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Braces Insurance | Dental Braces Insurance

Cost of Orthodontic Braces Covered by Insurance

$1,500.  Payout limit on the vast majority of dental insurance policies.  “The U.S. is facing a dental crisis. Only about 50% of the population has dental insurance, compared with the 85% who have medical benefits. Medicare doesn't cover dental procedures, despite the fact that aging teeth are just like aging bodies — vulnerable and brittle. That means more and more patients will be traveling abroad to take care of their pearly whites.  The problem in the U.S. is aggravated by the fact that even people with dental insurance aren't that well covered. The vast majority of policies have a $1,500 annual cap on payouts, a level that hasn't changed since the 1970s, though premiums have been rising. That $1,500 can easily be wiped out by one complicated root canal or a crown.” How much does orthodontic insurance cover? (Catherine Arnst, “Lack of Insurance Drives Dental Tourism,” Business Week, November 9, 2008)

$1500 or less. Typical lifetime benefit limit of dental plans. “[D]ental plans usually have a lifetime benefit limit [that applies to orthodontics treatment] of $1,500 or less.”  (Marylou Tousignant, “Brace Yourself - at Almost Any Age,” The Washington Post, April 13, 1994)

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How much do braces cost without insurance?

$2,500.  Amount covered by insurance for SureSmile orthodontic braces reported in Fort Wayne, Indiana.  “[Admittedly, [SureSmile orthodontic treatment] was an expensive solution, and [26 year-old bride-to-be Heather Claxton], a single mom with a 5-year-old daughter, said she had to learn how to budget accordingly. Her insurance covered $2,500 for the treatment (far more than the $1,000 most insurance plans typically cover), but she still paid $3,000 out-of-pocket. Despite a higher price tag, Claxton was happy with the results.  The [SureSmile] treatment costs about $500 more than conventional braces, up to $5,800 or $5,900, [Dr. Ron Cohen of Cohen Orthodontics] said.” What dental plan pays the most for braces?  (Michael Schroeder, The Journal Gazette, Sure to broaden smiles, orthodontic treatment cuts time in braces,” The Journal Gazette, Fort Wayne, Indiana, January 25, 2009, p. 4D)

$1,000 - $1,500.  Typical lifetime maximums of insurance policy coverage for the cost of orthodontic work.  “[Some] insurance policies have age limits that make adults too old for coverage.  All plans have lifetime maximums, [Vivienne Murray of Murray Orthodontics] said. Maximums for orthodontics work commonly are $1,000 or $1,500.  That's not nearly enough to cover an adult's bill. Adults might need to wear braces for 18 to 36 months, [Anchorage orthodontist John Murray] said, and the bill can reach $6,000 to $8,500. The bill for a teenager's braces ranges from $3,000 to $6,000, [orthodontist Tom Hartman] said.” (Ann Potempa, “Braces for all ages - Adults join teenagers in the waiting rooms of local orthodontists,” Anchorage Daily News, Anchorage, Alaska, February 25, 2003, p. D1) 

$1000 - $2000.  Lifetime maximum coverage for orthodontic braces allowed by HumanaDental.  “HumanaDental started offering adult orthodontic benefits in 2002 in response to the demand it saw in the marketplace. It also revamped the lifetime maximum its plans offered to include $1,000, $1,500 and $2,000 limits. HumanaDental covers up to 50 percent of the lifetime maximum.  “(Becca Mader, “More employers offer orthodontic benefit,” Business Journal of Milwaukee, Friday, September 19, 2003)


$1,000.  Amount covered by most orthodontic braces insurance plans.  “[Admittedly, [SureSmile orthodontic treatment] was an expensive solution, and [26 year-old bride-to-be Heather Claxton], a single mom with a 5-year-old daughter, said she had to learn how to budget accordingly. Her insurance covered $2,500 for the treatment (far more than the $1,000 most insurance plans typically cover), but she still paid $3,000 out-of-pocket. Despite a higher price tag, Claxton was happy with the results.  The [SureSmile] treatment costs about $500 more than conventional braces, up to $5,800 or $5,900, [Dr. Ron Cohen of Cohen Orthodontics] said.” (Michael Schroeder, The Journal Gazette, Sure to broaden smiles, orthodontic treatment cuts time in braces,” The Journal Gazette, Fort Wayne, Indiana, January 25, 2009, p. 4D)

$1000.  Most popular lifetime maximum cost amount covered in orthodontic dental insurance plans.  “On average, though, the most popular lifetime maximum benefit I see is $1,000; the next most popular is $1,500, and then we do see some that are as high as $2,000,” says [Cherie Foerster], who has been a practice manager for nearly five years.” (Diane Moore, “Brushing up,” San Antonio Business Journal, Friday, November 28, 2008)

