Does Health Insurance Cover Braces?

Braces are a common orthodontic treatment used to fix a variety of alignment issues such as overcrowding, spacing issues, overbites, underbites, and more. Problems with dental alignment increase the risk of serious oral health complications such as gum disease, cavities, and tooth damage. Poor alignment can also lead to problems that affect your eating, speaking, and overall health.

While braces are effective, one of the biggest patient concerns is how much braces cost. Your health insurance plan may cover you for routine dental checkups and certain dental procedures. But does health insurance cover braces?

Health Insurance and Braces

The answer is it depends. Not all health insurance plans are the same. Some plans provide coverage for dental and orthodontic treatments, while others do not.

In general, most plans that provide dental coverage will cover a portion of braces, since braces are considered a medically necessary treatment that will improve a patient’s oral and overall health.

However, some plans come with certain restrictions for braces. Plans may not cover treatments for patients over the age of 18—or may only provide partial coverage. Other plans have waiting periods before braces are covered; your plan may not cover the cost of braces if you begin your treatment before the effective start date of the policy. With these restrictions in mind, plan your finances and appointments accordingly. 

Some plans do not cover the cost of braces at all.

It is best to contact your insurance provider or HR department directly for the exact details of your plan and the scope of its dental coverage.

What about Invisalign?

Invisalign has become a popular alternative to traditional braces. The clear aligners provide a way to correct dental issues and improve your smile without using metal wires and brackets. Many older teen and adult patients prefer Invisalign over traditional treatment with braces.

Even if your plan covers the cost of braces, it may not cover the cost of Invisalign. The clear aligners are typically considered a cosmetic treatment, not a dental health procedure. However, this doesn’t mean that you must pay completely out of pocket. Some plans cover a portion of Invisalign treatment, which helps reduce your out-of-pocket obligation.

Again, it is best to contact your insurance provider directly to learn more.

Does Health Insurance Cover Other Orthodontic Treatments?

In addition to braces, your health insurance plan may cover the cost of other orthodontic treatments. Depending upon your specific plan, you may be able to receive coverage for:

• Palate expanders
• Treatments for bite issues such as an overjet or crossbite
• Retainers
• Corrections for defects that are the result of a cleft lip or palate
• Treatments for issues caused by congenitally missing teeth
• Other orthodontic treatments considered to be medically necessary

Conclusion

Orthodontic treatment is often expensive. Fortunately, many health insurance plans provide some form of coverage for orthodontic treatments. However, be sure to double-check the scope of your plan with your provider. Once you have confirmed your health insurance details and decide on a treatment, schedule your orthodontic appointment by calling Hansen Orthodontics today.