Braces- insurance?

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Braces- insurance?

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amother

Wed, Dec 01 2021, 6:59 pm

Are there any health insurance plans that cover braces? If a plan has a max out of pocket, will it cover? Im in ny

thunderstorm

Wed, Dec 01 2021, 7:03 pm

If I recall correctly you need dental insurance for braces coverage. Our orthodontist charged $6000 for the braces and the max covered by insurance was $1500 which was the amount of the required deposit. After that we had a payment plan set up for $150 a month that got charged automatically to my credit card. Because it was paid in installments it didn’t feel like it was that huge of an expense .

amother

Tuberose

Wed, Dec 01 2021, 8:29 pm

We had a similar experience. Braces were covered by dental insurance, not medical. The benefit was in the neighborhood of $1500, which the orthodontist subtracted from our bill. The remainder was divided over 24 months (the usual amount of time the treatment takes).

chocolate moose

Sat, Dec 04 2021, 7:42 pm

I got care credit and paid them out

amother

NeonGreen

Sat, Dec 04 2021, 7:54 pm

it's dental insurance and I was told that many insurances require that you have dental insurance for a year before they will pay out so if you don't want to wait a year it might not be worth it. We were warned by the orthodontist's secretary. We get through the marketplace and just spoke to an insurance person who is looking in to it for us.

Optione

Sat, Dec 04 2021, 8:05 pm

Fidelis medical (Child health plus) will cover it if you meet enough criteria.

amother

Cornsilk

Sun, Dec 05 2021, 5:15 am

Americhoice/United healthcare pays full coverage if approved

amother

Strawberry

Sun, Dec 05 2021, 9:08 am

Optione wrote:

Fidelis medical (Child health plus) will cover it if you meet enough criteria.

My daughter had a severe overbite (the most severe you can have) and they still didn't cover it so I'm not sure what those criteria are Surprised

amother

Wheat

Sun, Dec 05 2021, 9:42 am

amother [ Strawberry ] wrote:

My daughter had a severe overbite (the most severe you can have) and they still didn't cover it so I'm not sure what those criteria are Surprised

I was advised to switch to United Healthcare Community Plan as they're more likely to cover than Fidelis.

amother

Lightcyan

Sun, Dec 05 2021, 10:19 am

amother [ Strawberry ] wrote:

My daughter had a severe overbite (the most severe you can have) and they still didn't cover it so I'm not sure what those criteria are Surprised

In the US most braces are done for aesthetic reasons and are not medically necessary. Yes there are medical justifications for braces but in the end for the most part slightly misaligned teeth are not impacting a person's health in a major way.

FWIW Medicare doesn't cover ANY dental expenses including false teeth which means that many older people of limited financial means don't have teeth which for many people can impact their overall health as they are unable to chew food properly and therefore don't have proper nutrition.

amother

Sienna

Sun, Dec 05 2021, 11:24 am

I have jersey care - medicaid and my child got fully covered through insurance bh , and I didnt think her teeth were so bad.

amother

Crimson

Sun, Dec 05 2021, 11:35 am

I have childhealthplus unitedhealthcare and they didn't want to cover my child has a couple of big issues. The Dr claims Medicaid United healthcare is more likely to cover.

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