Orthodontic Reset
Our Orthodontic Maximum Reset allows your clients to continue enjoying the many benefits of maintaining a healthy lifestyle.
When a group employer selects Renaissance, members will receive the benefits of a fresh start with a new orthodontic maximum. That means if a new orthodontia claim is submitted, the full maximum is available and coverage is processed normally – even if they had orthodontic treatment in the past!
How The Orthodontic Maximum Works
The Orthodontic Reset helps ensure members get the coverage they need, regardless of the coverage they have received from a previous carrier. Here’s how it works:
When a group employer selects Renaissance, members will receive the benefits of a fresh start with a New Orthodontic Maximum. If a new orthodontia claim is submitted the full maximum is available and coverage is processed normally – even if they had orthodontic treatment in the past! If orthodontia treatment is in process, the full maximum is still available, but the plan will pay either the remaining treatment months or the remaining maximum, whichever comes first.
If orthodontia treatment is in process, the full maximum is still available, but the plan will pay either the remaining treatment months or the remaining maximum, whichever comes first.
| Example Savings | ||||
| Let’s say Renaissance receives an orthodontia in process claim with 5 months of remaining payments: | ||||
| Total bill of $6,000 | Initial fee (30%): $1,800 | Balance of $4,200 | ||
| We will process the claim as a standard orthodontia claim and consider the remaining 5 months of payments. The balance ($4,200) is divided by the total treatment months (25) for a monthly fee: | ||||
| $4,200 ÷ 25 = $168 | ||||
| The plan then pays its percentage of the claim each month: | ||||
| Monthly Fee | Orthodontic Plan Coverage (50%) | Renaissance Payment/Month | Remaining Months | Renaissance Payment |
| $168 | Multiplied by 0.5 | = $84 | Multiplied by 5 | = $420 |
The best part? Because of the Orthodontic Reset, the member still has $1,080 available from the $1,500 lifetime maximum if additional orthodontic treatment is needed!
*Subscribers who were previously enrolled in a Renaissance group dental plan will have any orthodontic coverage counted as part of their lifetime maximum from any prior plan coverage that was previously administered through Renaissance.
Note: Products and services not available in all states and jurisdictions. Contact your Renaissance representative for more details.