Braces, whether for cosmetic or medical purposes, are a life-changing smile-transformation treatment. But, there’s no denying they can sometimes come with a significant financial investment. If you know braces are in your future, it’s never too early to start talking to your insurance company about your coverage options. Before you pick up the phone, start by asking your orthodontist one key question: are your braces a medical necessity? Many dental plans cover braces, but to be sure if your plan does, you first need to be sure of your problem and the suggested solution.
Why You Need to Know If Your Braces Are Medically Necessary
Some insurance providers may place restrictions on their coverage. You may face difficulties trying to get braces covered under your insurance plan if restrictions are in place. This is unless a dental professional has deemed that they are a medical necessity. If you aren’t sure what restrictions you may have on your plan, contact your insurance provider directly. Discuss your intentions with them prior to beginning any treatment plan so you can prevent complications later on.
Questions to Ask Your Dental Insurance Provider
Aside from asking them about restrictions in your coverage, you should also ask your insurance company the following questions:
Is “Orthodontic Care” in your plan?
Most dental plans will include Orthodontic care as a benefit. However, if it isn’t then you will be held responsible for the full cost of your braces. Those who are eligible should make sure to ask their insurance providers how much financial assistance will be offered. Some companies will cover as much as 25 to 50 percent of the cost of braces. This can absorb a significant amount of the financial burden.
Do you have a Lifetime Limit?
If you have a lifetime limit on your policy, then you should double check with your provider to see how much it is. And whether or not you have already applied any treatment towards this total amount. If your plan does offer orthodontic care benefits to help cover part of the costs of your braces, a lifetime limit could impact the amount you end up owing out of pocket.
Many Dental Plans Cover Braces
Many dental plans cover braces, but there are certainly circumstances that may cause difficulties. So always check with your insurance company. Ensure you clarify your policy coverage before you commit to braces or any other treatment plan.
Book an appointment with Bachmayer Orthodontics to discuss your treatment options.