Having a beautiful smile and teeth is something that a lot of people want, regardless of their age. It is so crucial that you, your child, and your entire family want to benefit from orthodontic insurance coverage. Orthodontic treatment’s plan is to straighten a patient’s teeth and give them a more appealing smile while also improving their oral health. When it comes to orthodontic health insurance, you’ll likely need a supplemental plan, and it’s no wonder that this service is pricey. You can, however, use our guide to find the best dental insurance and orthodontic coverage for both children and adults.
What Is Dental Insurance for Braces?
Orthodontic insurance (dental insurance for braces) is tailored specifically to orthodontic therapy. This covers measures like braces and retainers that are intended to realign your teeth and jaw.
Typically, orthodontic insurance is not a stand-alone product. Alternatively, orthodontics could be funded by a dental discount program or by dental insurance. In order to receive orthodontic treatment, you might need to obtain a supplemental policy, a discount plan, or probably a rider. This is because many dental insurance plans do not cover orthodontics.
Orthodontic Insurance Coverage
Orthodontic insurance, or dental insurance that covers braces, is a type of dental insurance policy that is specifically designed for orthodontic treatment. It involves the use of retainers, braces, and any other procedures that deal with realigning your jaw and teeth in the correct position.
Furthermore, orthodontic insurance provides you with other health benefits. A significant number of adults choose orthodontic insurance to address problems that may arise with their teeth later.
You may have acquired dental insurance before, but just because you have dental insurance does not guarantee that you will have coverage for orthodontics. With that said, you will need to choose a supplemental dental coverage plan for orthodontics. This will provide you with the services you and your family need, or a rider, in order to receive financial assistance for your orthodontic treatment.
Note that orthodontic coverage and expenses for adults differ from those for children. So, if an adult also requires treatment, it is important to look for plans that are inexpensive and suitable for both kids and adults.
Orthodontic insurance can not stand alone as a separate product, and the amount you spend may change depending on the kind of braces or other treatments you get. Thus, when shopping for orthodontic insurance, be sure to pay close attention to what the policy covers and what may incur additional costs for the kind of treatment you have in mind.
Adults Orthodontic Insurance
Senior citizens and/or parents also want straight teeth and lovely smiles just as much as their children do. But orthodontic treatment can be expensive and it is difficult to locate dental insurance that would cover braces for adults. The good news now is that a good number of insurance policies now provide orthodontic benefits for adults, which means you should not give up if you’ve yet to get coverage as an adult.
Below are the available alternatives that can assist you in affording the orthodontic care that you require.
Employer-Sponsored Dental Insurance
Generally, employees usually get dental insurance as part of their overall health care package. In this case, employers determine the kind of insurance package an employee gets and the length of the coverage.
Although there are many different kinds of dental plans, the ones that offer orthodontic insurance treatments normally exclude adults and children over the age of 18. But all that is changing. Insurance policies are now increasingly covering the cost of orthodontic treatment for adults.
However, if your employer is providing you with a dental plan, you should check to see if it covers adults and if there are any maximums or waiting periods before orthodontic treatment may begin. You should also find out whether or not there are certain forms of braces that are covered by your insurance and whether or not you need to see a dentist or orthodontist, especially one that is part of your insurer’s network.
Individual Dental Insurance
Individual dental policies are now being offered by a good number of insurance providers. As such, you can easily enroll in a dental plan when you sign up for a medical plan through the Affordable Care Act. Even so, not all of these individual policies provide coverage for orthodontic treatment. And, of the few that offer orthodontic insurance, only a small percentage of them provide coverage for adults.
One great example of an individual dental plan that provides insurance for orthodontic treatment for adults is the DeltaCare USA PAA48 plan. Usually, the annual premium is $105, and your 24-month orthodontic treatment costs $2,500. This is like a 50% discount from the average treatment cost.
It would also be in your best interest to select a dental practitioner or orthodontic specialist who has an arrangement with Delta Dental so as to be able to honor this price cut.
With this plan in place, you won’t have to worry about deductibles or maximums. You won’t have to fill out any claim forms either.
So, just like with any other benefit, you should be sure to understand the limits outlined in the orthodontic coverage section of the plan. You can find the ones for DeltaCare PAA48 on page 29 of the Disclosure Form for that policy.
