Metal Mouth Message Board

I have been told at both my consults so far that my insurance is great as far as coverage for adult orthodontics goes. They cover 50% of the cost up to $2500. One of the office managers told me most insurances only cover $1000 or maybe if they are lucky $1500. She seemed really amazed at the coverage. I have Aetna Dental PPO.

How much does your insurance cover? That is, if it covers adult orthodontics at all?

parsleysage wrote:I have been told at both my consults so far that my insurance is great as far as coverage for adult orthodontics goes. They cover 50% of the cost up to $2500. One of the office managers told me most insurances only cover $1000 or maybe if they are lucky $1500. She seemed really amazed at the coverage. I have Aetna Dental PPO.

How much does your insurance cover? That is, if it covers adult orthodontics at all?

My insurance through my employer covered nothing: if you're over the age of 19, it's frequently not covered by most dental insurance. A crime because my braces cost $6,895!

My dental ins would cover $1k; only for children under 19. So nothing for me; all out of pocket.

1,500

samoorelaw wrote:My insurance through my employer covered nothing: if you're over the age of 19, it's frequently not covered by most dental insurance. A crime because my braces cost $6,895!

That sucks!!! Mine are right up with you, if I go with the ortho I'm leaning towards, at $6850 if I don't become a surgical patient. (Add $1290 if I do.) I am so thankful it will be partially taken care of by insurance.

$1500. I knew I'd be doing this, and also have other dental issues to resolve after this, so I looked through available plans and chose the best one.

Yeah, it all depends on what the employer feels like paying for, if anything. Orthodontics are VERY subject to Adverse Selection, so the riders are very expensive.

My dental insurance will cover $1500 if you're under the age of 19. If not, you're on your own.

I feel your pain... I'm paying $6400 for mine.

My insurance is pretty good...they paid $1500 and 80% of my oral surgery. I have flexible spending to cover the rest.

Our insurance is SO sucky, that not only does it not cover adult ortho, it does not cover orthodontics for CHILDREN either!!!!! Insane.

millersgirl wrote:My insurance is pretty good...they paid $1500 and 80% of my oral surgery. I have flexible spending to cover the rest.

This is my plan too. I am hoping to get the braces ASAP so I can know by open enrollment (November) whether I need the surgery, so I can increase my health benefits to the "premium" top tier which will give me a $300 deductible and 10% coinsurance with a $1500 max. I will be maxing out my FSA at $2500 too. (I put in $1500 this year knowing I would need some dental work but not knowing I would get braces... I wish I had put more in so I could get paid back more for my braces payments!) I think even with the higher premiums for the top tier it will be cost-saving in the long run since the deductible on the lower tier is $1500 and coinsurance is 30% with a max of $3500. $1800 max costs on the top tier compared to $5000 on the lower! And this is all assuming the surgery isn't denied as "cosmetic"... which I hope it wouldn't be!

MrsCharisma wrote:Our insurance is SO sucky, that not only does it not cover adult ortho, it does not cover orthodontics for CHILDREN either!!!!! Insane.

Holy guacamole!!! I don't really understand exactly what sirwired said (sorry sirwired) but maybe that has to do with why your employer won't cover it.

I work at a very large financial corporation. Not a big Wall Street bank or anything but a top 10 national bank you have seen commercials for. That probably explains a lot as far as our quality of insurance. It's pretty sad there's such a huge disparity but that is how money and insurance work in our society I guess.

Mine is the same .. 50% up to a lifetime maximum of $2500. I am also covered under my husband's insurance (same company) for a total of $5000. My braces are essentially free as they came in at $4800. I charge the monthly amount to my VISA and then submit it to the insurance company for re-imbursement. My step-daughter is covered the same way, her treatment time is longer (24-30 months vs my 15-18) so hers will only cost us $600 out of pocket.

MrsCharisma wrote:Our insurance is SO sucky, that not only does it not cover adult ortho, it does not cover orthodontics for CHILDREN either!!!!! Insane.

Holy guacamole!!! I don't really understand exactly what sirwired said (sorry sirwired) but maybe that has to do with why your employer won't cover it.

I work at a very large financial corporation. Not a big Wall Street bank or anything but a top 10 national bank you have seen commercials for. That probably explains a lot as far as our quality of insurance. It's pretty sad there's such a huge disparity but that is how money and insurance work in our society I guess.[/quote]

It's my husband's insurance...he works for a private school. The medical coverage is horrific too. Blah.

They pay nothing for over age 19.

Very lucky to have adult orthodontic coverage of $1,500 lifetime max and able to use a flexible spending account to help with the monthly payments. Every penny helps.