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Does Aetna Dental Insurance Cover Braces and Orthodontics?

Does Aetna Dental Insurance Cover Braces and Orthodontics?

Your teen has been begging for braces for months. Her four front teeth are crowded, and it’s starting to make her feel self-conscious around people at school. You never had the chance to get braces as a teen either and you’re starting to think about looking into orthodontics for the both of you.

But does dental insurance cover braces, much less orthodontics for adults?

Yes, With a Few Restrictions

Dental insurance typically includes braces for people under 18. You can find plans that cover orthodontic treatments for adults.

Here are a few things to keep in mind when it comes to getting insurance to pay for treatments with your orthodontist:

Most dental insurance plans will…

• Only cover one round of orthodontic treatment per lifetime. If your child requires Phase I and Phase II ortho, the second series may not be fully covered.
• Have a maximum allowable orthodontic fee that the plan covers, meaning they only pay for braces up to a certain dollar amount – typically $1000-$1,500. That’s roughly half the cost of basic metal braces.
• Put possible age restrictions on when they pay for braces.
• Cover all types of braces, but base your benefits on total cost. If you choose a more expensive type of appliance (such as tooth colored brackets or clear aligners,) you will still be using the benefits set up for conventional metal braces and have to pay the difference.
• Include diagnostic X-rays needed during your orthodontic therapy, but only if they do not coincide with duplicates taken by your family dentist.

Do Some Braces Cost More Than Others?

Over the past several years, a variety of braces designs have been developed to meet the diverse needs of patients. For instance, clear aligners eliminate the visibility of metal braces, and tooth-colored appliances make conventional designs more discreet.

At first, some of these braces cost significantly more than others. When it came to insurance benefits, it seemed like the plan didn’t cover as much of the total fee, because of the maximum amounts set in place.

Fortunately, many of these different types of braces are more affordable than they used to be. Some are almost the same cost as conventional orthodontics. As more technology becomes available, the fees for modern (and “invisible”) orthodontic therapies have become more competitively priced. As a result, a larger percentage of the treatment is covered by your dental insurance plan.

Does Length of Treatment Affect Costs?

Some people have to wear braces longer than others. Maybe you have an offset jaw or severe tooth misalignment. One person could complete their orthodontic therapy in just 12 months, while you need closer to 18-24.

Does this affect the cost of your braces? Yes, but not as much as you would think. While more complicated treatments do involve additional time and subsequent fees, wearing them for half has long does not cut the treatment costs in half. The total amount may only fluctuate by 15-25%, depending on your provider.

Since most people apply their insurance benefits to their total treatment costs, then finance the remaining balance, your overall month-to-month expenses will not vary by much.

Getting a Quote from Your Orthodontist

Fortunately, most orthodontists offer free or complimentary orthodontic evaluations. So, no matter what type of insurance plan you have, you can bring your card with you to the appointment and get a breakdown of the total cost (and length of time) involved.

Your orthodontist will verify your benefits and incorporate the estimated coverage into your treatment plan. Then if you decide to go ahead and move forward with getting braces, you may be able to start the very same day. Most offices also have flexible monthly financing at 0% interest.

Alternatives to Insurance for Braces

Another option to consider is enrolling in a dental savings plan. This specific type of discount dental program applies a set amount off of your braces treatment, regardless as to which type of appliances you choose to get.

Plus, discount dental plans don’t have maximum allowable amounts, so you can apply the discount to the total cost of your braces instead of up to a set dollar figure.

Ask one of Aetna Dental Offers savings representatives if a discount plan is right for you!


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