Can you get braces again with insurance?

Can you get braces again with insurance?
Image: Can you get braces again with insurance?

Yes, some insurance plans cover the cost of braces. The coverage and amount available vary between individual insurance providers and policies, so it is important to contact your insurer directly to find out if you are eligible for braces coverage and what restrictions apply. The type of dental services that are covered by a given plan may depend on whether you are enrolled in an employer-sponsored plan or an individual policy.

What are Braces?

What are Braces?
Image: What are Braces?

Braces are an orthodontic appliance used to straighten and align teeth. They are most commonly used in children and teenagers, however, adults can benefit from them as well. Braces consist of metal brackets or wires that are connected to each individual tooth. The brackets or wires can be adjusted over time to gradually move the teeth into alignment. In addition to being able to give your smile a straighter appearance, braces may also improve the function of your teeth by making it easier for you to bite, chew and speak without difficulty.

The type of braces that is best for you will depend on various factors such as the severity of misalignment and the goals you have for your treatment. A dentist or orthodontist will be able to provide advice on which type of brace would work best for you based on their professional opinion. Some common types include traditional metal braces, ceramic braces (which blend more easily with your natural enamel color), lingual braces (which attach to the backside of your teeth) and clear plastic retainers (which hold new positions in place). Your dental care provider can discuss all available options with you so that you can make an informed decision about which option is best for achieving desired results.

Benefits of Wearing Braces

Benefits of Wearing Braces
Image: Benefits of Wearing Braces

Braces can provide a number of advantages for those looking to get their teeth straightened. Not only do they help with providing a great aesthetic appearance but there are other long-term benefits as well.

When it comes to the health aspects of having properly aligned teeth, braces can prevent a wide variety of issues down the line such as gum diseases and jaw pain. Brushing and flossing becomes much easier when your teeth are in alignment since food debris won’t become trapped in between them leading to quicker plaque formation. Those who suffer from TMJ disorders may experience relief if they wear braces since the force exerted on the jaws is better distributed throughout the mouth rather than just focused on one particular area.

Using braces often helps people improve their speech which can be especially beneficial for children who are growing up learning how to pronounce certain sounds clearly and articulately. As an adult, you may also feel more confident talking in front of others knowing that your teeth aren’t jutting out or overlapping each other which is often seen as unappealing.

Who Typically Qualifies for Orthodontic Insurance?

Who Typically Qualifies for Orthodontic Insurance?
Image: Who Typically Qualifies for Orthodontic Insurance?

When it comes to orthodontic insurance, there are certain criteria that must be met in order to be eligible. Generally speaking, a person must meet the following conditions to qualify for coverage: they must have been enrolled in a dental plan prior to their braces being fitted and the dental plan must include an orthodontic component. The cost of braces should not exceed any existing caps or limits set forth by the plan.

The availability of orthodontic insurance also depends on one’s age and whether treatment is deemed medically necessary. Adults over the age of eighteen typically have difficulty getting covered due to insurers viewing adult braces as more cosmetic in nature than corrective; however there are exceptions that can allow adults access if their condition meets established medical requirements as outlined by their particular insurer. On the other hand, minors usually qualify for coverage easily, but depending on local laws may still need parental consent before undergoing such procedures.

In addition to meeting eligibility guidelines, some insurance providers will only cover braces when applied under the care of specific dentists and physicians who agree to accept predetermined fee schedules; this means patients may have a greater chance at getting approved if they find an expert within this small network who is willing and able to administer treatments according to pre-agreed upon terms and prices set forth by the insurer.

What Does Orthodontic Insurance Usually Cover?

What Does Orthodontic Insurance Usually Cover?
Image: What Does Orthodontic Insurance Usually Cover?

When searching for orthodontic insurance, it is important to be aware of the types of services that are typically covered. Generally speaking, most plans will include basic treatments such as braces or Invisalign aligners. Many also provide coverage for additional corrections such as crossbites and overbites. Sometimes, a policy can even extend to retainers and other corrective appliances.

For those who need more substantial work done, some insurances offer coverage for major surgeries such as jaw repositioning and wisdom tooth extractions if they are related to the correction of your bite or teeth alignment. They may also offer partial reimbursements on plastic restorations like veneers or dental bonding if they are necessary to perfect your smile following the procedure.

On top of all this, many policies actually cover pre-procedural consultations and checkups in order to determine whether you qualify for certain procedures under their plan before you begin treatment. All of these features vary from one insurer to another though so it is important to review each individual policy carefully before committing to it.

Are There Special Circumstances When You Can Get Braces Covered with Insurance?

Are There Special Circumstances When You Can Get Braces Covered with Insurance?
Image: Are There Special Circumstances When You Can Get Braces Covered with Insurance?

In some cases, people may be eligible to receive orthodontic coverage from their health insurance plan. Those who are able to obtain braces with insurance will likely have special circumstances in order to qualify for this service. This could include being referred by a dentist or doctor, having dental problems that would benefit from braces treatment, and being age appropriate for this type of care.

Individuals who had previously worn braces as a child but have noticed the teeth shifting back out of alignment could also be considered for reinsurance coverage. Insurance companies may take into consideration any past history with corrective dental work when determining eligibility for a new policy. It is important that applicants provide all relevant records pertaining to prior orthodontic work when applying for braces coverage.

Those looking to get covered through their health insurance plan should speak with an agent directly in order to verify if they meet the criteria set forth by their insurer. Qualifying members may receive coverage up to 80 percent of the cost of braces and related services such as retainers, mouth guards and other periodontal devices. Each year your premiums may increase depending on how much you use your benefits towards orthodontic procedures over that time span.

How to Get the Most Cost Savings from Orthodontic Insurance

How to Get the Most Cost Savings from Orthodontic Insurance
Image: How to Get the Most Cost Savings from Orthodontic Insurance

The cost of orthodontic care can be expensive, but insurance may help you get the most out of your braces. Many dental insurance plans offer comprehensive coverage for orthodontics, so it’s worth researching to find out if your policy covers all or some of the costs. If you have orthodontic insurance, there are a few steps you can take to maximize your savings.

First and foremost, be sure to keep up with regular check-ups and cleanings. Staying on top of these appointments means that problems will be caught early, saving time and money in the long run. It also allows your dentist to monitor any changes in alignment or bite which could make treatment simpler and less expensive down the line.

Second, compare different providers before selecting an office for orthodontic work. Some providers will offer discounts for paying upfront in full or direct billing with certain insurers – both methods that can lead to great savings over time. Researching each option is key for getting the best price point possible.

Don’t forget about other available options such as tax deductions or flexible spending accounts (FSAs). Although FSAs can only be used once a year at select times, they can often lead to greater overall reductions since FSA funds are not taxable income like other forms of reimbursement are. Inquire at your office about the best way to use these types of programs when looking into orthodontic care options.

  • James Berkeley

    Based in Bangkok, James simplifies insurance with a personal touch. Proud alumnus of the University of Edinburgh Business School with MSc in Law.


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