Does dental insurance cover braces?

When it comes to dental insurance, many people wonder if braces are covered. The good news is that many dental insurance plans help cover orthodontic care, so you or your children can get braces without breaking the bank. Understanding how dental coverage for braces works and what restrictions may exist can help prepare you before making any decisions. 

How does dental coverage for braces work

Insurance plans that include orthodontic care usually cover a percentage of the cost of dental work and braces, and that coverage depends on your plan. Some plans may require a deductible before any coverage kicks in, while others may not. Additionally, many dental plans have a lifetime maximum benefit that they will pay out for orthodontic treatment. Most insurance companies also require preauthorization before starting any orthodontic treatment, so check with your insurer first if you plan on getting braces.

Things to consider when picking dental insurance

When researching different dental insurance plans, there are a few essential items to consider. First, read the fine print in your plan to determine exactly what type of braces are covered and whether or not there are any limits on the amount of coverage offered. Some plans only cover specific options like traditional metal braces and not other more modern solutions like clear aligners. It’s also important to note that some insurance plans may only cover braces for children or teens, while others provide coverage regardless of age.

Here are some steps to take when picking a new plan:

1. Determine what your dental needs are and make sure the insurance plan helps meet those needs.
2. Check to see if the dentist you want to use is in-network or out-of-network for the plan you’re considering.
3. Look at how much you’ll pay out-of-pocket for each procedure, including deductibles, coinsurance, and copays.
4. Consider any restrictions on orthodontic coverage, such as waiting periods or annual maximums, that the plan might impose. 
5. Review the limitations on which providers can be used; some plans may require a referral from a primary care provider before visiting a specialist outside the network. 
6. See if any additional benefit services are offered, such as discounts on cosmetic treatments or whitening treatments, as well as discount programs for over-the-counter dental supplies and medications.

Other procedures dental insurance may cover

Other procedures covered by dental insurance may include root canals, fillings, crowns, bridges, orthodontics, dentures, periodontal treatments, and tooth extractions. Some policies may also include coverage for sedation dentistry or emergency care. The average dental insurance cost can vary, but this type of plan is often affordable for individuals and families.

Bottom Line

Overall, if you are looking into getting braces and want to know whether your dental insurance covers them, it is best to speak with your provider directly for more information. They can provide clear answers and help you determine the best plan for your individual needs to get the most out of your insurance coverage. 

Content within this article is provided for general informational purposes and is not provided as tax, legal, health, or financial advice for any person or for any specific situation. Employers, employees, and other individuals should contact their own advisers about their situations. For complete details, including availability and costs of Aflac insurance, please contact your local Aflac agent.  

This is a brief product overview only. Coverage may not be available in all states, including but not limited to DE, ID, NJ, NM, NY or VA. Benefits/premium rates may vary based on state and plan levels. Optional riders may be available at an additional cost. Policies and riders may also contain a waiting period. Refer to the exact policy and rider forms for benefit details, definitions, limitations and exclusions. For complete details, including availability and costs, please contact your local Aflac agent.

Coverage underwritten by Tier One Insurance Company:

Dental, Vision and Hearing: In Arkansas, Policy T80000AR. In Delaware, Policy T80000. In Idaho, Policy T80000ID. In Oklahoma, Policy T80000OK. In Oregon, Policy T80000OR. In Texas, Policy T80000TX. Plans not available in New York, Pennsylvania or Virginia. Dental claims are administered by Aflac Benefits Solutions, Inc. Vision claims are administered by EyeMed Vision Care, LLC.  Hearing claims are administered by Nations Hearing. NOTICE: The coverage offered is not a qualified health plan (QHP) under the Patient Protection and Affordable Care Act (ACA) and is not required to satisfy essential health benefits mandates of the ACA. The coverage provides limited benefits.

Coverage underwritten by American Family Life Assurance Company of Columbus. In New York ,coverage underwritten by American Family Life Assurance Company of New York:

Dental: In Arkansas, Policies A81100RAR through A81400RAR. In Idaho, Policies A81100RID through A81400RID. In New York, Policies NY81100 through NY81400. In Oklahoma, Policies A81100OK through A81400OK. In Oregon, Policies A81100OR through A81400OR. In Pennsylvania, Policies A81100PA through A81400PA. In Texas, Policies A81100TX through A81400TX. In Virginia, Policies A81100VA through A81300VA.

Aflac WWHQ | Tier One Insurance Company | 1932 Wynnton Road | Columbus, GA 31999  

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