Open Enrollment Made Easy with Elevated Ortho: Your Guide to Dental Insurance
Everything You Need to Know to Maximize Your Dental Benefits This Enrollment Season
Table of Contents
Introduction
Meet Dr. Don Montano and the Elevated Ortho Team
What Is Open Enrollment?
How Orthodontic Insurance Works
Dental Insurance Options During Open Enrollment
Questions to Ask During Open Enrollment
Timing Orthodontic Treatment with Insurance Benefits
Braces vs. Clear Aligners: Coverage Considerations
Cost Examples to Understand Your Coverage
Why Choose Elevated Ortho in Bakersfield
Conclusion
Frequently Asked Questions
Introduction
Open enrollment season may not sound exciting at first—but if you have been considering
braces, clear aligners such as
Invisalign®, this time of year could be the perfect moment to move forward. The choices you make now about your dental insurance can save you thousands of dollars and ensure your treatment journey fits comfortably into your budget.
At Elevated Ortho in Bakersfield,
Dr. Don Montano and our team have guided patients through orthodontic insurance for more than 35 years. With a reputation for excellence,
1,010+ five-star reviews, and thousands of transformed smiles, we believe that knowledge is power. And when it comes to braces, aligners, and insurance, the more you know, the easier your decisions will be.
This guide will walk you through everything you need to understand about open enrollment, orthodontic insurance coverage, and how Elevated Ortho helps families maximize their benefits for braces and aligners.
Meet Dr. Don Montano and the Elevated Ortho Team
Why Families Trust Dr. Montano
For families searching for 'orthodontist in Bakersfield,' one name has stood out for decades: Dr. Don Montano. With over 35 years of experience, Dr. Montano has become a trusted partner in creating healthy, confident smiles. Generations of patients return to him—not just for straighter teeth, but because of his expertise, compassion, and personalized care.
- Experience That Spans Generations: Many parents who once wore braces under Dr. Montano's care now bring their children in for treatment.
- Community Connection: From sponsoring local events to attending school games, Dr. Montano invests in Bakersfield families.
- Innovation + Tradition: While his experience is unmatched, his methods continue to evolve. He offers digital smile design, Invisalign, and tried-and-true braces.
The Elevated Ortho Team Advantage
Dr. Montano is supported by a team known for kindness, professionalism, and dedication. From front-desk scheduling flexibility to expert orthodontic assistants and 'smile coaches' who cheer patients on, the Elevated Ortho team ensures that every visit feels supportive and stress-free.
Together, we make orthodontics approachable—especially when insurance questions seem overwhelming.
What Is Open Enrollment?
Open enrollment is the designated period—typically once a year—when you can make changes to your health and dental insurance. It is your chance to:
- Enroll in a new plan
- Switch to a different plan
- Add or drop dependents
- Adjust coverage levels
Think of open enrollment as your benefits 'reset button.' Much like orthodontic treatment is a work in progress, your insurance choices are also adjustable during this window. If you miss it, you may have to wait another year, unless you experience a qualifying event, such as marriage, childbirth, or a job change.
Why It Matters for Orthodontics
Orthodontic treatment, whether braces or clear aligners, represents a significant investment. Costs in Bakersfield typically range from $3,500 to $7,000, depending on complexity. Open enrollment is your best opportunity to ensure your insurance aligns with your treatment goals, thereby lowering your out-of-pocket costs and making braces or aligners more affordable.
How Orthodontic Insurance Works
Understanding the fine print of orthodontic insurance is key. Here are the basics:
Lifetime Maximums
Unlike medical insurance, which typically renews annually, orthodontic coverage usually has a lifetime maximum per person (for example, $1,500–$2,500). Once used, it does not reset each year.
Percentage Coverage
Most plans cover a percentage of the treatment cost, commonly 50%, up to the lifetime maximum.
Example:
- Treatment: $6,000
- Insurance covers: 50% up to $2,000
- You save $2,000, and your portion is $4,000.
Age Limits
Some policies cover orthodontics only for dependents under the age of 18. However, many modern plans now include adult coverage, especially for clear aligners.
Waiting Periods
Certain plans require a waiting period before benefits begin. This detail is crucial to check during open enrollment.
In-Network vs. Out-of-Network
Choosing an in-network orthodontist may reduce costs. However, Elevated Ortho works with both in- and out-of-network patients and helps file claims either way.
Dental Insurance Options During Open Enrollment
When reviewing your benefits during open enrollment, you will likely encounter several types of dental insurance options. Each one has different strengths, costs, and coverage details. Understanding the differences can help you choose the plan that best supports your orthodontic needs, whether that means braces for your child or clear aligners for yourself.
Employer-Sponsored Plans
For many families in Bakersfield, dental coverage is provided directly by an employer. These plans often provide the most comprehensive benefits at lower group rates, making them one of the most affordable ways to access orthodontic coverage.
Pros:
- Typically include orthodontic benefits, especially for children.
- Lower premiums because costs are shared across many employees.
- May cover braces and aligners equally.
- Payroll deductions make premiums easy to manage.
Cons:
- Limited flexibility—you may only be able to choose from the plans your employer offers.
- Coverage for adult orthodontics varies, so it is important to check.
If you have access to an employer-sponsored plan, it is often the most cost-effective option. However, do not assume—always confirm the orthodontic details before enrolling.
Marketplace Plans
Families and individuals who do not receive benefits through an employer often turn to the Affordable Care Act marketplace. These plans are available during the same open enrollment period and can be customized to meet your specific needs.
Pros:
- Pediatric dental coverage (for those under 19) is considered an essential health benefit, meaning orthodontic treatment is often included for children.
