Dental insurance and orthodontic care
Oral health is vital to overall well-being, and having teeth that line up correctly is an important part of maintaining good oral health for life. Finding dental insurance that covers braces can help when you or someone in your family needs orthodontic care.
What is orthodontic care?
Orthodontics, or orthodontic care, is a specialization in dental care that deals with the alignment of a person’s teeth. Orthodontists are the dentists who specialize in this care. These dentists focus on the way teeth fit together with the jaw and typically spend a few years after dental school learning orthodontics.
The type of orthodontic care that most people are familiar with is braces. These are the traditional orthodontics with bands, wires and brackets. Clear aligners are another type of orthodontic care and a popular alternative to braces.
When someone is done with braces or clear aligners, they need retainers, which keep the teeth in place. This is ongoing orthodontic care that may be needed for a lifetime.
What does orthodontic care treat?
Orthodontic care is focused solely on the alignment of the patient’s teeth. As such, it doesn’t include annual cleanings or treatment for common dental problems like cavities.
Instead, orthodontic care seeks to treat problems like:
- Crooked teeth
- Tooth crowding
- Rotated teeth
- Teeth that overlap
- Impacted teeth
- Underbites
- Overbites
Though many people want orthodontic care to improve the appearance of their smile, there are many health reasons to need this care. Proper orthodontic care can1:
- Make teeth easier to clean
- Improve speech and chewing
- Helps reduce cavities and gum disease
Because the benefits of orthodontic care are so important, a dental insurance plan that includes coverage for braces may be valuable for your family.
Does insurance cover orthodontic care?
Some dental plans cover braces and other orthodontic care while others don’t. If someone in your family may need braces, be sure to check what a plan covers before purchasing. Learning more about how the plan works and any limitations on dental coverage for braces can help you plan for your family’s needs.
Do you need dental insurance with orthodontic care included?
Every person and family has their own needs. That’s why there are so many different dental plans. To decide whether you need dental insurance with orthodontic coverage, you need to consider how likely it is that someone on your plan will need orthodontic care and how much that will cost.
Will someone in your family need orthodontics?
According to the American Association of Orthodontists (AAO), the number of people getting orthodontic care is on the rise.2 The association estimates that about 6.6 million people in the United States and Canada are in active orthodontic care at any time, which is an all-time high.
How much do braces cost?
If someone in your household may need orthodontic care, it’s important to consider the cost. The cost of orthodontic care is on the rise.2 On average, traditional braces cost between $5,000 and $6,000.3 However, the exact cost you could pay depends on the type of braces needed, as well as the complexity and length of treatment.
Without the right dental insurance or savings plan, you would be responsible for paying the whole cost of orthodontic care. However, some dental plans and memberships cover a significant portion of the cost of braces.
Dental plans that cover braces may require you to pay a deductible first, which is typically about $50 to $200. Then, the plan may cover a portion of the cost up to a maximum amount.
Are there limitations on orthodontic coverage?
There are some limitations on how you can use a dental plan that covers orthodontics. The specific limitations differ for each plan. However, there are some common limitations that you should be aware of as you plan for your family’s oral health:
- Waiting periods – some plans require you to wait a specific amount of time, like 12 months, between the plan’s start date and when you can use orthodontic coverage
- Lifetime maximum – dental plans often specify how much orthodontic care they will cover. This limit may be around $1,000 per individual.
- Medical necessity – you may need your orthodontist to verify that the care is necessary for your health, not simply cosmetic
- Age limits – some dental plans that cover braces only cover children and teens
- Types of care – understand whether the plan covers traditional braces, clear aligners or both
How can I save on orthodontic services?
If you’re worried about the cost of braces and other orthodontics, you should know that there are several ways to save money on these services.
- Dental savings plans: These non-insurance membership plans can help you save money on dental care from participating providers, including orthodontics. It is a discount program with no deductibles or waiting periods.
- Dental insurance: Choosing a dental insurance plan that covers orthodontics can save on braces and more. In addition to insurance benefits, you may be able to save by using a network provider.
- Use your Health Savings Account (HSA): If you have a high-deductible health plan, you may qualify for an HSA. This account allows you to use pre-tax dollars on healthcare expenses, including orthodontic care.
- Use your Flexible Spending Account (FSA): If you have an FSA through your employer, you can use the money in that account to pay for orthodontics with pre-tax money.
- Shop around: No two orthodontic practices are the same. You can get consultations at several orthodontists and compare prices. Some might offer discounts for upfront payments or other programs.
If you’re struggling to pay for orthodontic care, you can also ask your provider about payment plans.
Dental savings memberships to cover orthodontics
A dental savings membership is not insurance. These memberships give you access to significant savings on dental care from participating providers.
- No waiting period or deductible, access your savings quickly.
- Helps with savings on dental expenses insurance doesn't cover.
- No annual limits, lifetime maximums or copays.
Some memberships also include savings on vision and hearing care, including glasses and contacts.
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