$750 - $2000.  Rough estimate of the portion of the cost of braces that is covered by dental insurance.  “Dental insurance pays roughly $750 to $2,000 [out of the total cost of $4,500 to $7,000 for braces]; often, the whole tab is paid out of pocket.” How do braces cost?  (Catherine Saint Louis, “Skin Deep - Many Cutbacks but Not for Straight Teeth,” The New York Times, April 16, 2009)

$750.  Low end price range for lifetime orthodontic care insurance coverage cited by San Antonio, Texas orthodontic professional.  “I see plans with a lifetime coverage as low as $750, to those that are up to 50 percent of the full cost of orthodontic care. . .says [Cherie Foerster], who has been a practice manager for nearly five years.” Find braces average cost.  (Diane Moore, “Brushing up,” San Antonio Business Journal, Friday, November 28, 2008)

$80 to $190.  Range of annual fees charged to individuals and families that belong to discount dental programs.  “Those who can't obtain private insurance face a trickier battle.  Some providers belong to discount programs and have agreed to charge those plans' members reduced fees. The website DentalPlans.com — which calls this approach an ‘attractive alternative to costly dental insurance’ without the ‘hassle’ of deductibles or claim forms — lists more than 30 such programs charging annual fees of $80 to $190 for individuals and families.  Members get 10 to 60 percent off the cost of care at thousands of participating dental providers.” (January W. Payne, “Taking the Cost Out of the Bite,” U.S. News & World Report, Volume 144, Issue 6, February 25, 2008, p. 57)

Percent of Orthodontic Braces Cost Covered by Insurance

50% or less.  Dental plans usually cover half the cost of braces or less.  “Dental plans almost never cover the entire amount of adult orthodontic costs. Few, in fact, do so for children either. Usually insurance covers half of the cost or a lesser percentage. The average total price for braces ranges from $3,000 to $5,000. Most orthodontists offer payment plans.”50% out of pocket for braces. (Scott LaFee, Staff writer, “Straight talk - When it comes to braces, there are new options that make it easier to straighten your teeth,” The San Diego Union-Tribune, San Diego, California, April 21, 2009, p. 22)

50%.  "
A typical [dental insurance] plan might cover 50 percent of the costs [of braces] up to $1,500.” (Lewis Taylor, “Getting Wired,” The Register-Guard, Eugene, Oregon, July 9, 2007, p. 1B)

50%. 
Percent of coverage to pay for the cost of braces offered by most orthodontic insurance plans.  “Having orthodontic insurance is not a bad good option, especially if you have children, but it's a plan that stands alone and must be purchased separately from regular insurance. Unfortunately, most of these plans provide very limited protection. 50% coverage per occurrence is standard and most policies have a very low maximum coverage per year. An example could $2,000 for an individual or $4,000 per family. Let's say that your child needs braces that cost $3,000. In this example, you'd still have to pay $1500 out of pocket because even though the costs didn't exceed the annual limit of the policy, you're still responsible for half because of the 50% deductible.” (J. Stewart, Ezine Platinum Quality Author, “How to Beat the High Cost of Orthodontic Braces,” Ezine Articles, June 20, 2009)

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"In general, orthodontists say, the insurance industry,
hasn't kept up with the cost of treatment."

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What do basic orthodontic insurance plans cover?

“Basic orthodontic coverage for employees and family members typically covers X-rays, an evaluation, followed by 20 to 24 months of treatment, which include monthly adjustments and retainers.” (Becca Mader, “More employers offer orthodontic benefit,” Business Journal of Milwaukee, Friday, September 19, 2003)

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"Braces are now to the teen years
what bifocals are to middle age.
They come with the territory
."

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Discount dental coverage (First Dental Health).  “The New Dental Choice card will cost $8 a month for individuals and $10 a month for families after a one-time $15 administrative fee. Card carriers will present the card to dentists in First Dental Health's network and receive 25% to 50% off full prices. The discounts apply to about 300 dental procedures including fillings, braces, crowns, teeth whitening and other cosmetic treatments often not covered by traditional insurance.

For example, a First Dental network dentist will accept the card for a reduced price of $650 for a crown immediately after the patient signs up for the program. The patient will pay the reduced rate plus the monthly fee that totals $96 to $120 a year.  An individual traditional insurance plan may cost $480 the first year, after which coverage kicks in for a crown that typically costs about $900. The patient would have to pay about half that procedure cost plus the first year's premiums, said Michael Grossman, First Dental's founder, president and chief executive officer.

First Dental has 8,000 dentists in its California network including approximately 1,000 dentists in Riverside and San Bernardino counties. Patients, called subscribers, can search for dentists by location and specialty on the First Dental Web site. First Dental will offer price breaks for businesses that purchase cards in bulk for their employees, Grossman said. Price reductions will be decided on a case-by-case basis, he said.” (Darla Martin Tucker, “Discount program reduces dental insurance bite,” Business Press, San Bernardino, California, October 23, 2006) 


 
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