Orthodontic Insurance for Child
Having a beautiful smile and straight teeth is something you want for your child as a parent, right? But your child’s toothache just won’t go away. And there’s always this impulse to take them to the dentist. Hence, the orthodontic insurance support you receive will be vital to you as well as your child.
While it is possible that your company does not provide dental insurance, it would be more cost-effective for you to buy a child orthodontic insurance plan. It can sometimes come as a benefit or supplement under many plans. Regardless, the orthodontic insurance services will include braces and various other forms of specialized dental care and treatments.
When Should I Get My Child an Orthodontic Insurance Plan?
The purpose of orthodontic treatment is to realign the teeth to make sure your child has a more attractive smile and a wholesome bite. Braces are quite common, but there are some ways to potentially eliminate the need for them. These treatments involve the use of retainers and removable plastic mouthpieces.
When you have young children, you likely have a lot on your mind. Although getting your teeth straightened may not be at the top of your priority list, specialists recommend considering orthodontics with your family dentist as soon as you get the chance. And get an insurance plan covering orthodontic treatment, particularly as soon as your child starts growing permanent teeth.
Where Can I Find Orthodontic Insurance to Cover My Child’s Braces?
Actually, there are two different routes that you can take to get dental coverage. Firstly, if your employer provides orthodontic insurance for its employees, you may be able to select a dental plan as part of your benefits package. If that’s not the case, you have the option of purchasing dental coverage independently through the Health Insurance Marketplace. This insurance provider offers individual and family dental plans, or through a health insurance carrier.
Check to see if the plan you select offers insurance coverage for your child’s orthodontic treatment. In most cases, there are limits, and not every health insurance policy provides coverage for child orthodontic services, such as braces and other ortho services. One health insurance plan may pay for orthodontic treatment for children but not for adults.
So, consider getting child orthodontist insurance if he or she has any of the following:
- Teeth that are crowded or crooked
- Early or late loss of baby teeth
- teeth that do not align with one another even when the mouth is totally shut.
Supplemental Orthodontic Insurance
According to estimates, about 77% of Americans have dental insurance. Dental insurance, however, may not always be enough. This means that dental insurance plans provided by your employer may only cover routine dental care and not pay for more extensive dental treatments like root canals, crowns, or any other major dental work.
Nevertheless, supplemental orthodontic insurance can assist in providing coverage to help fill in coverage gaps that other types of insurance plans do not cover. In addition, after reaching the yearly maximum of coverage that your plan provides, you may still be eligible for coverage for expensive dental work through supplemental orthodontic insurance.
Supplemental orthodontic insurance can make all of your dental care more affordable if you are aware of how to weigh the price of your treatment against the benefits it will bring you.
How Do You Decide What’s Best for Your Budget?
There is supplemental orthodontic insurance you can purchase to fill the gap your primary dental plan doesn’t cover. You should only get this if the coverage your primary plan provides is insufficient to meet you and your family’s requirements.
When looking for a supplemental orthodontic insurance plan, the first thing you should do is make sure you are familiar with the coverage provided by your primary dental insurance policy.
In order to choose a supplemental plan that will provide coverage that your primary plan does not, you will need to first have a thorough understanding of the provisions of your primary plan. So, when selecting a supplemental plan, you want to keep in mind some of the following considerations:
#1. Size of the Network
In order to find a dentist who can deliver the treatment that you require, make sure that any supplemental insurance plan you choose has a large provider network of dental practitioners.
#2. The Kind of Coverage You Require
When selecting a plan for supplemental dental insurance, think about the kind of coverage that you want to get for yourself. Look for a supplemental plan that will cover major procedures like root canals or implants. One that allows your primary insurance to take care of the cost of routine care if your existing plan already covers diagnostics and preventives.
#3. Waiting Period
Ensure that the plan you choose does not have a waiting time before the work can be performed. This is to avoid a case where you are required to postpone the treatment in order to guarantee that the extra insurance will cover the therapy in question.
#4. Coverage for Orthodontic
Even if your existing health insurance does cover a percentage of the cost of your treatment, the entire cost could exceed the maximum benefit allowed for the year. As a result, for the rest of the year, you’ll have to foot the bill for the dental treatment of everyone in your household. Orthodontic treatment can be quite expensive if you don’t have insurance to help cover the costs.
