Patient affordability tool
Dental Insurance and Out-of-Pocket Cost Estimator
Start with a treatment estimate, model the plan rules you know, and carry the remaining balance into the monthly-payment planner.
Insurance estimator
Estimate what insurance may contribute
Use your plan documents or benefit portal when possible. Every percentage and limit can be changed.
What this estimate models
The tool applies an optional allowed amount, subtracts the remaining deductible, applies the procedure coverage percentage, and then limits payment to the remaining annual or lifetime orthodontic maximum. It also flags waiting periods, network uncertainty, frequency limits, missing-tooth clauses, and alternate benefits.
What to verify with the plan
- The exact procedure codes and the plan's allowed amount for the provider.
- Remaining annual or lifetime orthodontic benefits, not only the original maximum.
- Deductible, coinsurance, waiting period, replacement interval, exclusions, and preauthorization requirements.
- Whether an out-of-network provider may bill above the plan's allowed amount.
This tool is educational. It is not insurer preauthorization, a binding Explanation of Benefits, or a guarantee that a claim will be paid.