What's the best insurance to cover cost of braces, etc?

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peskywabbit
Posts: 40
Joined: Thu Oct 14, 2010 10:19 pm

What's the best insurance to cover cost of braces, etc?

#1 Post by peskywabbit »

Wondering what insurances archwired members are using to get reasonable coverage for ortho and orthognathic surgeries

I'm currently paying @$400/month for medical and dental. Since it's Kaiser it's an HMO and the dental only covers half my dental costs. I'm letting go of this real soon. Instead I'm shopping for a PPO that will cover some ortho, oral surgery and/or maxillofacial surgery costs as well.

I hear Aetna, Cigna and United Healthcare PPOs are decent. Have to admit, I'm worried that Cigna has gone cheap in the last couple years and not paying the docs much at all.

Would love to know what you're all using.

ArchWired28
Posts: 636
Joined: Mon Jun 20, 2011 10:44 am
Location: Tampa, FL, USA

Re: What's the best insurance to cover cost of braces, etc?

#2 Post by ArchWired28 »

From what I know, no insurance will pay for the orthognatic surgery UNLESS you (or your doctor) can really prove that this is medically needed. You can look up a very good explanation of what is considered medically needed or what is not in the web, at least I have Aetna and their explanation was very comprehensive. Also, many insurances will specifically exclude TMJ as a medically valid factor, so beware of that as well.
In general, good luck with your search. I have several friends going on through orthognatic surgeries and their fights with insurance companies were unbelievable :-+
Had full mouth metal braces for 21 months. Debonded April 2013. Now wearing clear plastic retainers every other night.

I have no formal dental or orthodontic education. Hence, all opinions expressed by me on this forum are those of an "informed consumer" and by no means intended as an expert advice.

Snowglobe32
Posts: 1224
Joined: Fri Oct 02, 2009 9:05 pm

Re: What's the best insurance to cover cost of braces, etc?

#3 Post by Snowglobe32 »

I would research for your area the different companies because the amounts vary from each state.
I have delta and lifetime ortho coverage is $1,500.00 and regular dental coverage, I think, is $2000 a calendar year. Other folks who have delta have higher amounts than me...not sure why.

Are you paying on your own?
Can you do more than one company at a time?

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methoddan
Posts: 55
Joined: Mon Aug 15, 2011 7:42 pm
Location: Colorado

Re: What's the best insurance to cover cost of braces, etc?

#4 Post by methoddan »

I have Delta Dental of California (Delta PPO) through my work. My lifetime ortho is $2000 and my calendar year max for dental is $1500.
Braces on August 9, 2011
Braces off November 30, 2012

My braces story take #2

blogtarp
Posts: 1
Joined: Fri Aug 26, 2011 7:31 pm

Re: What's the best insurance to cover cost of braces, etc?

#5 Post by blogtarp »

We have dental insurance through work but coverage is not good. It only covers 1 prophylaxis per year, 6 tooth fillings and 2 tooth extractions. Any ortho procedure is not covered. Thats the reason we got full coverage dental plans because our dental insurance is not good.

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