I took my son to the orthodontist this morning for a consultation regarding his second set of braces. He had the first set a few years ago, complete with expanders for both his top and bottom jaws. (They're those miniature torture devices that get cemented in and require that you turn a wire key in them at least once daily in order to manually widen the jaw.) Due to economic concessions, we had to postpone his second set. The hard times aren't over, but the waiting has to be. He only has so long before the work necessary to correct his overcrowding and narrow jaw will end up including oral surgery. So, since I don't want that to be part of the process, we're moving forward.
I made the appointment for today, because it was the earliest available appointment that would allow me to get the pricing information and still be within the open enrollment period for my insurance (so I could adjust how much to have deducted from each check for my Flexible Spending Account). For those who don't know how all this orthodontic insurance stuff works (like me a few hours ago), my provider covers 50% of orthodontia with a lifetime cap of $1500. Yes, you read that right, only fifteen hundred. With the first set, we had two insurance providers. Since my birthday falls earlier in the year (April versus November), mine was the primary last time, covering 50% of set 1, while my husband's policy covered 50% of the remainder (or 25% of the overall cost), leaving us with 25% to cover out of pocket. This time, mine is the only coverage. So, while they cover 50%, they'll only cover up to whatever is left of the $1500. The good news? They apparently overpaid a little over $600 last time. The gal at the orthodontist's office said they had tried to get in touch with us to let us know, but they couldn't reach us. (I blame the unreliable voice mail we had at the time.). So, they're crediting that toward this set, along with the remainder of the $1500. That leaves just over $3100 for me to pay out of pocket.
Now, if you're anything like me, you probably just choked a little when you read that last dollar figure. Here's where the Flexible Spending Account comes in ... The federal government has capped FSA's to $2500 per year, so the max I can put into my FSA is $96.15 per pay period (which is a lot of money, to my way of thinking). Still, $2500 doesn't cover the cost. Ready for more good news? She told me that, if I can pay the initial $2500 with my FSA card, she'll carry over the remainder til next year. So, I can use my FSA again instead of having to scrape together the balance before he can get started.
So, today, I'm thankful for insurance and the people who understand how it works.