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
- Afordable 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 our web site www.amdps.com
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.
This program is not a health insurance policy and the program does not make payments directly to the providers of health services. The program member is obligated to pay the provider for all the health care services that the member will receive, but the member will receive a pre-negotiated discount from the providers listed in the network, in accordance with the specific pre-negotiated discounted fee schedule. This program provides discounts at certain locations for health services.