How much does insurance cover for braces?

[Aurora D]

I'm a teacher. No ortho coverage. My daughter's braces cost $6,000 out of pocket. Luckily the doctor offered a payment plan. My daughter is 21 now. The braces came off 4 years ago and I'm still paying for them!But down to the last $400 owed. Very depressing! lol

 

[wendow]

Our dental insurance pays a grand total of $0.00 for orthodontics.

Yup, same here. So jealous of everyone who had even a small part paid!

 

[tvguy]

It depends on your insurance. When my DD got her braces, the insurance covered 50% and I had to pay the other 50% out of pocket

Absolutely.

No way for us to know what your insurance covers. Mine was a joke, cap of $1,000, but required you to keep the coverage for 2 years, which added up to, drum roll, $1,000 in premiums.

 

[shelly3girls]

Our insurance only covered $1000 per person. I would get another opinion. Is there anyone near you who uses the Damon system? Both my girls were told they would need an expander but neither did with this system. Oldest DD has a small mouth with lots of over crowding while younger DD had a cross bite. Using traditional braces both girls would have needed two phases and different gear. Using the Damon system they both only needed the braces.

It's taking over two years to fix the oldest one's mouth but only a year for the younger one. Even though the oldest is taking longer than expected we are not being charged anything extra.

 

[4shinystars]

Our dental insurance pays a grand total of $0.00 for orthodontics.

Same here, DD 1 was $4200 Back in 2002 and DD2 was $5100 in 2008.

 

[tasha99]

My insurance as a teacher was 50% up to $2000 total. Switched to healthcare (I was a speech teacher--more of a therapist) and it's the same. We moved and it will be interesting to see what the new insurance pays. They say they will deduct what previous insurance paid, which seems wrong to me.

Braces are about $7500 and in progress. Teeth pulled added about $3000. Luckily, insurance paid for the tooth pulling at 80%.

 

[Eureka]

Our Delta Dental plan covers $1000 per patient. Certainly helps but is not even close to the total bill. DS12 is getting his off soon after a little over a year, a "quick easy fix" according to the ortho, and our part was still over $3000. And our dentist just told us that once he loses all his baby teeth, we will be sending DS10 there too. Hope that is a quick, easy fix too!

 

[descovy]

She knows - its $800. I think she's trying to figure out if she has decent insurance, because there is the option of switching from her husband's plan to her plan.

And at this point, its worth looking at her benefits and delaying until she can enroll in her plan if the benefits are better.

Also, OP, you should know that there usually isn't a burning need for two phase braces. My daughter had them, and something like 80% of kids who have phase one will need phase 2. If you skip phase one and wait, phase two will take longer - but its rare that there are issues that REALLY should have been fixed by phase one braces. For us, two phases wasn't a financial stretch - if it is for you, get a second opinion on two phases. Orthodonists love it - its more money for them - and frankly, I loved having my daughters teen set on for less than a year - but its an expensive choice.

I would add too, you should see more than one orthodontist. Consults are usually free. Not only do prices vary (by a lot!) but so do treatment options. On the same kid, I have been told 2 phases, wait until later, want to pull teeth, no pulling teeth, ortho wants to make a custom appliance, etc., etc.,

I made my final decision by talking to their dentist. Without giving Orthodontist names, I told her the treatment options I was given. I have 3 kids, and she picked the same ortho for all 3.

In that mix, one waited to have braces and will have them for 2 years. 2 will have 2 phases. One needs teeth pulled the other did not.

Our dental insurance seems to change annually (ugh) Insurance has covered $1000 in one plan and $1500 the next plan. (not all kids had braces at the same time)

So check different orthodontist too. Don't be lured by the cheapest, especially if they want to pull teeth. That is done by an oral surgeon, and it may not be the cheapest option in the end, if you know what I mean. However, it doesnt take from the orhodontist benefit, and sometimes medical insurance picks up part of the tab.

Been there, done that... times 3

 

[descovy]

Our insurance only covered $1000 per person. I would get another opinion. Is there anyone near you who uses the Damon system?.

We checked an ortho that did the Damon system.

BTW... my ortho was THE Dr Damon that invented the system. Spokane WA 1990-'92, he was my ortho!

