How much does insurance cover for braces?

[2Pirates2Princesses]

Our DD11 just got her braces on earlier this year and will have them for two years and her twin brother will be getting his put on within the next year so we will have two kiddos in braces at the same time. Our insurance covers 50% of the cost and we paid half of the balance up front out of pocket and the remainder we are paying off in monthly installments. I agree with the suggestion of getting a few different consultations for the best price; but I would choose an orthodontist that has a location you can get to conveniently because the appointments are frequent.

 

[Desnik]

Our insurance covers $2000. Our DD's braces cost $5500

 

[bdcp]

Paying for braces did not used to be the norm. My boys are 27 and 29 and our insurance (we had fabulous dental and medical coverage) paid ZERO. We had payment plans for both, fortunately they were 2 years apart so we rolled from one right into the next.

 

[tzolkin]

Our insurance has no orthodontic coverage.

I am actually taking my middle DD for Phase I braces tomorrow morning. I knew she would likely need braces since she was a preschooler. Her baby teeth were perfectly straight, but so close together that it was almost impossible to floss them. She is very petite and there is just no way her adult teeth will fit in her mouth as it is.

Mine didn't either. My canines didn't start to erupt until I was in my late teens. At that point it was going to be a very involved process and I was old enough to be very aware that my parents really couldn't afford it, so I refused to get the braces.

My teenage DD has perfect teeth and I'm hoping that DS7's will be the same. He is bigger than DD9 and seems to have extra room in his mouth.

That will be an extra Disney trip for us

 

[DCDisney]

We are almost done with phase 2 and with similar issues to what you describe we almost could have gotten away with just phase 1. After phase 1 there was just one crooked tooth and it was on the side and a few bite fine tuning things. We did phase 1 on one plan and then switched insurance companies for phase 2. They usually have a 1 orthod treatment for life clause. We did have over lap for a few months and it was a total pain to deal with and ultimately the better company paid less than usual expecting the bad company to pay some. It didn't save us anything. You might want to check if you think about signing up for a new plan some have a waiting period for ortho. Our ortho offered a cash discount if you paid the non-insurance balance in full. Got lots of Disney dollars on my Disney visa. 10% so it was worth pulling from savings. They also offer free financing for the length of time braces are to be worn. Prices were pretty similar at the 3 we got estimates from but one wanted to pull a ton of teeth which was totally unecesary.

 

[lisaross]

Our insurance covers 2000 lifetime! My older son already went thru the (2) phases and his cost 4500 (that is the cap if we use a orthodontist on the plan) my younger son will be starting and his will cost 4200 - a little bit of a discount for the 2nd child. I choose to use an inhouse ortho because others could charge as much as 7000.

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.

 

[luvmy3]

Our insurance covers $2500.

 

[ktmo]

Yep, we are in Phase 1 right now. Our insurance covers a one time only $1,000 per person. I am thinking about playing an insurance game and changing our dental insurance after Phase 1, but I am not sure if it would work.

Luckily, I had just got an offer from Discover, which gave me 0% financing on any purchase for a year. Perfect timing. And my Orthodontist gave me a discount for paying it all at once.

I immediately set up an Capital One 360 savings account and starting putting money away each week for Phase 2 and DD#2 (her teeth are ten times worse).

 

[3boymthr]

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!

I worked in insurance as an underwriter for 17 years. The standard benefit for Ortho, if your plan has Ortho, is 50% to a max of $X. Most commonly that $X is $1,000. So if your braces billable amount is $2,000 your insurance would pay $1,000 of that cost, but if your braces billable $1,500 then the insurance would pay $750. But that max and that 50% is very important because the dentist has a negotiated rate that he can charge for that billable amount and then he gets to charge a different rate for the next amount over that cap. If your max is $800 it's probably actually 50% to a max of $800. Double check these amounts because he'll have a contracted amount of service he has to perform for that $1,600.

 

[kkmcan]

WOW! Some of you must have really good insurance! Ours only paid $1000 per child. DD's braces were $5600 and DS's were $5300. DSs was less because they gave us a $500 repeat customer discount.

 

[Tinkerbellie16]

50% of cost but only up to $1500 (so up to a total bill of $3000). They added adults to the plan in 2010 so I got braces in 2011 and had them removed a year later. They paid 100% of the bonding I needed as a result. I used flex spending for my half of the costs. I only had 8 braces on the top but opted for the more expensive clear ones (which break way too easily!). Retainer cost and all appointments to the end of time were included as well in my cost of $1500 total. I'm happy my front gap is gone now . And my orthodontist is way cool and nice too!

 

[LLLSRL]

We have Delta Dental and they paid $2400.00, we paid the other $3400.00 on a 24 month payment plan.

 

[WeLuvDiznee]

Our insurance pays absolutely nothing! We are on a 24 month payment plan.

 

[francileb]

Our insurance pays up to $2,000 lifetime. Maybe my son needed a lesser amount of treatment or maybe it is just cheaper in Colorado, because the totals people are mentioning ($5,000, $6,000, etc.) are way higher than our total of $3,800. We are paying $109 a month for the 18 months they expect him to be in braces.

 

[lovesdumbo]

Our dental pays lifetime max of $1,500 per child.

DS(12) just got braces this summer. $6,000-of which 1/2 had to be prepaid and if you paid the 2nd half by credit card you got a 5% discount or 7.5% if you paid with check. We chose to pay upfront.

Insurance is now paying me back up to the $1,500 every month.

 

[angierae]

My exes paid nothing, mine paid $1500 lifetime so we added her to my plan until we maxed it out and then dropped her.

 

[aprilgail2]

My insurance covered 2,000. I had won a 1,000 gift certificate for braces so it cost me 3,000.00 out of pocket after that. I ended up paying half in jan and the other half the following jan since I used my flex spending account and broke it up to two payments. She got the braces in 4th grade and they came off the beginning of 7th grade. She doesn't need to get a phase two or anything. It was important to me that she didn't go into high school with braces, wanted them off before that!

 

[sookie]

Since your children are going to need a lot of work, it may be worth it to look into dual coverage - you and your husband both cover the children. Good luck!