Does your insurance cover adult orthodontics? How much?

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parsleysage
Posts: 351
Joined: Tue Mar 18, 2014 10:42 am
Location: Virginia

Does your insurance cover adult orthodontics? How much?

#1 Post by parsleysage »

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?

samoorelaw
Posts: 441
Joined: Sun Jul 14, 2013 4:44 pm
Location: Las Vegas, Nevada

Re: Does your insurance cover adult orthodontics? How much?

#2 Post by samoorelaw »

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!
Braces removed for 3rd and final time July 14, 2016!!!!

Permanent 8 crowns front 8 teeth (upper) January 30, 2015

Braces removed again December 3, 2014!!

Partial braces re-installation September 25, 2014

Braces removed September 4, 2014!

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Nozzelnut
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Location: Rochester, NY

Re: Does your insurance cover adult orthodontics? How much?

#3 Post by Nozzelnut »

My dental ins would cover $1k; only for children under 19. So nothing for me; all out of pocket.
Round 3 (lifetime) Damon stainless applied 3/16/20 (after 4 weeks attempting invisalign) On for about 18 months
Night time elastics with invisalign retainers; still...
Double jaw surgery was 6/18/15...
Orthodontics never really ends...
I'm emphatically against extraction orthodontics!

TheKT
Posts: 184
Joined: Thu Dec 19, 2013 4:44 pm

Re: Does your insurance cover adult orthodontics? How much?

#4 Post by TheKT »

1,500

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parsleysage
Posts: 351
Joined: Tue Mar 18, 2014 10:42 am
Location: Virginia

Re: Does your insurance cover adult orthodontics? How much?

#5 Post by parsleysage »

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.

boodles8
Posts: 139
Joined: Thu Jul 25, 2013 4:10 pm

Re: Does your insurance cover adult orthodontics? How much?

#6 Post by boodles8 »

$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.
Boodles8

Braced July, 2012
BSSO August, 2013
Debraced October 2, 2014

sirwired
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Joined: Thu Oct 30, 2008 10:05 am

Re: Does your insurance cover adult orthodontics? How much?

#7 Post by sirwired »

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.

Woobster
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Joined: Sun Aug 25, 2013 11:09 am
Location: Columbus, OH

Re: Does your insurance cover adult orthodontics? How much?

#8 Post by Woobster »

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.

millersgirl
Posts: 118
Joined: Tue Feb 04, 2014 1:46 am

Re: Does your insurance cover adult orthodontics? How much?

#9 Post by millersgirl »

My insurance is pretty good...they paid $1500 and 80% of my oral surgery. I have flexible spending to cover the rest.
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MrsCharisma
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Re: Does your insurance cover adult orthodontics? How much?

#10 Post by MrsCharisma »

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

http://www.archwired.com/phpbb2/viewtop ... 13&t=45175

Female, 34
Braced: 1/24/13 (upper) and 5/3/13 (lower)
Sentence: 18-24 months
Ceramic uppers, metal lowers


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parsleysage
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Re: Does your insurance cover adult orthodontics? How much?

#11 Post by parsleysage »

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! :shock: 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.

Fidget77
Posts: 46
Joined: Fri Jan 03, 2014 6:07 pm
Location: Ontario

Re: Does your insurance cover adult orthodontics? How much?

#12 Post by Fidget77 »

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.

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MrsCharisma
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Re: Does your insurance cover adult orthodontics? How much?

#13 Post by MrsCharisma »

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.

http://www.archwired.com/phpbb2/viewtop ... 13&t=45175

Female, 34
Braced: 1/24/13 (upper) and 5/3/13 (lower)
Sentence: 18-24 months
Ceramic uppers, metal lowers


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SunshineRay
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Re: Does your insurance cover adult orthodontics? How much?

#14 Post by SunshineRay »

They pay nothing for over age 19.

kathydell
Posts: 268
Joined: Thu Jun 06, 2013 2:02 pm

Re: Does your insurance cover adult orthodontics? How much?

#15 Post by kathydell »

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.

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