HomeCoverWhich Health Insurance Covers Braces

Which Health Insurance Covers Braces

Where Can I Find A Plan

Will Health Insurance Cover My Orthodontic Treatment?

Not all health plans cover orthodontics or even dental work. It doesn’t mean that your plan sponsor chose to include orthodontics in their dental package if you’re covered under an employee health benefits package. Check under the dental section of your benefits package, or ask your human resources representative or benefits manager to help you figure out whether this type of treatment is covered. There are many other places you can look to find orthodontics coverage.

The National Association of Dental Plans is a great resource to help you find a plan. It’s a dental insurance marketplace that offers you options and information on the various plans available. You can choose your state and search based on what you’re looking for.

Ask dental and orthodontic doctors’ offices whether they have any recommendations. Knowing what insurance certain doctors accept is key if you’d prefer to go to a certain doctor.

Your health insurance broker or agent can help you find a plan that meets your needs. The agent may save you some time if you find the research to be more than you care to handle on your own.

Your spouse or domestic partner might have insurance that covers dental care. Find out whether there’s a possibility of coordinating benefits or supplemental insurance on their plan. Ask about the coverage for orthodontic work.

One catch to buying dental insurance on the Marketplace is that you’re required to buy a healthcare plan at the same time.

Supplemental Orthodontic Insurance For Braces: A Must

Children Guide Tips

Braces can transform a smile and restore confidence in your appearance. Did you know that getting the smile you or your child have always longed for could be less expensive than you thought? To pave the way to a beautiful smile without breaking the bank, consider purchasing supplemental insurance for braces.

Two: Choose A Preferred Treatment Option

Just because you have orthodontic benefits doesnt mean youll receive coverage for every orthodontic treatment. For example, some plans might cover in-office treatments like braces and Invisalign, but not remote services like SmileDirectClub or Byte.

This is a common scenario, although several large insurance providers have begun offering coverage for certain online clear aligner companies. Heres an overview of the main types of treatment that might be covered:

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What Does Dental Insurance For Orthodontics Typically Include

Orthodontic insurance for adults typically includes discounts and some coverage for treatment.

This coverage may include:

  • Traditional braces

However, just because you have orthodontic insurance does not mean your braces will be free. When orthodontics is included in a dental insurance policy, you will likely experience waiting periods before benefits begin.

Once benefits begin, you will need to meet a minimum deductible before the insurance begins to pay. Depending on your dental plan, you could still owe 50% or more of the cost for orthodontic treatment.

Comparing Dental Insurance Plans For Braces

What Insurance Covers Invisalign Braces

There are a few factors you should consider when comparing dental insurance plans for braces. These include:

  • Orthodontics coverage: You should ensure that your dental plan covers braces, especially if youre an adult.
  • Cost: Look for dental insurance plans with low monthly premiums and deductibles.
  • Waiting periods: Depending on when you need braces, you should consider plans with low or no waiting periods.
  • Availability: Make sure to choose an insurance carrier thats available in your state and has an extensive provider network.

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How To Find The Best Dental Insurance That Covers Braces For Yourself

Dental insurance plans vary greatly from one to the next. It isnt enough just to find a dental insurance plan that covers braces for adultsyoull also want to look into the insurance providers dental network, the type of plans they offer, whether or not your current dentist or orthodontist will accept your insurance, how much your monthly premiums cost, out-of-pocket costs such as deductibles and co-pays, and more.

Weve compiled a bank of resources to help you find dental insurance that covers braces and helps you save money on taking care of your oral health.

What Limits Are Applied To Orthodontics

Annual limits

With extras insurance, each specific benefit has an annual limit. That means you won’t be able to claim more than a certain amount every year. If your annual limit for orthodontics is $800, that’s the most you’ll be able to claim until your benefit limit resets. Limits usually reset in January, but some funds reset in June. Sometimes, your annual benefit may increase every year, for a certain number of years. For example, you may have $500 annual benefit which increases to $700 the following year and $900 the year after that. This isn’t always the case, but it’s something to keep an eye out for.

Lifetime limits

Most funds apply lifetime limits to orthodontics. That means, no matter how long you hold your policy for, you’ll never be able to claim over a certain amount on orthodontics treatments. Importantly, this lifetime limit applies across funds. That means you won’t be able to switch funds and access more orthodontic benefits. The only way to access more money back would be to take out a more comprehensive policy and increase your limit amount.

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How Much Does Orthodontic Care Cost

Dental insurance plans or dental discount plans can help you get access to the orthodontic care you need. Research what orthodontic care is covered in the plans you’re looking at and how much you’ll be paying. You might pay less than $20 per month, or you might pay hundreds of dollars per month, depending on the coverage you select.

Four areas relate to orthodontic services and treatments that are essential to the costs you’ll pay and the coverage you’ll receive: premiums, deductibles, copays, and exclusions.

