Dental Insurance Plans With Orthodontic Coverage – Advertisement Disclosure: If you purchase products or services through our links, we may earn commissions. These orders allow us to create carefully researched reviews. Unless otherwise stated, we rely on the accuracy of the information provided by the provider and have not independently verified it. Learn more.
You may have used your dental insurance to cover routine teeth cleanings and fillings, but now you’re thinking about something bigger: teeth straightening treatment.
Dental Insurance Plans With Orthodontic Coverage
If you don’t know your insurance plan, you might think it covers orthodontics like any other treatment, but that’s not always the case. The fact is, orthodontic services are not included in every dental plan.
What Does Dental Insurance Cover?
Luckily, there are ways to find dental insurance that covers adult braces, Invisalign, and even online clear aligners like SmileDirectClub. How? With a few simple steps.
Dental insurance is not a magic card that gives you free health care. Sure, some of your procedures and fees will be covered, but there’s a little more to it than that. Many people get dental insurance through their employer, but you can also get individual or family plans. Either way, you can usually choose from a few different options, each with different benefits and policies.
Some plans include orthodontic services, while others do not. Orthodontic services can cover braces, Invisalign, and even at-home clear aligners like SmileDirectClub, but typically don’t cover the full cost (many cover 50%, for example).
They may also include certain restrictions. Some plans cover orthodontics for children under the age of 19, but not for adults. Others may have a lifetime spending limit where they will cover up to a certain amount ($1,500 to $3,000 on average). Sometimes a plan also includes a waiting period, so you may have to wait a few months (or even a year) before you can get your orthodontic services.
Does Metlife Cover Braces & Clear Aligners?
Insurance policies are riddled with jargon, which can make it difficult to decipher your coverage. In an ideal world, you would clearly understand your policy word for word. However, we recommend that you familiarize yourself with the following terms first.
Just because you receive orthodontic services does not mean that you are covered for every orthodontic treatment. For example, some plans may cover in-office treatments like braces and Invisalign, but not remote services like SmileDirectClub or Byte.
This is a common scenario, although several major insurance providers have started offering insurance coverage for certain online clear aligner companies. Here is an overview of the main types of treatment that can be covered:
Adults are often drawn to Invisalign because it offers a similar effect to braces but without all the metal. But it can also be quite expensive — an average of $3,000 to $8,000 before insurance. However, if you have orthodontic benefits, Invisalign is often adopted. Just be sure to check age limits and lifetime spending limits. You don’t want to commit to one treatment only to find out your plan only covers Invisalign for people under the age of 19.
How Much Do Braces Cost In Charlotte, Nc?
The coverage provided by braces is usually the same as that of Invisalign. Braces are covered by orthodontic benefits, but age and expense restrictions may apply. Without insurance, braces cost about the same price as Invisalign, sometimes even a little cheaper. If your insurance plan doesn’t include orthodontic services, your braces will likely cost around $4,000 to $6,000. Of course, for minor or complicated medical conditions, your bill may fall outside of this range.
Tip: Learn more about how dental benefits work, whether braces are likely to cover them, and how to claim your benefits by checking out our comprehensive guide to braces insurance coverage.
At-home clear aligners like SmileDirectClub are not always included in orthodontic services. Some insurance providers have formed partnerships that bring home aligner companies into the network:
Some other insurers refuse to cover at-home treatment by a remote aligner provider. However, this situation is rapidly evolving and more and more providers are beginning to include at-home aligners in their orthodontic services.
Best Dental Insurance Of 2023
If you’re interested in clear online aligners, check out our comprehensive insurance guides for some of the most popular options.
Tip: Byte, our top-rated clear aligner provider, is the only provider that does the work for you when it comes to treatment coverage.
Most insurance providers offer at least one plan option that includes orthodontic benefits. What these benefits include may vary by provider and plan. Different providers have different policies, networks, and restrictions. If you are insured through your employer, you may not have a say in your choice of provider, but there may be a plan that will cover some of your treatment.
We looked at different insurance providers and their typical orthodontic services. Again, a lot depends on your specific plan, but these guides should help you get a feel for whether you get coverage from your provider:
Free Dental Insurance Verification Form
If you plan to have orthodontic treatment in the future, you should select an insurance plan that offers appropriate orthodontic benefits. Here are some questions that will help you find the right one:
Many people get health and dental insurance through their employer. When you start a new job, you will have the opportunity (in the next enrollment period) to enroll in one of their insurance plans. Before enrolling, be sure to check with Human Resources for available benefits and policies.
If you don’t have a job that offers benefits, or you don’t like your employer’s plans, you can always sign up for an individual or family plan. These usually offer similar benefits, but you may have to pay higher premiums. You can find these plans on each insurance provider’s website or through Healthcare.gov.
Some people buy insurance through their employer and then add an individual plan to get more benefits. If your employer does not offer a plan that includes orthodontic benefits, you can purchase a second plan that includes those benefits. Of course, you’d be paying for two plans, so you want to make sure the money you’re saving is worth it.
What Is Orthodontics?
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If you have questions or need help finding the perfect plan (e.g. a plan that covers braces/aligners), you can contact the support hotline and get help from the knowledgeable, friendly staff.
If your plan doesn’t include orthodontic services and you have no other options, you may be out of luck. But no worry; There are still ways to save money on your treatment.
Tooth savings plan: Also known as a tooth savings plan. This is a subscription-based service that some insurance companies offer. You pay monthly or annually and receive discounts on certain treatments at selected dentists. Sometimes this includes orthodontic treatment, but not always.
Dental Braces Cost And Dental Braces Financing
Take a look around: The costs for treatments in the practice are not fixed at a flat rate; Every dentist and orthodontist chooses their own rates. That means one doctor may be a lot cheaper than another.
Use an HSA or FSA account: HSAs and FSAs can usually be used for orthodontics. HSAs and FSAs can usually be used for orthodontics. However, this is designed so that you can save pre-tax income and apply it to qualifying medical expenses. However, this may depend on whether your case is cosmetic or not. Ask your account manager for details.
Tip: For more information on using an HSA or FSA to cover orthodontic treatment, see our in-depth guide on the topic.
Consider using at-home aligners: If you use clear aligners for your treatment but can’t afford the in-office treatment, online clear aligners may be the solution that works for you. They often cost at least $1,000 less than traditional aligners. However, keep in mind that they can only treat mild and moderate cases.
Can I Get Orthodontic Insurance
If you’re interested in home aligners, check out our guide to the top 5 brands and in-depth review for our top pick, Byte.
Be encouraged by the fact that you may be able to get coverage for your braces, Invisalign, or at-home aligner treatment. However, remember that there are several factors at play. Plan ahead and research the options. You will find a plan that fits your condition, your treatment, and your priorities.
If you choose the traditional route (braces or Invisalign), your orthodontist or dentist will likely do this for you before you book in for treatment. However, you can call the number on the back of your insurance card and speak to a representative about your orthodontic coverage limits.
It is possible. More and more providers are offering coverage for remote treatment. So check with your insurance company regularly. Additionally, some of these mail order clear aligner services will help you further. For example, if you choose Byte, they will do all the work for you so that you can claim your services.
Does Insurance Cover Orthodontics?
Orthodontics is a complex medical science practiced by highly qualified physicians with years of additional training beyond their dental education. It’s about special devices, high-tech equipment and comfortable offices. All of this feeds into the pricing of the services.
No, double billing by insurance companies is illegal, but you can get one insurance company to cover what the other won’t, as long as the policy allows it. Advertisement Disclosure: If you purchase products or services through our links, we may earn commissions. These orders allow us to create carefully researched reviews.
