your half. SD sent a "promise to pay" type letter but it had the full amount. I just ignored and paid our amount and he never signed letter. Then the dentist asked if we wanted our own account so now we get statements for our half only. At the end of SD braces, last check, I wrote Paid in full AND sent a letter for the to sign that said "father is paid in full on this account" with a pre-paid stamped envelope. They stamped and signed it and returned it.

Another option is to send your letter to your ex asking for paid receipts, then you reimburse her your half. This is what usually happened before the dr offices started to do two accounts. This will force her to lay out the money first.

If the dentist wont do two account, you can just send them payments to the one account and keep track and print the checks after they are cashed/ask for receipts.