Does Health Insurance Cover Braces?
Everyone wants a beautiful smile, but how can you get one if you have to pay up to $7,000 for braces? Few people these days have that kind of money laying around to spend on a perfect smile when there are so many other pressing financial needs.
Fortunately, you do not have to worry about paying that much money for braces if your insurance covers you for orthodontic work. Here are some tips on how to find out if your health insurance will pay any of the cost of your braces, as well as some other avenues to explore to help you finance your cosmetic dental work.
Examine Your Health Insurance Policy Carefully
Every policy is different, so just because your sister’s health insurance does not cover braces, it does not mean that your own policy is the same. Some health insurance policies cover orthodontic work only if “medically necessary”—for example, if you are in a car accident and have a broken jaw. Others will cover for children under 18, but not for adults. Generally, in order to have orthodontic coverage you must have dental coverage and this is often a separate policy that may be administered by a different company than your normal health insurance provider.
All Dental Insurance is Not Created Equal
Be aware that dental plans vary widely on how much they will pay for cosmetic orthodontic work. Few plans pay 100 percent of the cost; many pay 50 percent after the deductible is met and some pay nothing at all. You can review your dental insurance policy or call your company to determine how much they will pay toward your orthodontic plan.
Discuss Your Treatment Plan with Your Orthodontist
In many cases, there are treatment options available to you. You might be able to have one procedure done now and another at a later time. Your orthodontist can explain your options and help you control the cost of your orthodontic care if your insurer will not provide all of the cost.
Work out a Payment Schedule
Orthodontists realize that many insurance companies will not cover orthodontic treatment or only pay a small amount toward the cost. Therefore, many of them have joined networks to provide financing for their services or sponsor their own in-house financing. This means that the orthodontist will facilitate a loan for you to pay for your orthodontics. You must meet minimum credit requirements and make monthly payments in a timely manner if you choose this option. Some people prefer this option over paying the entire fee up front even if they are able to as it forces the orthodontist to wait for his or her complete payment; this is a good incentive for the doctor to complete the work. Also, if an orthodontic office closes without warning, the patient has not lost a large investment.
Consider Alternative Methods of Treatment
If your orthodontic needs are relatively simple, you can go to a dentist rather than an orthodontist. Dentists often charge far less to install braces than specialists. However, be aware that dentists do not receive special training for orthodontics beyond the required amounts learned in dental school. If a dentist installs your braces, you are not receiving the guarantee that an “expert” is doing the work that you get with an orthodontist. You can also combine your treatment between your dentist and orthodontist, seeking “simple” treatment from your regular dentist and going to the orthodontist for the more complicated work.
Join a “Dental Plan.”
A dental plan is not insurance but a discount plan offered by a private company. Under a dental plan, participants pay a monthly fee and then use dentists and orthodontists in the “network” of providers under the plan. In most cases there are restrictions on exactly what work can be done under the plan; usually dental plans do not pay for previously-started orthodontics or specialized, expensive treatments. Nonetheless, the dental plan can be a great option for someone who does not have dental insurance; however, be sure that the monthly fees charged by the plan for membership are not more than you would pay if you simply financed the orthodontic work through the doctor.
Find a Discount Dental Group
Many dentists and orthodontists, in an effort to cut overhead costs, have joined dental groups. These groups keep costs down for patients by combining expenses and dividing them among many practitioners. If you do not mind seeing a different dentist or orthodontist every time you visit the office, a discount dental group may be a good choice for you and may allow you to save significantly on your orthodontic work.
Locate a Dental School
Dental schools are busy training orthodontists and need patients on whom the students can work. For this reason, many dental schools offer free or low-cost orthodontics to patients who are willing to allow students to work with them. The students are always supervised by experienced doctors, so there is little to no risk involved in this choice. You can find a list of schools accredited by the American Association of Orthodontics website.
Government Programs Could Meet Your Needs
While Medicaid does not cover cosmetic treatments or surgery, braces may be deemed “medically necessary” by your dentist. If so, Medicaid will usually cover the entire cost. There are other government programs that can also assist you with covering the cost of your braces. Contact your local office for human services to speak to someone about your proposed dental work.
Dental Charities May Help
Since government programs are reluctant to pay for cosmetic dental work, several charity organizations have been formed to help those who simply cannot afford expensive dental work. These programs, such as Smiles For A Lifetime Foundation and Smiles Change Lives, primarily work with children but may also help adults with functional jaw issues or badly diseased teeth. You may be able to receive the full cost of your dental care if you meet the requirements for these programs.
Getting the smile of a lifetime may require some research, budgeting and hard work, but seeing your face light up in the mirror makes it all worthwhile.