Girl smiling with braces

Are braces covered by your insurance?

“You need braces.”

Whether you’re the parent of a child or teenager hearing this news from your orthodontist, or an adult who’s finally made the (excellent) decision to correct your smile, there’s probably one question that pops into your head next: “How am I going to pay for this?”

First off, if you’re unhappy with your smile and you’ve decided to do something about it, congratulations! Whatever age you are, you’re making a great investment that is likely to have a positive impact on many parts of your life – your self-esteem, your performance at work or school, your mental well-being, even your relationships. When you can smile with confidence, it changes everything for the better. Who wouldn’t want that?

But yes, all these perks do come at a cost. And without insurance, braces can potentially put a dent in your budget. Are braces covered by insurance? What about Medicaid? How do I find a plan that will cover my orthodontics? Shawano Orthodontics is here to answer all your orthodontics cost questions – so you can worry less about finances and focus more on enjoying your fabulous new smile.

The benefits of braces: beyond the smile

It’s undeniable that the long-term benefits of orthodontic treatment are both physical and emotional. Braces and Invisalign® clear aligners can fix a host of oral health issues that extend beyond proper alignment of the jaw (think overbites and underbites) and teeth (crowded, crooked, and misaligned teeth). A properly aligned smile reduces the occurrence of tooth decay, gum disease, jaw pain and pressure, and abnormal wear of the teeth.

Here at Shawano Orthodontics, we believe that oral health is a vital part of your overall health. We’ll do everything we can to not only give you the smile of your dreams, but help you build healthy oral habits that last a lifetime. Shawano Orthodontics even offers a $0 down, 0% interest financing program to make getting treatment easier for everyone, especially those without insurance.

Your insurance options

Oftentimes, if your employer offers health insurance, they may also offer a dental plan as part of your benefits package.  In the event they don’t, you can buy a dental insurance policy on your own through a health insurance carrier that sells individual and family dental insurance plans or through the Health Insurance Marketplace.

Not every dental insurance plan includes coverage for braces and other orthodontic treatments. If you already have dental insurance (or are currently shopping for a plan), now’s the time to check with your insurance provider and familiarize yourself with the fine print.

Hopefully, your plan will cover at least part of the cost of orthodontic treatment for you or your child. You should be aware that there is usually an annual cap or lifetime maximum for orthodontic services, and your plan may cover braces for children but not for adults over the age of 18. Some plans require waiting periods for certain procedures. Other plans may only cover braces for medical purposes (such as improving your ability to chew food properly or fixing a misaligned jaw) but not for cosmetic reasons.

Still confused? Here are some tips to help you maximize your dental plan benefits.

  • If your dental plan has a waiting period, be sure to enroll with plenty of time before your child needs braces or you plan to get them.
  • Try to keep the same dental plan throughout your entire orthodontic treatment. Some plans won’t cover braces if you or your child got them before the policy started, which makes them an out-of-pocket expense.
  • Make sure that your orthodontist participates in your dental plan’s network. You’ll save money when you stay in-network for treatment.
  • Even if Invisalign aligners are not specifically covered under your dental plan, some insurance companies will contribute a fixed amount of money toward the cost.
  • Consider purchasing a supplemental orthodontic insurance plan if your dental plan does not provide ample coverage.

The bottom line: when in doubt about what your dental plan covers, ask your insurance provider. That way, you’ll know exactly where you stand before making any decisions about orthodontic treatment.

Other ways to pay

Medicaid

If you qualify for Medicaid and your braces are deemed medically necessary, Medicaid may cover them. Check with your orthodontist to confirm if your treatment plan qualifies. And again, be sure to ask about the percentage of coverage and the lifetime maximum benefit.

FSA/HSA

If you have health insurance with a flexible savings account (FSA) or a health savings account (HSA) option, you may be able to save money directly from your paycheck for your orthodontic treatment as well as other medical and dental bills. If you are paying out-of-pocket for a portion or all of your braces or Invisalign aligners, this portion of your money will be tax-free. An HSA can even move with you from job to job if you change employers during treatment.

Shawano Orthodontics Payment Plan

We saved the best for last! Shawano Orthodontics always wants to make you smile – and that’s why we offer a $0 down, 0% interest financing program to our patients for both traditional braces and Invisalign® treatment plans. We’ll do everything we can to work within your budget and help you reach your smile goals.

Schedule your free consultation today

Shawano Orthodontics makes it easy to learn about your financial options and so much more. Contact us today to schedule a free consultation with a Shawano orthodontist! No dentist referral is necessary.

Your visit will include:

  • One-on-one time with a doctor
  • Digital x-rays and an iTero® 3D model of your teeth and gums
  • A personalized treatment plan for braces or Invisalign aligners
  • Financial information on insurance and our $0 down, 0% interest financing program

Your time is just as valuable to us as it is to you – that’s why we provide so much in one easy, convenient visit. We can’t wait to meet you!