Does Candid Accept Insurance?

Is Candid Treatment Covered By Insurance?

Candid treatment costs $3,300 (on average) before insurance. How much is covered depends on your CandidPro provider, insurance policy, and insurer. 

You'll have no direct financial relationship with Candid. Instead, the CandidPro provider will be your health care provider.

This means Candid won't help you file an insurance claim. The CandidPro provider's billing department will run your insurance the same way they do for teeth cleanings and dental work.

Whether or not the treatment is in-network will depend on your dentist (CandidPro provider). Candid treatment falls under insurance code D8090 just like all other clear aligner products.

Depending on the insurance plan, this cost may be reduced up to 50%, either up-front or after the fact.

Candid Aligners Overview

Candid is a partially remote clear aligner company. They offer a reliable, affordable, and convenient way to straighten your teeth.

Candid recently shifted its business focus, no longer offering at-home impression kits. It’s now a hybrid option for those who want some of the freedom of at-home teeth-straightening without sacrificing the quality of care. 

To begin treatment, you’ll visit a qualified CandidPro provider (dentist or orthodontist) for an initial consultation. Your bite is digitally scanned and impressions are taken. You’ll also see them at the end of treatment to ensure your teeth are aligned correctly and you’re satisfied with the results. 

The CandidPro provider then has a licensed orthodontist from Candid's team personally design your treatment plan. After that, your treatment progress is monitored remotely through CandidMonitoring™, a telehealth platform (mobile app).

We recommend Candid for several reasons:

1. Expertise — It’s the only at-home clear aligner brand that works exclusively with orthodontists (teeth-straightening experts). 
2. Affordable — Treatment typically costs less than Invisalign or traditional braces.
3. Effective —  Candid can treat more severe teeth alignment issues than other at-home options.
4. Treatment is also faster than other methods — Candid aligners straighten teeth in a third or even a fourth of the time it takes for Invisalign or braces. 

What Insurance Plans Cover Orthodontics?

Some insurance providers include orthodontic coverage for adults. This coverage usually extends to clear aligners like Invisalign in the same way as braces.

How much they reimburse depends on the provider and plan. A provider may cover either a certain percentage or dollar amount of your clear aligner treatment. 

There’s usually a lifetime limit on coverage.

It’s also important to note that dental coverage is not the same as orthodontics, so be sure to read the fine print before deciding on a plan.

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Is Candid Covered Differently Than Invisalign and Braces? 

Unfortunately, there’s no simple answer here. Most dental insurance plans cover Invisalign and traditional braces the same way.

Here are 3 reasons why a denial may be less likely with Candid than other at-home brands:

1. Greater Expertise 

Unlike other brands, Candid only works with experienced and licensed orthodontists. This consulting orthodontist also designs your treatment plan. 

Orthodontists specialize in malocclusion (bite alignment issues) to a much greater degree than general dentists. This may make insurers more favorable to approving your claim.

2. In-Person Consultations

Some insurers consider remote treatment not to be truly comprehensive because there are no in-person office visits. But Candid is no longer considered 'fully remote.'

Because care is initiated in person with a qualified CandidPro provider (licensed dental professional), this may strengthen your reimbursement claim.

3. Direct Coordination of Benefits

Your CandidPro provider (dental office) will work directly with your insurance company on your behalf to get you reimbursed. They are experienced in speaking with insurers, which might make success more likely.

By contrast, other fully remote aligner brands will only provide you the paperwork to file the claim yourself. And in some cases, they only provide the paperwork after you pay for the aligners.

Can Candid Guarantee Reimbursement?  

Whether or not the treatment is in-network will depend on your dentist (CandidPro provider).

Candid treatment falls under insurance code D8090 just like all other clear aligner products. This is the orthodontic procedure code for comprehensive orthodontic treatment of adult dentition.

Important note: some insurers consider comprehensive treatment to include regular, in-office visits. 

How to Check Your Coverage 

Insurance carriers like Delta Dental and Cigna let you check your coverage by logging into your account. 

You can also usually find a phone number for more information on the back of your insurance card.

Contact your insurance provider to see if you have any adult orthodontic coverage. 

Many states also offer Consumer Assistance Programs, which provide educational resources to guide consumers in making healthcare decisions. These programs are intended to help people understand what benefits are available to them.

What to Do if You’re Denied Coverage

If your claim is denied due to a submission issue on your CandidPro provider's end, they will work quickly to fix the problem. 

If the denial was due to a lack of orthodontic coverage under your plan, you'll need to reach out to your insurance provider directly for clarification.

You have the right under the Affordable Care Act to appeal denied claims. If you appeal, the insurance company must review the denial. If they still deny, you can submit the appeal to a third party. 

Other Ways to Pay for Candid Aligners

Candid treatment is covered by most insurers that offer adult orthodontic coverage. 

If your insurance plan won’t pay, your CandidPro provider may offer several other ways to reduce the cost:

FSA/HSA

Most CandidPro providers accept both HSA and FSA.

Payment Plans

Many CandidPro providers also offer payment plans. Talk to them about your options.

Summary

• Candid treatment costs $3,300 (on average) before insurance.
• You have no direct financial relationship with Candid (the CandidPro provider is also your health care provider).
• NewMouth recommends Candid for their expertise, affordability, user experience, and effectiveness.
• Candid clear aligners straighten teeth faster and for less money than Invisalign or braces.
• Some insurance providers include orthodontic coverage for adults.
• Check your insurance coverage via your online account or by calling the number on the back of your card.
• Reimbursement is not guaranteed but your CandidPro provider will help you with the process.
• Clear aligners are usually covered in the same way as Invisalign and braces. 
• You can appeal denied claims.
• Many providers accept FSA and HSA and offer the ability to pay in monthly installments.

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