Orthodontic Insurance: What You Should and Shouldn’t Expect it to Pay
Photo by Atikah Akhtar on Unsplash
There isn’t any dental insurance that pays the total cost of your modern orthodontic treatment. However, some pay for more than others. For most patients, any little bit helps, and orthodontic insurance benefits can help reduce the overall out-of-pocket expense for your modern orthodontic treatment.
But what should you look for when choosing dental insurance for braces? How do you compare policies, and what should you know before you select coverage? There are a few answers to these questions, and we will do our best to relay them here.
What You Should Look for to Find the Best Orthodontic Insurance Benefit
How the orthodontic insurance works depends on the policy you have. The best orthodontic benefits with your dental insurance policy offer flexibility in treatment options and a significant coverage amount. Sometimes the coverage amount is paid annually up to a certain amount, like up to $500 per year. In some dental insurance policies, the orthodontic benefit is a pre-negotiated rate or discount percentage agreed upon by participating (in-network) providers.
However, even the best orthodontic benefits have limits. For example, most orthodontic insurance benefits have a maximum lifetime benefit for orthodontic treatment per subscriber, usually in the $1,000 to $1,200 range. Sometimes the coverage is restricted to braces only, rather than clear aligners or other forms of invisible braces. Other policies might have age limits for coverage, which tends to be 19 years or younger. In addition, there are often waiting periods for orthodontic insurance benefits, which are usually around 12 months.
What is and isn’t covered varies. Many basic plans do not cover orthodontics at all. Orthodontic insurance benefits tend to begin on the most comprehensive plans. Therefore, it is good to read the benefits and exclusions carefully to understand what is available with the dental insurance policy you are considering.
To read about some of the best dental insurance for braces by category, please click here.
Comparing Dental Insurance for Braces Policies
Many patients have access to dental insurance through their employer. However, even if your employer does not offer dental insurance coverage through their benefits package, individuals and families can invest in dental insurance policies. Whichever way you have access to dental insurance benefits, comparing dental insurance policies and their orthodontic insurance benefits is a job well-suited to online research.
Many different companies offer dental insurance that has orthodontic benefits. Some of the big brands of insurance that can help include:
When you are comparison shopping, particularly if you are not going through your employer, you will notice that most websites will ask for your personal information, e.g., name, age, zip code, etc., before directing you toward plans. The website asks because what insurance benefits are available vary by state and other demographic details. Some websites might inquire whether you smoke, which is another factor that goes into what you pay.
Another resource can be a Google search about the topic. Many larger websites specialize in this kind of comparison shopping. For example, Investopedia.com has already aggregated the best dental insurance policies for braces for you. While this type of article can’t choose the policy for you, it can narrow your search parameters to weed out providers that didn’t have orthodontic insurance or didn’t have significant benefits for subscribers.
For another comparison article by Benzinga, please click here.
Details to Consider
You might have heard the phrase, “the devil is in the details.” That is true in many things, but especially for orthodontic insurance benefits. Here are four categories that you should consider in your comparison shopping:
- Orthodontic Lifetime Maximum: This is the amount the policy will pay toward your modern orthodontic treatment per subscriber, for as long as you have that insurance.
- Treatment Specifics: Some policies specify the type of treatment they cover or the patient’s age that qualifies for coverage; fail to meet the specifics, and your policy could exclude your orthodontic treatment.
- Orthodontic Deductible: There is often an additional deductible, in addition to any other dental insurance deductible, that applies to orthodontic insurance, which usually is around $150 per subscriber.
- Waiting Periods: Many orthodontic policies require the patient to have insurance for a period before the orthodontic benefits kick in, usually around 12 months.
To read some more dental insurance considerations, please click here.
It is essential to read these policy details in your comparison process. Sometimes, the details will reveal that the dental insurance policy for braces won’t help in your situation.
However, the details aren’t always devilish. You might also learn the good news in the details. For example, waiting periods sometimes have wiggle room. In some cases, like discount programs, there is no waiting period for benefits. In others, the insurance company might waive the waiting period provided the patient has had dental insurance for the previous 12 months.
Dental insurance for braces doesn’t take care of everything, but every little bit helps. We understand that paying for modern orthodontic treatment is a significant part of the treatment process. Having dental insurance reduce the amount you pay out of pocket is excellent for most of our patients. The team at Bloom Orthodontics in Long Beach is here to help. Be sure to share your dental insurance information with us to maximize the orthodontic insurance benefits available to you.
To schedule your free consultation today, call Bloom Orthodontics office in Long Beach at 562-421-8883.
Bloom Orthodontics in Long Beach has a long history of improving our patients’ smiles. We provide modern orthodontic treatments delivered with old fashioned excellence in patient experience. Follow us on Facebook and Instagram.
Sources:
Dore, Kate. “Best Orthodontic Insurance Options.” Thebalance.com. 4 June 2021. Web. 9 June 2021. <https://www.thebalance.com/best-orthodontic-insurance-4801111>.
Rosenberg, Eric. “Best Dental Insurance for Braces.” www.investopedia.com. 9 May 2021. Web. 9 June 2021. <https://www.investopedia.com/best-dental-insurance-for-seniors-4844535>.
Huffman, Eric. “Orthodontic Insurance.” Benzinga.com. 16 April 2021. Web. 9 June 2021. <https://www.benzinga.com/money/orthodontic-insurance/>.
Davenport, Tammy. “Should You Purchase Dental Insurance?” www.verywellhealth.com. 8 April 2020. Web. 9 June 2021. < https://www.verywellhealth.com/should-you-purchase-dental-insurance-1059199>.