Does Dental Insurance Cover Orthodontic Treatments?

Does your child need braces? Do you have dental insurance but are unsure if orthodontic treatment coverage is part of your plan? When it comes to orthodontia, it’s important that it is included in your policy, so you don’t run the risk of having to pay upfront for your child’s full treatment. Read on to learn how dental insurance and orthodontics work together to keep more money in your pocket.

How to Select the Right Plan

When enrolling in a dental insurance policy, you will receive it through your employer or independently. After looking at your premium, deductible, and annual maximum, you settle on a plan that fits your budget and offers optimal coverage. But what about orthodontics? Are they covered?

Before you decide which plan you want to sign up and pay for each month, you’ll want to make sure they offer ample coverage for braces. The truth is that every dental insurance plan differs. While some make it possible for both adults and children to take advantage of available funds, others have limits that only cover braces for dependents under the age of 19. You’ll also need to determine if your plan has a certain limit as to how much you can spend toward orthodontics each year. It’s also helpful to remember that by staying in-network and choosing an orthodontist who works with your dental insurance, you’ll save money.

Orthodontic Stipulations

When bringing your child in for an orthodontic evaluation, you can expect the orthodontist to determine if braces are necessary for aesthetic or oral health purposes. This is important, as it will be noted on any paperwork that is sent to the dental insurance company. If braces are only recommended to help improve a child’s appearance, it’s unlikely your insurer will agree to pay, as it is considered more of a cosmetic treatment. However, if your child requires braces to help them eat and chew their food, this falls under “medically necessary,” and will likely be covered by insurance.

What is Included with Orthodontic Coverage?

As you consider which plan is right for you and your family, make sure you pay close attention to understand what is covered when it comes to orthodontic treatment. The most common services include the initial evaluation and treatment planning, extraction for overcrowded teeth, orthodontic appliances (i.e., braces, retainer, space maintainers, etc.), and even follow-up visits.

Don’t rush to decide which dental insurance plan is right for your family. By taking your time to discover the type of orthodontic coverage your child needs, you’ll be better prepared to save the most money as your little one embarks on a straighter, healthier smile.

About the Author
Dr. Ronni Bruck earned her Doctor of Dental Medicine from the University of Pennsylvania before completing her general practice residency at Abington Memorial Hospital. She then chose to complete an orthodontic residency at St. Barnabas Hospital in New York. As an orthodontist in Coatesville, she is pleased to be a part of Chester Country Dental Arts, providing orthodontic treatment to both children and adults. In-network with many dental insurance providers, she and Dr. Simeone want all patients to have the confidence of knowing they’re covered for upcoming treatment. If you need help navigating your dental insurance policy, contact us at (610) 383-1600.