The expense of orthodontic treatments like braces, retainers, and other orthodontic services may be covered by a dental insurance policy while the rest of the family receives essential preventative care.
If you’re already paying premiums for a dental insurance plan, you might want to keep premium costs low. When you are considering premium costs, make sure that you are looking at the premium costs considering the coverage offered by that plan. Supplemental dental insurance reviews can also help you choose affordable supplemental orthodontic insurance.
What Does Dental Insurance for Braces Typically Exclude?
When orthodontic treatment is covered by dental insurance plans, there are usually stringent limitations in place. Orthodontic insurance typically includes lifetime limits that often do not fully cover the total cost of treatment. Despite having a comprehensive dental insurance policy that includes orthodontic coverage, it is possible that you may still be required to bear a significant financial burden, amounting to thousands of dollars, for braces and similar orthodontic treatments.
Certain policies may have individual limits in place to ensure that coverage remains within a specific threshold. In the event that you possess a policy lifetime limit, it is possible to exhaust your coverage while treating your initial child, even before commencing orthodontic treatment for a subsequent child.
Discount plans can serve as an effective means to augment the savings obtained from dental insurance when it comes to orthodontic treatments such as braces. Certain astute consumers opt to supplement their existing dental insurance with a discount plan. This service provides the opportunity to avail discounts on braces at a competitive annual fee while ensuring that there is no need to alter existing dental plans.
Best Dental Insurance for Orthodontics
Dental insurance plans that offer coverage for orthodontics are a valuable investment for individuals and families seeking orthodontic treatment. Approximately 3.9 million children in the United States receive orthodontic treatment annually. Braces, as a result, often incur significant costs amounting to thousands of dollars. Orthodontic coverage can assist in mitigating the substantial expenses associated with orthodontic braces.
The best dental plans for braces provide extensive, affordable coverage and come with coverage limits that are high. A dental plan with short waiting periods is preferable, but this decision is contingent on when you will need braces. Additionally, you need to look for a dental plan that has a large network of providers to choose from. Below are some of the best dental insurance options for orthodontics.
Best Dental Orthodontics Insurance
- Humana: Best for No Waiting Period for Orthodontic Discounts
- DentalPlans: Best Place to Shop for Plans
- Delta Dental: Best for child-only coverage
- Aetna: Best Price
- USAA Dental Insurance: Best for Military Families
- Aflac: Best for Adults
- Cigna: Best for a Low Deductible
Comparing the Best Dental Insurance for Orthodontics
| Company | Waiting Period | Coverage Limit | Plans | Deductible |
| Humana | None | Varies | 8 | $50-150 |
| DentalPlans | Varies | Varies | 30+ | Varies |
| Delta Dental | Varies | Varies | 5 | $50 |
| Aetna | Varies | Varies | 2 | $50 |
| USAA Dental Insurance | 12 months | $2,000 | 3 | $200 |
| Aflac | 24 months | $1,400 | 2 | Varies |
| Cigna | 12 months | $1,000 | 3 | $50 |
Are Braces Ever Covered by Insurance?
Indeed, certain dental insurance plans offer coverage for orthodontic treatment, encompassing the placement, adjustment, and removal of braces, as well as the associated expenses for hardware, retainers, X-rays, and examinations. However, it should not be assumed that every insurance plan provides coverage for orthodontic braces. It is advisable to carefully review the plan benefits, coverages, waiting periods, reimbursement caps, deductibles, limitations, and exclusions prior to enrolling in the aforementioned plan.
Does Medical Insurance Cover Braces?
Typically, health insurance plans do not provide coverage for orthodontic treatment. However, it is possible to explore health plans that offer supplementary coverage in this area. Certain marketplace plans under the Affordable Care Act provide dental coverage, while the marketplace itself may additionally offer standalone dental plans.
Conclusion
Orthodontic services help in straightening teeth, covering braces, and other specialized dental treatments, but not all dental insurance plans cover orthodontics. If your child needs orthodontics for health reasons, your insurance policy can cover the cost of orthodontics.
However, you shouldn’t delay buying a supplemental plan for your children’s insurance, especially once you find out that you may need additional coverage for your children soon.
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