June 20, 2024

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Are Teeth Braces Covered by Insurance?

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Most typical health insurance policies in the U.S. do not cover dental work as this is something that must be purchased separately. And as dental work that includes braces can be awfully expensive, it is important to consider this add-on, especially if you have young children who might require this corrective work as they get older.

Checking Your Insurance Policy

While most people associate braces with children and teens, the reality is that many adults also want straight teeth. If their own parents were not in a position to have their teeth corrected when they were younger, they may look to get braces themselves when they are older. But because orthodontia is very expensive, it is often necessary for many people to have this cover on their insurance policy.

What is worth noting though is that even if you purchase dental insurance separately to your regular health insurance, orthodontic work may not always be included. It is crucial to check this when taking out a policy, as you may need to add it on.

Dental policies and what they include will vary from one state to the next, but all insurance companies must offer their customers the option to purchase such a policy for their children aged eighteen and under when they are purchasing their regular health insurance. The dental policy on offer must meet the criteria set down by the ACA (Affordable Care Act). However, there is no obligation on the part of parents to purchase dental insurance for their kids.

In some states, dental insurance for children must cover braces, but there may be limitations on what is actually covered. For example, in some instances cover for braces will only be included if they are deemed medically necessary, in other words, that they are required to help the child chew properly. If the braces are for cosmetic purposes, they will probably not be covered.

What If You Don’t Have Cover

If you have checked your dental insurance policy and found that it does not include cover for braces, all is not lost. You can purchase an individual dental insurance plan from most insurance companies these days. But you must check that it covers orthodontia, as not all will. Furthermore, as already mentioned, there may be limitations on cover if you are choosing to have braces to improve your appearance and not for a medical reason. You may also have a waiting period before you can claim on your insurance, so do check this out before going ahead with treatment.

Some plans that cover orthodontic work will only partially cover the cost, so you may find that you still need to pay around fifty percent of the treatment costs yourself. Find-A-Code (findacode.com) say that you should ask your orthodontist for a list of the work that will be done and then use diagnostic code lookup to get the medical billing codes. This will make it easier to check with your insurance company to see what is and what isn’t covered.

If insurance cover is not available, you might be able to access a discount plan which would allow you to avail of lower priced dental treatment. These plans are becoming extremely popular because they almost always cover cosmetic procedures, including braces for adults. To use a dental plan, you will probably need to pay a small processing fee and a yearly membership fee of around $99.

Whether you or your child requires teeth straightening, treatment to close gaps, or work to correct a bite irregularity, orthodontia cover is likely something you need. Check your plan to find out what you are covered for.

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