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Finding Orthodontic Coverage

Jamie King

Jamie King

Marketing Manager

August 3, 2018 Dental Insurance Verification 3 min read

Orthodontic treatments benefit people because “the goal of healthy, functional occlusion may contribute to healthier teeth for a lifetime—as well as teeth that are esthetically pleasing” (Larson 2017). Furthermore, these treatments, which improve the structure of the teeth, can help future dentists perform necessary procedures, such as restorations, more easily in the long run (Larson 2017). Like younger people, older adults can go through those procedures “for the esthetic benefits or to correct a bite issue,” but some of them may not be able to afford them or only have enough money for their children’s treatments (Larson 2017). When people find an adequate insurance plan with orthodontic benefits, their financial burdens
Finding Orthodontic Coverage could be alleviated.
Although children have relatively more access to orthodontic coverage, adults may have to search for policies or supplements with this coverage. If possible, adults can utilize their employer’s dental insurance for orthodontic procedures, but it “may only provide limited coverage” (Araujo 2018). Some health insurance policies have different amounts of orthodontic coverage, while others “only cover orthodontics for children” (Araujo 2018). People can enroll into a supplemental health plan that includes orthodontic coverage (Araujo 2018). Some dental insurance companies have policies with this coverage, but a small amount of them “offer it for adults” (Pleis). In contrast, depending on the state, dental insurance must provide coverage to children who need braces, depending on the circumstances (“Does Dental Insurance Cover Braces and Orthodontist Services?” 2015).
Policies may restrict orthodontic coverage with their conditions. Dental policies with orthodontic coverage for adults and children could pay for “Examinations,” “Orthodontic treatment,” “Retainers,” and “Pre- and post-orthodontic treatment” (“Does Dental Insurance Cover Braces and Orthodontist Services?” 2015). Albeit, some of them may provide coverage only to those who are younger than 19 or 26 years old (“How to Get Orthodontic Insurance and What It Covers” 2016). People still have to consider other caveats, such as the waiting periods, out-of-pocket payments, network of dentists, etc. (Pleis). Particularly, some policies may contain an annual maximum or lifetime out-of-pocket maximum for orthodontic treatments (“How to Get Orthodontic Insurance and What It Covers” 2016). When a person has a policy with an annual maximum, it usually has “a 24-month maximum so that the orthodontic benefit will not exceed, for instance, $2,000 if the annual maximum is $1,000” (“How to Get Orthodontic Insurance and What It Covers” 2016). When a person has a policy with a lifetime out-of-pocket maximum, it would stop paying for orthodontic procedures forever after a certain limit, such as $1,000 or $2,500 (“How to Get Orthodontic Insurance and What It Covers” 2016).
While health and dental insurance could cover orthodontic procedures, adults may have to spend more time finding suitable policies that help pay for them. Furthermore, this coverage comes with many rules. Even so, it could still help people access these treatments for their long-term benefits to their oral health.

Works Cited
Araujo, Mila. “Your Dental Insurance Plan – Orthodontic Insurance.” the balance. Last modified
April 27, 2018. https://www.thebalance.com/your-dental-insurance-plan-orthodontic-insurance-2645591.
“Does Dental Insurance Cover Braces and Orthodontist Services?” eHealth, April 20, 2015.
https://resources.ehealthinsurance.com/dental-insurance/dental-insurance-cover-braces-orthodontist-services.
“How to Get Orthodontic Insurance and What It Covers.” Carlyle Orthodontics, November 5,
  1. https://carlyleortho.com/blog/how-to-get-orthodontic-insurance-and-what-it-covers/.
Larson, Priscilla K. “Smiles are forever: Orthodontic treatment at any age.” By Stacey L.
Simmons. DentistryiQ, July 3, 2017. https://www.dentistryiq.com/articles/2017/07/smiles-are-forever-orthodontic-treatment-at-any-age.html.
Pleis, Donna. “How To Find Dental Insurance That Covers Braces For Adults.” Colgate.
Accessed July 5, 2018. https://www.colgate.com/en-us/oral-health/procedures/fillings/how-to-find-dental-insurance-that-covers-braces-for-adults-0115.
Jamie King

By Jamie King

Marketing Manager

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