Can my orthodontist refuse to remove my braces because my insurance hasn’t paid the balance?

UPDATED: Dec 28, 2010

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Can my orthodontist refuse to remove my braces because my insurance hasn’t paid the balance?

My dental insurance covered a large majority of my orthodontic treatment and I paid the remaining balance on a 9 month plan. Now that it is time to remove my braces my orthodontist refuses due to insurance issues. I was previously covered by my significant others employee benefits. He was laid off in February and our plan changed to COBRA. Insurance claims that I have not been covered since February and has not paid any of the orthodontic balance. My treatment is complete but they refuse to remove the braces until I pay the full balance. I cannot pay $2000 and the braces need to be removed.

Asked on December 28, 2010 under Malpractice Law, California


M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

You are being caught up in a web of insurance coverage issues and you are going to need help to try and figure it out.  First, did the cobra coverage cover all the same benefits that you had under your original insurance plan?  It should have and it should have been discussed with you by the employer before he was paid off.  And why NOW is the orthodontist office advising you of a problem that has started almost a year ago?  This is a major concern of mine in this matter.  They should have been working toward resolving the matter with you and allowing you to work on it on your end.  They can not just refuse to remove your braces.  That is akin to malpractice and I would let them know that.  I would also report them to the state agency that licenses them and see where that will get you.  But in the meantime work on getting your insurance issues straightened out.  Good luck.

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