Does Fidelis Cover Dental Braces

Coverage of Dental Braces by Fidelis

As a renowned dentist based in Los Angeles, I have seen the positive impact that dental braces can have on a person’s oral health and confidence. Fidelis recognizes the importance of providing coverage for dental braces to its members, aligning with the goal of promoting overall dental well-being. By offering this coverage, Fidelis aims to make orthodontic treatment more accessible to individuals who may benefit from it.

Dental braces coverage by Fidelis includes various types of braces, such as traditional metal braces, ceramic braces, and clear aligners. This coverage extends to both children and adults, acknowledging that orthodontic treatment can be beneficial at any age. Fidelis understands the significant role that dental braces play in correcting misalignments and improving overall dental health. It is reassuring for members to know that Fidelis prioritizes their dental well-being by providing coverage for these essential orthodontic treatments.

Eligibility Requirements for Dental Braces Coverage by Fidelis

To qualify for dental braces coverage through Fidelis, there are specific eligibility requirements that must be met. Firstly, individuals must be enrolled in a Fidelis insurance plan that offers orthodontic benefits. Additionally, most plans require that patients be under a certain age, typically minors or young adults, to be eligible for coverage of braces. This is because orthodontic treatment is often considered a preventive measure for long-term oral health, and is most effective when initiated during the developmental stages of adolescence.

Furthermore, in order to be eligible for dental braces coverage, patients may need to meet certain clinical criteria. This can include factors such as the severity of the malocclusion or misalignment, as determined by a qualified orthodontist. Additionally, some plans may require pre-authorization or a referral from a primary care provider before beginning orthodontic treatment. It is important for individuals considering braces to thoroughly review their insurance policy and speak with their dentist or orthodontist to understand the specific eligibility requirements set forth by Fidelis.

Procedure for Submitting a Claim for Dental Braces Coverage by Fidelis

When submitting a claim for dental braces coverage through Fidelis, it is essential to follow the outlined procedure to ensure a smooth process. Firstly, gather all necessary documentation such as invoices from your orthodontist detailing the treatment provided, the dates of the braces installation, and any other relevant information. Make sure all documents are accurate and up to date, as this will expedite the approval process.

Next, complete the claim form provided by Fidelis accurately and legibly. Double-check all information before submission to avoid any delays. Include any additional documents or notes that may support your claim, such as letters from your orthodontist explaining why the braces were necessary for your dental health. Once everything is in order, submit the claim through the designated channel as instructed by Fidelis, whether it be online or by mail. Keeping a record of your submission will help you track the progress of your claim and ensure that it is being processed efficiently.

Limitations and Exclusions of Dental Braces Coverage by Fidelis

Fidelis provides coverage for dental braces, but it’s important to be aware of the limitations and exclusions that come with this coverage. One key limitation to note is that Fidelis may only cover a certain percentage of the total cost of the braces, leaving the patient responsible for the remainder. Additionally, Fidelis may have specific criteria that must be met in order to be eligible for braces coverage, such as age limitations or the severity of the dental issue.

Exclusions from Fidelis’ dental braces coverage may include certain types of braces or treatments that are deemed as cosmetic rather than essential for dental health. It’s important to carefully review the policy details to understand what specific treatments may not be covered under the plan. Patients should also be aware that coverage for braces may have a lifetime limit, meaning that once this limit is reached, the patient may no longer be eligible for coverage for any future orthodontic treatments.

Does Fidelis cover dental braces?

Yes, Fidelis does offer coverage for dental braces as part of their dental benefits.

What are the eligibility requirements for dental braces coverage by Fidelis?

To be eligible for dental braces coverage by Fidelis, you typically need to meet certain criteria such as age restrictions and specific dental conditions that require braces.

How can I submit a claim for dental braces coverage by Fidelis?

You can submit a claim for dental braces coverage by Fidelis by contacting their customer service department and following their specific procedures for claims submission.

What are the limitations and exclusions of dental braces coverage by Fidelis?

Some limitations and exclusions of dental braces coverage by Fidelis may include age restrictions, certain pre-existing conditions, and specific types of braces that may not be covered. It is important to review your policy details for more information on limitations and exclusions.