- Wide range of choices depending on your state and provider network.
- Subsidies may be available based on income, reducing monthly premiums.
Cons:
- Adult orthodontic coverage is less common. Many marketplace plans do not include braces or aligners for adults.
- Coverage details can be harder to navigate, and orthodontic care may only be included in higher-tier plans.
If you are considering aligners or braces as an adult, marketplace plans may require more careful research to ensure you are covered.
Private Insurance
Standalone private dental plans are another option, particularly if you require additional coverage beyond what an employer or marketplace plan offers.
Pros:
- Flexibility to choose the plan that best suits your orthodontic needs.
- Some private insurers offer orthodontic-specific riders or add-ons.
- Can supplement gaps in employer or marketplace coverage.
Cons:
- Premiums may be higher since you are not part of a group.
- Benefits vary widely; some private plans exclude orthodontics entirely.
- May require longer waiting periods before orthodontic benefits apply.
Private insurance is best suited for families who want tailored benefits and are willing to pay slightly higher premiums for more comprehensive coverage.
FSAs and HSAs
Even if your dental insurance does not cover orthodontics in full, Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) can help bridge the gap. These accounts allow you to set aside pre-tax dollars specifically for healthcare expenses—including orthodontic treatments.
Flexible Spending Accounts (FSA):
- Offered by many employers.
- You contribute a set amount each year, deducted from your paycheck before taxes.
- Funds can be used for braces, aligners, retainers, and related expenses, such as mouthguards.
- Important: FSAs are 'use it or lose it,' so any unused money may expire at the end of the year (some plans offer a grace period).
Health Savings Accounts (HSA):
- Available only if you are enrolled in a high-deductible health plan.
- Contributions are tax-deductible, grow tax-free, and roll over year to year.
- Funds can be used at any time, even years later, for orthodontic care.
- An HSA can become a long-term savings tool for healthcare needs.
Using FSAs or HSAs strategically can save you hundreds, sometimes thousands, of dollars in taxes, lowering the overall cost of your braces or aligners.
Questions to Ask During Open Enrollment
When reviewing plans, ask:
- Does the plan cover orthodontic treatment?
- What is the percentage of coverage and lifetime maximum?
- Is adult treatment included?
- Are braces and aligners covered equally?
- Do I need an in-network orthodontist in Bakersfield?
- Are there waiting periods?
- Can I use FSA or HSA funds?
Timing Orthodontic Treatment with Insurance Benefits
Strategic timing can help you maximize savings.
- End-of-Year Starts: If your plan renews in January, beginning treatment before year-end may let you access benefits from two different years.
- New Plan Activation: If you switch plans during open enrollment, confirm when coverage starts and coordinate your treatment accordingly.
Dr. Montano and our team frequently help patients map out ideal timelines for starting orthodontic treatment, such as braces or aligners.
Braces vs. Clear Aligners: Coverage Considerations
Patients often wonder: will insurance cover clear trays the same way as braces?
- Braces: Almost always covered if orthodontic benefits are included.
- Invisalign: Coverage depends on the plan. Many insurers now consider aligners medically necessary orthodontic treatments and cover them at the same percentage as braces.
- Tip: Confirm orthodontic coverage during open enrollment.
At Elevated Ortho, you will have both options available, traditional braces and Invisalign—so you can make the choice that best fits your lifestyle.
Cost Examples to Understand Your Coverage
Scenario 1: Braces with Insurance
- Total cost: $6,000
- Insurance: 50% up to $2,000
- Patient responsibility: $4,000
Scenario 2: Aligners with Insurance + FSA
- Total cost: $5,500
- Insurance: $2,000
- Out-of-pocket: $3,500
- FSA contribution: $2,500 (pre-tax)
- Effective savings: $700–$1,000 (tax savings)
Why Choose Elevated Ortho in Bakersfield
A Legacy of 35+ Years
Dr. Montano has treated thousands of patients, from children to adults, earning the trust of patients across generations.
Cutting-Edge Options: Braces & Invisalign
Patients can choose between traditional braces and discreet clear aligners such as Invisalign, both of which are supported by expert planning and oversight.
Support for Every Step of the Journey
The Elevated Ortho team helps you:
- Review insurance benefits
- File paperwork and claims
- Understand costs up front
- Explore financing and flexible payment plans
With over 1,010 five-star reviews, Elevated Ortho is Bakersfield's most trusted orthodontic practice.
Conclusion
Open enrollment is not just about choosing coverage—it is about investing in your health, confidence, and future. By carefully reviewing your options, asking the right questions, and initiating treatment at the right time, you can save money and position yourself for success.
At Elevated Ortho, Dr. Don Montano and our team are committed to making the process as stress-free as possible. From insurance support to expert treatment, we will guide you every step of the way.
📍 Located in Bakersfield, CA
📞 Call us today at 661-665-7600
🌐 Visit
elevatedortho.com to schedule your consultation.
Your smile is worth it—let's make this open enrollment season the one where you take your smile to the next level.
Frequently Asked Questions
What happens if I miss open enrollment?
You will likely need to wait until next year unless you have a qualifying life event.
Can I use insurance for adult braces or aligners?
Yes, depending on the plan. More policies now include adult coverage.
Do braces and clear trays cost the same?
Costs are similar, but insurance coverage can vary. Confirm aligner benefits before enrollment ends.
What if my insurance does not cover orthodontics?
Elevated Ortho offers flexible financing options, and FSAs/HSAs can reduce out-of-pocket costs.
How do I know if Elevated Ortho is in-network?
Our team can help you verify your insurance benefits and determine coverage details.
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