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Use it Or Lose It: Does Dental Insurance Cover Orthodontic Treatments?

April 18, 2024

Filed under: Uncategorized — clearcoastdental @ 10:21 am
A closeup of a dental benefits claim form

Your family will likely need orthodontic work at some point. Maybe your child requires a fix for their crooked teeth, or you’d benefit from having your bite re-aligned. Given these facts, it’s easy to wonder: Does dental insurance cover orthodontic treatments? The answer to this question can impact whether (or how) you get crucial care. Well, your New Bedford dentist will gladly address your concern. Here’s how dental insurance can cover orthodontics and other ways to save money on treatment.

Context: What Does Dental Insurance Usually Cover?

Before moving on, it’s best to review what dental plans normally cover. A brief recap will help you learn the context of the “insurance and orthodontics” matter.

In general, most dental plans at least partially cover preventive and restorative services. This coverage tends to follow a 100-80-50 structure, as embodied by the following categories:

  • 100% of Preventive Care –  Dental plans almost always offer full preventive care coverage. That amount applies to checkups, teeth cleanings, dental X-rays, etc.
  • 80% of Basic Procedures – Basic procedures are services like dental fillings, tooth extractions, and root canals. Often enough, a dental plan will cover up to 80% of each option’s cost.
  • 50% of Major Procedures – Major restoration procedures include dental bridges, dental crowns, dental implants, etc. An insurance provider usually covers 50% of the cost of such treatments.

Will Insurance Cover Orthodontic Work?

As a rule, dental insurance rarely offers coverage for orthodontics. A given plan isn’t certain to cover this field’s treatments.

You see, orthodontic coverage varies from one plan to the next. Person A could have much of their care covered, while person B isn’t covered at all. Plus, it’s quite tricky to find coverage for adult orthodontics. Many dental plans only cover braces or aligners when the patient is 19 or below. That said, more insurance providers today have begun offering coverage for adults.

How Else Can You Save on Orthodontics?

Whether you have insurance or not, other ways exist to make orthodontic work affordable. Just look at a dental practice’s unique payment options. Given the right one, a smile can be aligned without “breaking the bank.”

Many dentists today have options like the following:

  • Special Offers – Depending on the time and place, some dentists offer free orthodontic consultations.
  • Dental Membership Plans – In exchange for a monthly or yearly fee, a dental practice could give you a major discount on orthodontic treatment.
  • Flexible Financing – A lot of dental practices work with 3rd party financiers like CareCredit and WiseTack. Through such groups, a patient could pay for orthodontic work in monthly installments.

So, does dental insurance cover orthodontic treatments? It can if the plan is a good one. That said, confirm your plan’s benefits before pursuing treatment.

About the Practice

Clear Coast Dental is based in New Bedford, MA. Led by its talented trio of dentists, our practice strives to provide quality dental care that meets your unique needs. We thus offer preventive, cosmetic, and restorative services, as well as emergency smile treatments. Our office also takes great pride in being a certified provider of Invisalign clear aligners and ClearCorrect. For more details or to book a visit, you can reach us on our website or by phone at (508)-812-9294.

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