Use Medical Insurance To Help Pay For Clear Aligners Or Braces

By Tontra Lowe, DDS

It is estimated that roughly four million children under the age of 18 are undergoing some form of orthodontic treatment. This can range from braces or clear aligners used to guide jaw growth and development, or to treatment to the jaw, teeth, and mouth due to trauma. There are an additional two million adults seeking treatment as well for various reasons. Ever thought about using medical insurance to help cover out-of-pocket costs if eligible?

Here are three things to consider when trying to access medical benefits to help cover costs for your orthodontic treatment:

1. Remember, your mouth is part of your body. Treatment due to defective upper or lower jaws that cause cross-bite, deep-bite, or a narrow roof of the mouth is based upon a medical condition. The teeth go wherever the jaws take them. Use medical insurance to help cover your portion of the treatment with or without dental insurance.

2. Children as they grow may need phased orthodontic treatment that may include braces or other appliances like a palatal expander, headgear or herbst. With technology today, clear aligners can have the same impact and act as an alternative to braces for some teens and adults. Dental insurance usually has a lifetime benefit for braces, but medical does not. Try to use your medical insurance to cover your patient responsibility.

3. Not all medical insurance will cover treatment if it is not a covered benefit no matter what’s wrong. Additionally, not all dentists or orthodontists know how to access medical benefits to help pay for your treatment. Discuss with your provider what options you may have and encourage them to undergo training to learn how to access medical benefits on your behalf.

Make sure to ask your dentist or orthodontist if your braces or clear trays qualify for medical billing. Accidents that cause trauma to the mouth and require braces may qualify too. Malocclusion secondary to jaw defects may be covered under your medical plan and reduce your costs. Remember, the teeth can only go where the jaws lead them. It’s worth a try, right?