What Are the Pros and Cons of Orthodontic Coverage?

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  • Written By: Geri Terzo
  • Edited By: PJP Schroeder
  • Last Modified Date: 27 May 2020
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Dental procedures and equipment can be difficult to afford for the average individual. Orthodontic procedures are even more expensive than average dental care, and coverage provided by an insurer can make circumstances more manageable. Insurance is there to supplement the cost of dental care, including orthodontic work, and this makes an expensive process more affordable. Cons tied to orthodontic coverage may reside in the fact that insurance companies can sometimes be slow about paying a dental provider.

Orthodontic coverage can make the difference in a young person or adult receiving the proper care, such as braces, retainers, and follow-up visits. An insurer may not pay for all of the expenses tied to orthodontic care, but it will at the very least pay something. Orthodontic coverage may be more extensive for a child or teenager than for an adult. Still, the insurer may pay for some of the orthodontic costs for an adult, but there may need to be some proof that the procedures are absolutely necessary.

Traditional dental coverage may not be comprehensive enough to include orthodontic coverage. This tends to be because braces and other orthodontic work is often more pricey than average dental work. As a result, a patient who knows that orthodontic procedures are in the future should select an appropriate plan to begin with or be willing to take on an orthodontics insurance plan.

If dental and orthodontics insurance is provided by a corporate employer, the benefits are most attractive. Typically, the employer contributes toward the monthly insurance payment, leaving the balance left to the employee. The employee's portion can be deducted from a paycheck. For the most part, if insurance premiums are paid on time, the insurance coverage should do what it is designed to do, and that is pay all or part of the expenses incurred.

Also, if there is any confusion or dispute about a claim, the patient might become responsible for the payments. This is why it may be a good idea to get confirmation from an insurer ahead of time outlining the percentage of dental and orthodontics expenses that will be covered and why. Orthodontic coverage may be more frustrating for the dental office than the patient because payments could be slow in coming. Sometimes, insurers lose paperwork and request that the same information be sent again before payment is made. This may not interfere with the orthodontic procedures for the patient, but it could cause more work for a dental office manager.

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