Slightly over half of all Americans have dental insurance. Such plans don’t always cover orthodontic procedures, like getting braces or having jaw surgery. Those operations are usually paid for by plans that specifically cover orthodontia. But is orthodontic insurance worth it?
The answer isn’t the same across the board and depends on a few factors. Let’s take a closer look at orthodontic insurance and some things you should consider before taking out a policy.
What Is Orthodontic Insurance?
Orthodontic insurance covers procedures and practices related to teeth and jaw alignment. This type of insurance is typically offered as an “add-on” to a dental plan and usually isn’t available as a standalone insurance that can be purchased separately from dental insurance.
Mostly, orthodontic treatments involve using appliances to correct issues over time. Some typical items covered by orthodontic insurance include braces, retainers, clear aligners, bite correctors, and space maintainers. Orthodontic insurance can also cover surgical procedures to correct severe alignment problems, including osteotomies (jaw repositioning), facial profile adjustments, chin surgery, and tooth repositioning.
In short, the procedures and products orthodontic insurance covers involve skeletal and structural issues. These include common conditions like overbites, underbites, crowded or irregularly spaced teeth, and jaw displacement.
What Does Regular Dental Insurance Cover?
Regular dental insurance generally addresses issues related to oral health. The procedures and treatments it covers largely fall under the category of preventive care — regular cleanings, checkups, X-rays, etc.
Dental insurance covers treatments and procedures to keep teeth healthy and functional. This includes common practices like filling cavities, extracting teeth, and performing root canals, as well as corrective implements like dentures, bridges, and crowns.
The key difference between regular dental insurance and orthodontic insurance is one of form versus function. Orthodontia addresses structural and physical issues, while normal dental procedures focus on keeping teeth healthy and operational.
With that in mind, is orthodontic insurance worth it on top of regular dental insurance?
When Is It Useful to Get Orthodontic Insurance?
There are a few situations where you might benefit from having a separate orthodontic insurance policy. For instance:
You’re planning to get braces for yourself or your child
Your family has a history of orthodontic issues
You or a loved one need surgical procedures to resolve pain issues
You’d rather pay for orthodontic needs in insurance installments rather than one lump sum
You want to fill in coverage gaps in your dental insurance plan
All of these reasons for getting orthodontic insurance are valid, but are they enough to justify the added expenses? Let’s take a closer look.
Can Adults Get Orthodontic Insurance?
One reason many people question whether to get orthodontic insurance is tied to public perceptions of orthodontia. Specifically, people often associate the practice with issues mostly affecting children and teenagers.
The most common and well-known orthodontic procedure is the installation of braces. This procedure is most frequently used to correct issues that occur during adolescence, like facial alignment and bite problems.
However, this perception is changing. More adults are turning to advanced orthodontic measures to correct various issues, even if they’re more aesthetic than health-related.
Some of the advances that have emerged in the late 20th and early 21st centuries include clear aligners (Invisalign), lingual braces, temporary anchorage devices (TADs), and “smart” braces.
Adults can get orthodontic insurance to cover all these procedures and products. Even so, it’s relatively rare for adults to take out this specific type of coverage.
How Much Does Orthodontic Insurance Cost?
The cost of orthodontic insurance varies from one policy to the next. Monthly premiums may depend on several factors, including coverage level, age, maximum coverage limits, waiting periods for certain benefits, and even the state you live in.
Generally speaking, however, basic orthodontic plans are relatively affordable. In 2022, Aetna offered comprehensive dental insurance, including orthodontics, for around $22 a month. Additionally, many orthodontic insurers offer low deductibles on orthodontic services.
Although premiums and deductible costs can differ based on coverage limits and other conditions, orthodontic insurance can make a big difference when it’s time to have a procedure.
Getting braces without orthodontic or dental insurance can cost between $3,000 and $10,000. Comprehensive dental coverage that includes braces can cut that cost by as much as half.
Questions to Ask When Considering Orthodontic Insurance
If you’re on the fence about getting orthodontic insurance, it can help to come up with answers to the following questions:
Do you or your family have pressing or historical orthodontic needs?
Does your dental plan already cover orthodontic procedures?
What network does the plan use, and is your preferred orthodontist in it?
What are the coverage limits?
Are there any exclusions in the policy?
Can you get discounts on orthodontic services without a dental or orthodontic plan?
Given the typical complexity and cost of orthodontic procedures, reflecting on these considerations is important before talking to an agent.
Is orthodontic insurance worth it? If you’ve weighed your options and decided you have room in your monthly budget, an orthodontic insurance policy can help defray the costs of more expensive orthodontic procedures. The improvements they make to your health and happiness may be worth the cost.