Insurance Covering Ortho?

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#1 Post by **KJNELLAMORE** » Wed Apr 26, 2006 12:34 pm

Has anyone in the US had any part of their Ortho treatment covered by their Medical or Dental insurance? If so, what was covered and by whom? TIA!!

#2 Post by **blondie111** » Wed Apr 26, 2006 12:50 pm

I looked into it on my insurance, but it only covers it for members up to 18 yrs. old

which they need to change, since more and more adults are doing it. If I could prove it was for medical reasons, it would pay part of it, but I really don't have any seriuos medical issues... sorry that didn't help much.

#3 Post by **jeniwan** » Wed Apr 26, 2006 1:25 pm

My husband and I have double coverage through the same dental insurance... combined it's covering $3000 of my treatment. Luckily, my insurance covers adults as well.

#4 Post by **jcdamon3** » Wed Apr 26, 2006 1:25 pm

My dental covers 50% of ortho up to $2,000.00 for anyone, including adults. I have been in braces 8 months and they are almost done paying. I think I have around $400.00 left and the max of $2000.00 will have been hit.

When the ortho and I negotiated they took the $2,000.00 right off the balance and computed my payments based on the fact that the insurance company would pay.

My dental insurance also covers things like cleanings @ 100%, fillings @ 50%, implants @ 50%, root canals @ 50%.

I am lucky. I think my insurance was one of the final deciding points in getting this treatment. The benefit was there and unused. Better to use it now and get my teeth fixed than spend more on other stuff later.

#5 Post by **jaswi** » Wed Apr 26, 2006 1:35 pm

while my insurance coveres 80% of just about all dental work, 50% on rest, 100% of preventative, they only cover $1500 on orthodontics, and only for children.

#6 Post by **Leslie022** » Wed Apr 26, 2006 3:24 pm

My parents have double coverage. My dad is a retired state trooper and current county sheriff's deputy, so we have state and county benefits. I didn't think I would have any part of my treatment covered because of my age. I think the insurance company might have felt sorry for me, though, because I am the resposible party (not my parents) and I am a full-time student. I've received around $600 back from them. It's been a month or two since I received a check but the way I see it, if that's all I get from them, then I'm happy. It's $600 extra I'm able to put toward my treatment.

#7 Post by **KJM** » Wed Apr 26, 2006 6:05 pm

When I started we didnt have ortho coverage ( we had dental but no ortho) , but this March dh's company added it!! It covers 50% ( up to $2000) for kids and adults, and will even cover in progress ortho. ( pro-rated but since I was only a 6 months into a 30 month treatment plan I should get the whole $2000 coverage)

#8 Post by **DizzyKitty** » Wed Apr 26, 2006 9:52 pm

No, sadly our dental doesn't even cover ortho for kids. My husband had the option of going w/ a better plan but he would have had to wait for 1 yr b4 using it and he had immediate work that needed to be done to be pain free. We will have to upgrade eventually if kiddo needs braces, which looks like he will.

#9 Post by **KJM** » Thu Apr 27, 2006 4:25 am

Meryaten wrote: KJM - your new insurance covering work already in progress is awesome

Oh yeah we were really excited about it!!!! The ortho office was surprised to say the least, and I was doing a happy dance!!!

[/quote]

#10 Post by **Aine** » Thu Apr 27, 2006 10:21 am

I have my dental coverage through a company called Concordia. Luckily, it covers adult orthodontics up to $1,500......that is a little over a third of my cost so that is a significant help!

#11 Post by **KJNELLAMORE** » Thu Apr 27, 2006 12:20 pm

Aine wrote:I have my dental coverage through a company called Concordia. Luckily, it covers adult orthodontics up to $1,500......that is a little over a third of my cost so that is a significant help!

Hmm we have concordia, but apparently ours doesn't cover ANY ortho? Hmm.. I wonder if there are different plans? do you have yours through an employer or do you have it by yourself?

#12 Post by **cheerikimi** » Thu Apr 27, 2006 1:46 pm

I have Delta Dental and they cover 50% up to $2000 for children and adults.

#13 Post by **mommy1** » Thu Apr 27, 2006 2:00 pm

i'm under my parents' dental insurance until i'm 23 years old. i have delta dental, which instead of covering a particular amount they gave me a discount on my treatment. for example, at my ortho's office, people who don't have insurance would have paid $4200 for the braces itself. since i have delta, i only have to pay $1800.

For an 18 month treatment, I paid a total of $3500 that included:
- full upper/lower ceramics with maintanence/treatment
- retainers afterward and 2 years of follow-up for it
- initial records and final records

hope that helps

#14 Post by **KJNELLAMORE** » Thu Apr 27, 2006 2:04 pm

thanks all! darn, delta isn't available here in Louisiana. Blah!

#15 Post by **cat t** » Thu Apr 27, 2006 8:48 pm

I believe I was very lucky. I only paid $895 for my braces, everything, followups, etc. included. HOWEVER, we are paying about $95 a month for a family dental plan. With health, dental, and vision we were paying more in premiums than our house payments last year, and my employer pays my portion. So I do not know if that is really the bargain it initially sounds like. If I would have to pay 3 or 4 grand I doubt I would have done it. Ths almost $900 chunk was quite a bit because my teeth were not really badly out of whack. But having the braces off for 10 days now my teeth look great, even with retainers, and I am glad that I did it. And I plan to faithfully wear my retainers the rest of my life, because I will never again be able to have braces.

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