Does Delta Dental Cover Braces for Adults?
Braces are not just for teenagers; many adults also opt for orthodontic treatment to improve their smile and bite. One common question that arises among adults considering braces is whether their dental insurance plan, Delta Dental, covers the cost. In this article, we will explore whether Delta Dental covers braces for adults and the factors that might affect coverage.
Understanding Delta Dental Insurance Plans
Delta Dental is a well-known dental insurance provider with various plans designed to meet the needs of different individuals and families. While the specifics of coverage can vary depending on the plan, it is essential to understand that Delta Dental generally offers coverage for orthodontic treatment for children under 19 years of age. However, the question of whether adults can receive coverage for braces is more complex.
Eligibility for Adult Orthodontic Coverage
To determine whether Delta Dental covers braces for adults, you must first check your specific insurance plan. Some plans may provide coverage for adult orthodontic treatment under certain conditions. Here are some factors that might affect your eligibility:
1. Pre-Existing Condition Exclusion: Some plans exclude coverage for pre-existing conditions, including orthodontic treatment. If you have had braces in the past, this exclusion might apply.
2. Age Limitations: While Delta Dental plans typically cover orthodontic treatment for children, some plans may offer limited coverage for adults up to a certain age, such as 26 years old.
3. Medical Necessity: In some cases, your dentist may need to provide documentation that shows the orthodontic treatment is medically necessary. This might include issues such as jaw misalignment or bite problems that could lead to future dental problems.
4. Waiting Period: Some plans may have a waiting period before covering orthodontic treatment for adults. This waiting period can range from six months to a year or more.
Maximizing Coverage
If you are eligible for Delta Dental coverage for braces as an adult, there are steps you can take to maximize your benefits:
1. Review Your Plan: Carefully review your insurance policy to understand the coverage limits, co-pays, and any other requirements.
2. Seek Pre-Authorization: Before starting treatment, obtain pre-authorization from Delta Dental to ensure that your treatment is covered under your plan.
3. Stay Informed: Keep track of your treatment progress and communicate with your dentist and insurance provider to ensure that all necessary documentation is in order.
Conclusion
In conclusion, whether Delta Dental covers braces for adults depends on your specific insurance plan and its terms. While some plans may offer coverage, others may have limitations or exclusions. It is crucial to review your policy, consult with your dentist, and understand the requirements to determine your eligibility for adult orthodontic coverage. By doing so, you can make an informed decision about your dental treatment options.
