Does Dental Insurance Cover Braces?

Dental Insurance Benefits for BracesOn average, braces cost $5,000 to $6,000.[1] For most families, that is no small expense. Paying for braces can be a real financial strain and a source of stress for those who realize their children will eventually need orthodontic treatment to correct a bad bite.

Whether or not dental insurance covers braces and other orthodontic services varies. Many dental plans do not include benefits for orthodontic services, including braces. Plans that do include benefits for braces will typically only cover a small percentage for children under 18 and not adults.

Of course, every little bit helps. When shopping for dental insurance and anticipating that a family member will need braces:

1. Look for a dental insurance plan that includes orthodontic care benefits or a plan that allows you to tack on orthodontic care benefits through a discount program. Some plans sold at dentalinsurance.org offer an optional discount program called OrthoCare for just a few dollars more each month. OrthoCare provides savings of 15 to 20 percent on services performed by a contracted OrthoCare orthodontist.

The amount of assistance insurance benefits and discount programs offer may be similar. When comparing plans, consider both monthly premium costs and the benefits or discounts offered, this can help you determine the best option to help pay for braces.

2.  sure to ask if there is a waiting period for orthodontic benefits or discounts. You may not be able to use them right away, which means it is important to enroll in the right dental plan before you need it.

Braces and the pediatric dental EHB

As part of the Affordable Care Act, all state-based and federally facilitated health insurance exchanges were required to offer the pediatric dental essential health benefit embedded in, bundled with or sold separately from health insurance.

The pediatric dental EHB may include benefits to help cover the cost of medically necessary orthodontia. However, the pediatric dental EHB varies from state to state, depending on the benchmark plan selected. If your child has the pediatric dental and vision EHB, look over the plan materials or contact the plan’s provider to find out if and how orthodontic care is covered.

Read “Get the Best Dental Insurance Plan for Braces” for more tips, and visit dentalinsurance.org to get a free dental insurance quote for you and your family.

If you need help finding a plan or have questions about coverage for braces, call 888-468-3390 to talk to one of dentalinsurance.org’s licensed agents.

 



[1] Academy of General Dentistry. “Chapter_1125.5: Cost & Adjusting to Braces.” Know Your Teeth. Reviewed January 2012. Retrieved from http://www.knowyourteeth.com/infobites/abc/article/?abc=%20&iid=153&aid=4112.

This entry was posted in Ask the Agent, Dental Insurance and tagged , , , , . Bookmark the permalink.