You’ll find that the more you pay upfront in the way of monthly premiums, the less you’ll pay at treatment time. First, you’ll have to decide how often you or your family will be visiting the orthodontist and what kind of treatments might be needed. Then you can decide how much you might need to pay for supplemental insurance based on prices from different providers when you have an estimate.

How Much Do Braces Cost Without Insurance

Paying for Braces With Your HSA

Braces can cost anywhere from $4,500 to $15,000+ for a 12-24 month treatment, including the cost of regular consultations. The cost of braces varies significantly based on the type of treatment required, the time it takes to correct your teeth and the clinic or specialist you use. This table summarises a few of the quotes we were able to find online.

Type of Braces
$4,500 $9,500

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What Dental Services Fall Within Orthodontics

Its a good idea to understand the services that are typically associated with orthodontics before you evaluate your dental insurance options. According to the American Association of Orthodontists , an orthodontist provides procedures to fix teeth that result in conditions such as dental overbites, underbites, and crowded or misaligned teeth. These issues can be fixed by slowly applying pressure on specific teeth to coax them into place without surgery. Often orthodontic treatment involves the following services:

  • An initial evaluation, which may include x-rays of the jawand teeth, and treatment planning, as indicated
  • Tooth removal if needed to correct overcrowding
  • Routinely scheduled treatment visits
  • Orthodontic appliances, including braces and/or a retainer

Orthodontists design and fit appliances to realign teeth and jaws to produce and maintain normal function and to improve appearance. Among the most common orthodontic appliances are:

Braces Might Also Be Tax

Fair warning, we are *not* tax experts, and tax laws change all the time, so you will want to check with a CPA about this. You may hear that braces that are considered a medical necessity are tax-deductible, however, the cost has to exceed a certain amount. That said, all the costs associated with braces can add up, so keep track of office visits, x-rays, and so on .

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Health Insurance And Braces

The answer is it depends. Not all health insurance plans are the same. Some plans provide coverage for dental and orthodontic treatments, while others do not.

In general, most plans that provide dental coverage will cover a portion of braces, since braces are considered a medically necessary treatment that will improve a patients oral and overall health.

However, some plans come with certain restrictions for braces. Plans may not cover treatments for patients over the age of 18or may only provide partial coverage. Other plans have waiting periods before braces are covered your plan may not cover the cost of braces if you begin your treatment before the effective start date of the policy. With these restrictions in mind, plan your finances and appointments accordingly.

Some plans do not cover the cost of braces at all.

It is best to contact your insurance provider or HR department directly for the exact details of your plan and the scope of its dental coverage.

Dental Savings Or Discounts Plans

Does Medical Cover Braces

Technically, dental savings plans are not insurance policies. In dental discount plans, a company selling the plan contracts with a network of dentists who agree to discount their dental fees³. Joining the plan allows you to access dental services, including braces, from member dentists at a discount. Make sure to read the fine print and ask specifically if you can use the plan for adult braces.

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Five: Consider Other Ways To Save

If your plan doesnt include orthodontic benefits and you dont have any other options, you might be out of luck. But dont worry, there are still ways to save money on your treatment.

Dental Discount Plans: Certain providers may also offer dental discount plans . These are not insurance plans. Rather, theyre like a subscription where you pay a monthly or annual fee and receive discounts on certain procedures or designated dentists. Sometimes these plans include orthodontic treatments.

Shop Around: Different dentists and orthodontists have different rates. And theres nothing wrong with getting multiple estimates on Invisalign to compare prices. Just make sure that the doctor you choose is in your providers network or you might not receive coverage.

Use an HSA or FSA Account: These accounts are nice because they allow you to make tax-free contributions that you can use later on health expenses. Theyre an option in many employer-sponsored insurance plans. If you have an HSA or FSA, you can use it to pay for your Invisalign treatment.

Tip: For more information about using an HSA or FSA to cover orthodontic treatment, check out our detailed guide dedicated to this topic.

Consider At-Home Aligners: If you like the appearance of clear aligners but dont want to pay Invisaligns high prices, check out home aligners. Theyre a faster and cheaper alternative, but theyre restricted to treating mild and moderate cases of crowding and spacing.

Do Orthodontic Benefits Cover Braces

Many times, orthodontic benefits do cover braces, but it depends on the plan. Typically, the most basic plans wont include any orthodontic coverage, while the more comprehensive and expensive plans will. Every insurance company outlined above has a plan that might cover braces or clear aligners.

This coverage also can extend to other braces types , but to be sure, you should double-check with your dentist/orthodontist and insurance provider.

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How To Know If Your Child Needs Braces

Keep a close eye on your growing child’s teeth and gums. You might notice that their teeth aren’t growing in as straight as they should or that they’re too crowded, prompting you to seek the advice of an orthodontist. Also, regularly taking your child to the dentist can help you become aware of problems early on. A dentist can evaluate your childs mouth carefully and look for signs, such as an overbite, that a trip to the orthodontist is necessary. That’s why you need dental insurance that covers orthodontics.