Last summer we were at a consult where the ortho was explaining the Damon system. I just kinda said off hand, oh my ortho's name was Dr Damon. Had no idea he was THE Dr Damon.

Sure he's doing pretty well these days! I went to school with his kids... they were doing quite well then too!

 

[C_leen]

I agree to check 2-3 orthodontists as cost does vary a lot. Consider your drive time though as there is typically a lot of appointments! Also I am not sure where you live but here there is a dental school and they do braces WAY cheap!

 

[Cindy B]

Our orthodontist told me that he did not believe in Phase I and Phase II- he actually said it can all be accomplished in Phase II- so why put the kids through all that.

Yes, my kids were in braces longer- but we waited until they were both in middle school and did it that way. Our insurance paid a set amount- we had the rest set aside in a FSA account. We got the insurance amount, used the FSA amount at the beginning of treatment and did not have to pay another dime!

 

[dfchelbay]

I took my DD for a orthodontist consult and was told she will need braces. They are suggesting phase 1 of possibly two phases to correct her "issues". She has overcrowding and a crossbite. She has only lost about 8 baby teeth but the adult ones that came in are a mess. Phase one is a palet extender and braces on her four top front teeth, that will be $3K If that doesn't correct it then phase two will be a full set of braces.

The orthodontist told me that our insurance has a lifetime cap of $800 for braces. As you know that is a drop in the bucket especially if she needs two phases. I don't opt into my insurance at work since we are all covered under my husband's plan, but I'm wondering if it would be more cost effective to pay into my healthplan if they would cover more of the cost or orthodontics.

Just wondering what other people's carriers cover for braces.

Our insurance paid $1,000 of the $6000 total for the braces.

 

[toystory1130]

I second the Dental School option if you have one available. Our total was 3200, 1500 covered by insurance and I paid the difference. They even gave me a 5% discount for paying my part in full on top of the great price. They are using the newer SmartClip system for her and she get's triple checked by the lead ortho, it has been a good experience so far.

 

[grassmower]

Our dental insurance pays a grand total of $0.00 for orthodontics.

This is the reason we're paying $169.00 a month for the next 30 months.

 

[mjkacmom]

$1500 lifetime for each child. Four of my kids either had braces, or have them now, and the average for them is $6200 each. Fortunately, they are staggered, and so far, have payed one off before really starting to pay on the next (expect for a couple of palate expanders). One more payment for ds15! Unfortunately, my twins are going to have their actual braces put on around the same time.

 

[Pigeon]

Our orthodontist told me that he did not believe in Phase I and Phase II- he actually said it can all be accomplished in Phase II- so why put the kids through all that.

Yes, my kids were in braces longer- but we waited until they were both in middle school and did it that way. Our insurance paid a set amount- we had the rest set aside in a FSA account. We got the insurance amount, used the FSA amount at the beginning of treatment and did not have to pay another dime!

Yeah, when my oldest was that age, I did a lot of reading of the peer reviewed dental literature and it seems that for most patients there are few benefits to the 2 phase system that cannot be measured in yacht payments.

 

[5 Disney Fans]

Thanks so much for all of your responses. It is all very helpful! We have Delta Dental also, but I guess my husband's employer doesn't spring for the better coverage some here are reporting.

We have benefit selection coming up in November, I will check out how much our dental covers at work. As someone mentioned they paid $1000 in premiums to find out the insurance covered $1000.

The orthadontist offered 12 month payment plan (no interest) and the montly payment is manageable for us... thankfully!!!

I had heard a few friends say insurance pays half for orthodontics so I was a bit shocked to hear $800, but I guess that is better than nothing!

 

[Halloweenqueen]

We have four in braces right now. Delta dental/employer paid $1500 towards the $6000 per kid. Orthodontist allowed us to pay over 18 months. Last payment is October 1st!

 

[SEA333]

Our primary is through me, and it pays $1500/lifetime max per person. We took on DH's dental for JUST him and DS13, and they will pay another $1500. His total bill is $4530, and I put $500 down, so I am making payments on $1030. I will probably just pay a couple hundred each month from my HSA account so it will be paid off sooner AND tax free. Every little bit helps, especially since I have two more coming up.

 

[Green Tea]

Zero! We have a Dental Insurance policy and of course a medical policy. Nothing was covered for any of our children's braces.