Your Dental Insurance Plan - Orthodontic Insurance

Getting coverage for braces and orthodontic dental care

Woman Having Teeth Checked While Smiling at Orthodontist
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Orthodontic Insurance for Adults and Kids

Orthodontic insurance used to be something that people only thought about for their kids, but these days if your health insurance can help you get that smile you always dreamed of, it is definitely worth shopping around for and finding the best supplemental health with dental insurance that will cover what you need. 

Orthodontic Coverage in Dental Insurance 

Orthodontic insurance can provide many benefits aside from braces.

Many adults turn to orthodontics to correct a number of problems that may only come up later on in life. For example, moving teeth or previous orthodontic work that may be shifting and require a retainer. The field of orthodontics has a lot to offer people at all stages of life, so it is no wonder that finding coverage for yourself and your family can be important.

Do health insurance plans with dental benefits cover orthodontic work?

Not all health insurance plans with dental benefits cover orthodontic work, although more health plans are covering orthodontic work, the level of coverage varies, and some plans only cover orthodontics for children.

If I have dental insurance in my employee benefits plan, does this cover orthodontics?

All health plans do not cover orthodontics, just because you are covered under employee health benefits package, it does not mean your plan sponsor chose to include orthodontics.

They may only provide limited coverage. You can check under the dental section of your benefits package or ask your HR person or benefits manager to help you figure out if it is already covered.

If you have a spouse or domestic partner who also has dental insurance, you should also find out if there is any possibility of coordination of benefits or supplemental insurance on their plan.

It is very important to specifically ask about the coverage for orthodontic work, ask about the annual limits, if there are annual deductibles or other deductibles and if the coverage is for all plan members or if it only covers children under 18.

7 questions to ask to get good orthodontic dental Insurance coverage:

  1. Are there early or lifetime maximum benefit limits?
  2. Does coverage apply to adults or only children?
  3. Is there a waiting period before coverage can begin?
  4. If treatment has begun before the plan starts, will it still be covered after the waiting period? Are there any restrictions?
  5. Are there any non covered types of braces?
  6. Are there any restrictions on orthodontists, for example, do they have to be within a specific health network?
  7. Is there a deductible for orthodontic work?

Does your dental insurance plan cover orthodontic care such as braces? 

Many people who currently have dental insurance assume that they have some coverage for orthodontic care but that is not always the case. 

Review Your Current Dental Plan Coverages

The first step in starting your search for orthodontic insurance is to review what you have currently. Take a look at your individual or employer-sponsored dental insurance plan to see what coverage you have for braces and orthodontic care.

If you find you have no or little coverage, or if you are unemployed you can research other dental or health insurance plan options.

How to Find a Dental Discount Plan

You have a few options on how to go about getting a dental plan. You may want to decide if you want a dental insurance plan or a dental discount plan first. With a dental insurance discount plan, you will get a certain percentage off your dental visits and orthodontic care. Discount plans may restrict you to certain doctors that accept the discount plan. You can find out more about Dental Discount Plans in the DentalPlans database which represents over 40 different discount plans.

With a dental insurance plan, you would use it as you would health insurance. You would possibly pay a co-pay for some services and maybe a deductible before some services depending on what you choose.


What orthodontic care is covered?

After you have decided which dental plan you would like, either a dental insurance plan or a dental discount plan, next you will want to research what orthodontic care is covered. Along with researching the orthodontic coverages, you will want to research four more areas of the dental plan:

  • Premiums
  • Deductibles
  • Co-pays
  • Exclusions.

Everyone's situation is different so just because you find a dental plan with a low premium, that does not mean it is the best plan for you

4 places to help you find dental insurance

  1. The National Association of Dental Plans is a great resource to help you find a plan, it is a dental insurance marketplace that can offer you options and information on the various dental plans available. You can choose your state and do a search based on what you are looking for. It can really save you the time of searching aimlessly online.
  2. As you are doing your research to find a plan that covers orthodontics, besides associations you should also check with your employer.
  3. Another great place to look is by speaking to dental and orthodontic doctor's offices to see if they have any recommendations. Knowing what insurance certain doctors accept is especially important if you would like to go to a specific doctor. 
  4. If you have a health insurance broker or agent, you can get their help to find a plan that will serve your needs and what you are looking for, if you find that all the research is overwhelming, they may be able to save you some time.