How To Find Dental Insurance That Covers Orthodontics

Different Types of Insurance for Braces

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Maybe youve used your dental insurance to cover routine cleanings and fillings, but now youre considering something bigger: teeth-straightening treatment.

If youre unfamiliar with your insurance plan, you might think that it will cover orthodontics like any other treatment, but that isnt always the case. The fact is that orthodontic benefits arent included in every dental insurance plan.

Lucky for you, there are ways to find dental insurance plans that include coverage for adult braces, Invisalign, and even online clear aligners like SmileDirectClub. How? With a few simple steps.

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Dental Insurance For Braces

Despite the fact that an estimated 75% of people might need orthodontic treatment, braces are very expensive and out of reach for many. Paying for braces or other dental work without insurance can be very difficult. That’s why dental insurance plans for braces could help you find cheap braces.

Ready to get answers to all of your braces insurance questions? Let’s dive in!

How Do I Choose The Best Braces Insurance For Me

There is a lot to consider when it comes to choosing the best insurance for braces for you. Some things you’ll want to keep in mind as you’re browsing orthodontic insurance plans are:

  • Verify: Make sure the plan you enroll in covers the orthodontic treatment you need!
  • In-network: Dental plans come with a network of providers that will provide braces covered by insurance. If you have a particular orthodontist you’d like to go to for treatment, make sure they are within the plan’s network.
  • Coverage limits: Most plans have limits to how much they’ll cover for the year.
  • Waiting periods: Many plans have waiting periods, so you’ll want to sign up six months or so before you actually want to get treatment, depending on the length of your plan’s waiting period.

Have a look at the table below for a summary of the different ways to save money on braces through the best insurance for orthodontics and discount plans.

Stand-alone plan

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Does Aetna Dental Insurance Cover Braces And Orthodontics

Your teen has been begging for braces for months. Her four front teeth are crowded, and its starting to make her feel self-conscious around people at school. You never had the chance to get braces as a teen either and youre starting to think about looking into orthodontics for the both of you.

But does dental insurance cover braces, much less orthodontics for adults?

Yes With A Few Restrictions

How Does Insurance Cover Braces

Dental insurance typically includes braces for people under 18. You can find plans that cover orthodontic treatments for adults.

Here are a few things to keep in mind when it comes to getting insurance to pay for treatments with your orthodontist:

Most dental insurance plans will

Only cover one round of orthodontic treatment per lifetime. If your child requires Phase I and Phase II ortho, the second series may not be fully covered. Have a maximum allowable orthodontic fee that the plan covers, meaning they only pay for braces up to a certain dollar amount typically $1000-$1,500. Thats roughly half the cost of basic metal braces. Put possible age restrictions on when they pay for braces. Cover all types of braces, but base your benefits on total cost. If you choose a more expensive type of appliance you will still be using the benefits set up for conventional metal braces and have to pay the difference. Include diagnostic X-rays needed during your orthodontic therapy, but only if they do not coincide with duplicates taken by your family dentist.

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Braces Are Not Just Aesthetic

Teeth straightening does not only provide an improved aesthetic outcome, but more importantly it advances the overall health of the patient and is considered a contributing factor to disease prevention. When teeth are crowded, it makes the gums more difficult to clean which results in a build-up of bacteria that can lead to health problems over time. Braces are a very common treatment and there is a vast age-rage of patients who get them.

The Harvard Medical School suggests Although childhood is the ideal time to make changes in the positioning of the teeth, more adults are opting for orthodontic treatment and coming away with excellent results.

Does Dental Insurance Cover Braces And Orthodontist Services

Major medical insurance plans do nottypically include dental coverage. It is most often a supplemental plan thatyou need to purchase separately.

When it comes to braces andorthodontics, it is important to know what your dental insurance covers andwhat different coverage exists for both children and adults.

If you have children age 18 or younger, insurance companies must offer an option to purchase dental insurance that meets the criteria of the Affordable Care Act when you are purchasing health insurance. But whether or not you purchase it is up to you. There is also no ACA tax penalty if your children dont have dental insurance.

Dental policies for children differ from state to state and cover different dental services. For example, some plans pay the entire cost for topical fluoride, sealants, and preventive care, but the patients parents are responsible for a portion of the cost of fillings. Other dental plans may cover the full cost of preventive care services provided by one of the plans participating dentists, and the insured person pays a portion of the cost of all other covered dental services.

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What Is Orthodontics Insurance

Orthodontics insurance helps towards the cost of orthodontics treatments, such as braces, aligners and retainers. Cover for orthodontics is found inside some extras health insurance policies. This is the type of health insurance you should be looking for if you want cover for orthodontics, as well as for services like optical and physiotherapy.

Just be aware, not every health insurance policy with dental covers orthodontics. Always pay close attention to the benefits and features included, and use Finder to compare policies side by side.

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