Orthodontic Insurance

While the cost of braces can be expensive, orthodontic insurance can help to defray some of that cost. If you believe your child may need braces in the future, now is the time to begin researching possible insurance options to help pay for treatment. Many people often assume that their dental insurance will pay for orthodontic care. Not all dental care plans cover orthodontic care, so it is important to research your options early. Does the Affordable Care Act Cover Braces?

Do Dental Plans Cover Braces?

Begin by investigating your current dental plan to determine whether it offers coverage for braces. Make sure you obtain specific information. Even some dental plans that do provide for orthodontic care will only cover a small percentage of the total treatment, so make sure you know precisely what will be covered.

If you discover that your plan provides no coverage or only covers a small portion of orthodontic treatment, take the time to review other options. Keep in mind that both dental discount plans and dental insurance plans are available and there is a difference between the two. A dental discount plan allows you to receive a discount off the cost of orthodontic care and dental visits. With this option, you will typically be required to use certain dentists that accept that plan. Dental insurance works the same way as any other type of health insurance. You will typically be required to pay a co-pay and may also be responsible for a deductible for certain services.

HSA and FSA Coverage

The great news is you can use your HSA (Health Savings Account) and FSA (Flex Spending Account) to finance the cost of braces. With high deductible Insurance Plans, many companies offer HSA or FSA accounts. How this works is you can bank money from your paycheck tax free into an account that can be used for health related charges. Learn more by clicking the correct link below.


HSA Account Info

Compare Orthodontic Insurance Plans

In comparing various types of dental insurance plans, be aware that there are often different options available, including HMO network plans, indemnity insurance packages, and PPO dental insurance plans. An HMO network dental insurance plan is a type of comprehensive plan that provides coverage to a large group of individuals. This is often an employer plan. Through this type of network, services are often provided through certain dental clinics. Prices for this type of plan are usually based on the number of people who are included in the network. An indemnity plan usually offers more flexibility regarding your choice of provider. With this plan, you have the freedom to choose the orthodontist of your choice and services are often covered up to a maximum of 80 percent. You should be aware that an indemnity plan will often limit procedures that are included.

PPO Insurance Plans

With a PPO or Preferred Provider Organization, you will be restricted to a designated group of providers. This means that you will only be able to obtain services from the designated dentists in order for your treatment to be covered. . If you already have a dentist you like, make it a point to confirm whether that dentist is accepted under the dental insurance plan you are considering. In the event your favorite dentist or orthodontist is not covered, you may find it worth the cost to pay more for a plan that does cover your preferred provider.

Regardless of which option you choose, it is important to determine the types of orthodontic care that are covered. In comparing dental insurance plans, it is important to consider the cost of the premium, deductibles, co-pays, and any exclusions that may apply. It is also important to determine whether the plan will allow you to choose your own doctor

Look for Orthodontic Exclusions

You also need to carefully research exclusions. Some dental insurance plans may restrict coverage to the least expensive treatment option available, even though other treatments may be available. For instance, in terms of orthodontic care, some insurance plans may only cover traditional metal braces. If you are interested in some of the newer orthodontic treatments, such as Invisalign, it is important to determine whether those treatment options will be covered by your dental insurance plan.

Only Some Types of Braces are Covered

Keep in mind that orthodontic devices are not the only area that you need to be sure are included. During the course of orthodontic treatment, you may also require other services that should be covered by your dental insurance plan. Such services include two cleanings per year. You should also ensure that fluoride treatments and X-rays will also be covered at no additional cost. In addition, inquire about the coverage level for other services. Under most dental plans, 50 percent of other services are typically covered.

You should also find out whether you will be limited to certain appointment times. While this is not the case with all dentists, some doctors will only see certain dental insurance participants at certain times.

Shop Around

When shopping for dental insurance, you should also be aware that most plans have a lifetime maximum benefit amount for each covered family member. In some instances, age limitations may also apply. If you are an adult considering orthodontic treatment, this could prove to be quite important.

Orthodontic insurance can help to reduce your out-of-pocket costs. Researching your options can help you to find the best insurance plans for your needs and budget.

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