Parents often have to deal with various health-related expenses, and one of them is dental care. Braces are not only important for correcting youngsters’ teeth, but they also play a significant role in the child’s overall health. However, the cost of braces can be expensive, making it difficult for some families to afford them. Fortunately, insurance plans can cover some or all of the costs associated with braces. In this article, we will explore the different types of insurance that cover braces and provide information about each of them.
Table of Contents
- Why Are Braces Necessary?
- Types of Dental Insurance Plans
- Braces Coverage under Dental Insurance Plans
- FAQs
Why Are Braces Necessary?
Unaligned teeth can cause problems such as overbite or underbite, making chewing and speaking difficult for children. Braces ensure that teeth are aligned in their correct position, providing better oral health for the children. Adolescent’s teeth may be crooked or overlap each other, making them difficult to clean, but orthodontic treatment can reduce the risk of tooth decay and gum disease. Properly aligned teeth give children confidence to smile and feel good about their appearance.
Types of Dental Insurance Plans
Dental insurance plans differ from the traditional health insurance you may be used to. Dental insurance plans often have a lower premium than regular health plans and cover routine dental care more extensively. There are several types of dental insurance plans available to families with children who require braces.
Discount Dental Plans
Discount dental plans offer the cheapest premiums for individuals and families. The primary benefit of a discount dental plan is that it provides a discount on dental services rather than providing insurance benefits. Discount dental plans are often much less expensive than PPO or HMO plans, but they have a limited number of participating providers.
The cost for braces under a discount dental plan varies by region, and also by the procedures and services you want covered under your plan. Benefits vary widely, and you may need to pay a deductible first. Before purchasing a discount dental plan, you should review the list of in-network providers, coverage limitations, and out-of-pocket expenses.
PPO Dental Plans
PPO dental plans are similar to traditional health insurance plans, but with more emphasis on dental coverage. PPO plans give you the freedom to choose your dentist, but you may need to pay more for out-of-network providers. PPO plans typically have a deductible, and once you have paid your deductible, the plan will cover a portion of the cost of your dental care.
With PPO plans, braces coverage is typically provided, but the coverage level and cost share may vary. You may need to pay a portion of the cost for braces, while the insurance plan covers the rest. Some PPO plans limit the amount of money they will pay for orthodontic treatment, so make sure you review your plan documents carefully.
HMO Dental Plans
HMO dental plans are similar to PPO plans, but with fewer options for dental care providers. HMO plans offer a lower monthly premium than PPO plans, but you will need to select healthcare providers from within the network. HMO plans offer orthodontic coverage similar to PPO plans, but you may need to follow certain rules, such as obtaining a referral from your primary care dentist before seeing a specialist.
Braces Coverage under Dental Insurance Plans
If you have insurance that covers braces, then you can expect some financial relief. However, not all insurance plans cover orthodontics, and those that do have a range of coverage levels.
Traditional Dental Plans
Traditional dental insurance plans may not cover orthodontic treatment. If your plan does, then you may have a lifetime cap on coverage, meaning that the plan will only pay for a certain amount of orthodontic care throughout your child’s life.
Discount Dental Plans
Discount dental plans generally do not offer coverage for orthodontic treatment. However, they do offer a discount on braces treatment costs. This discount can range from 10% to 60%, depending on the plan you choose.
Ortho Insurance Plans
Ortho insurance plans are designed specifically to cover orthodontic treatment. These plans typically have a lifetime cap on coverage, with a range of coverage of 50% to 80%. Ortho insurance plans often have additional benefits such as periodic adjustments and retainers. Some plans may require a waiting period before coverage begins.
FAQs
Q: How much do braces cost?
A: The cost of braces varies depending on the type of braces, the orthodontist’s experience, and the location of the orthodontist’s office. On average, braces cost between $3,000 and $7,000.
Q: Will insurance cover the cost of braces?
A: Depending on the type of insurance plan you have, orthodontic treatment may or may not be covered. Check your plan documents or contact your insurance provider to see if your plan covers orthodontic care.
Q: Can I use my Health Savings Account (HSA) to pay for braces?
A: Yes, you can use your HSA to pay for orthodontic treatment. You will need to check with your HSA provider to see what documentation they require and what expenses are eligible.
Q: How long does orthodontic treatment take?
A: Orthodontic treatment can range from 12 months to 36 months, depending on the severity of the alignment issues.
Q: Can adults get braces covered by insurance?
A: Yes, some dental insurance plans will cover orthodontic treatment for adults. Check your plan documents or contact your insurance provider to see what coverage is available.
Q: What is the best type of dental insurance plan for braces?
A: The best type of dental insurance plan for braces depends on your individual needs and budget. If you want the most comprehensive coverage, a PPO or HMO plan may be best. If you want to save money on the overall cost of braces, a discount dental plan may be more suitable.
Type of Insurance Plan |
Advantages |
Disadvantages |
|---|---|---|
Discount Dental Plan |
Low monthly premiums, discounts on braces treatment costs |
Limited network of providers, no coverage for orthodontic treatment |
PPO Dental Plan |
Freedom to choose providers, orthodontic coverage provided |
Higher monthly premium, deductibles may apply |
HMO Dental Plan |
Lower monthly premium, orthodontic coverage provided |
Limited network of providers, referral required for specialist care |
Ortho Insurance Plan |
Specifically designed for orthodontic care, periodic adjustments and retainers provided |
Lifetime cap on coverage, waiting period may apply |
In conclusion, braces can be a costly expense for families, but dental insurance can help ease some of the financial burden. There are several types of insurance plans available to families, including discount dental plans, PPO dental plans, HMO dental plans, and ortho insurance plans. Each plan has its own advantages and disadvantages, and it’s essential to review the plan documents carefully and consult with a dental professional to make an informed decision. By taking advantage of dental insurance coverage, parents can ensure that their children receive the orthodontic care they need to maintain excellent oral health.