SmileDirectClub is a pioneer of doctor-directed, remote clear aligner therapy, offering an at-home treatment option for mild to moderate orthodontic care. Founded in 2014, SmileDirectClub represents 95% of the doctor-directed at-home clear aligner industry. They have helped more than 400,000 people transform their smiles – with 235+ SmileShop locations and counting. SmileDirectClub joined UnitedHealthcare’s national dental network as a virtual dental provider in April 25, 2019.
SmileDirectClub offers clear aligner therapy to straighten smiles, which includes a 3D digital image or at-home dental impression kit, a series of custom-made BPA-free clear plastic aligners, a professional quality teeth whitening kit, and virtual check-ins performed by duly licensed orthodontists and dentists.
Employees in a qualified dental plan with orthodontic benefits will get exclusive network pricing and services. With their plan, they may pay $1,000 or less for SmileDirectClub services compared to their standard cost of $1,850. This includes:
Yes, SmileDirectClub is available throughout the U.S.
SmileDirectClub is a new virtual provider in UnitedHealthcare’s Preferred Provider Organization (PPO) networks as part of UnitedHealthcare’s PPO and In-Network Only (INO) dental plans. Similar to other UnitedHealthcare orthodontic PPO providers, SmileDirectClub services will be covered in the network as long as orthodontic benefits are covered by the employee’s dental plan and the employee has orthodontic benefits remaining. The SmileDirectClub network discounts will not apply if the employee’s plan does not include orthodontic benefits for their age group or if they have exhausted their orthodontic benefit.
Yes, orthodontic coverage is required in order to receive exclusive pricing and receive a benefit payment toward SmileDirectClub clear aligners.
No, SmileDirectClub is a new orthodontic dental provider in the UnitedHealthcare network, which offers many members with orthodontic coverage a new orthodontic care option designed for affordability.
No, if a qualified dental plan currently has orthodontic coverage, then SmileDirectClub will be available as a network provider option. Groups with no orthodontic coverage can consider adding orthodontic coverage to their plan offering and then be able to access SmileDirectClub as a network provider.
All dental plans with orthodontic coverage have specific age ranges and maximum limits. Most plans with orthodontic coverage cover children up to age 19 or include coverage for both children and adults. SmileDirectClub’s minimum age requirement is 12 years old, and customers must have all permanent teeth. For patients under the age of 18, SmileDirectClub requires a parent/guardian signature on the Medical/Dental History Form provided during the evaluation step. In addition, parents/guardians are encouraged to remain actively engaged in their covered dependent’s treatment.
No, SmileDirectClub cannot be used for orthodontic services for pediatric essential health benefits under the Affordable Care Act (ACA). Unlike traditional orthodontic coverage on employer group plans, the ACA plans limit orthodontic coverage to more severe pediatric orthodontic care needs. There is no coverage for mild to moderate orthodontic care under ACA-approved plans.
You may share your last name, first name, and date of birth in order for SmileDirectClub to confirm benefits with UnitedHealthcare. You may also share your subscriber ID number. SmileDirectClub complies with all applicable data privacy laws and regulations.
Receiving SmileDirectClub services may result in utilizing most or all of the lifetime orthodontic benefit. Conversely, if an employee already utilized their orthodontic lifetime maximum in the past with UnitedHealthcare, they would not have benefits to use for SmileDirectClub.
SmileDirectClub will work with the employee to collect their coinsurance or copayment similar to all PPO providers. As a PPO network provider, SmileDirectClub will file the claim and wait for the portion paid by the dental plan.
Similar to all network providers, claims can be paid either electronically or manually based on the manner of claim submission and the provider’s preferred payment model.
The average customer’s treatment plan lasts 6 months. The licensed dentist or orthodontist assigned to each case will determine the appropriate course of treatment. Similar to some other orthodontic care, individuals will need to wear retainers after completing treatment to maintain their new smile.
SmileDirectClub’s clear aligner treatment is best for people with mild-to-moderate tooth crowding, rotations and gaps. Severe tooth crowding and spacing, significant jaw misalignments and large open bites are generally not recommended for treatment.
SmileDirectClub has a network of 240 licensed dentists and orthodontists reviews each case and determines whether the individual is a candidate. It is recommended that individuals also be up-to-date on their regular dental cleanings.
18-10812 Updated 4/22/2019