Does Delta Dental Cover Adult Braces?
Orthodontic treatment is not just for teenagers; adults are increasingly seeking braces to improve their smiles and oral health. One of the most common questions 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 adult braces and what you need to know before making your decision.
Understanding Delta Dental’s Coverage
Delta Dental offers a variety of dental insurance plans, and coverage for adult braces can vary depending on the specific plan you have. Some Delta Dental plans provide coverage for orthodontic treatment, including braces, while others may not cover it at all. To determine whether your plan covers adult braces, you should review your policy documents or contact Delta Dental directly.
Factors Influencing Coverage
Several factors can influence whether Delta Dental covers adult braces:
- Plan Type: Delta Dental offers several types of plans, including PPO, HMO, and indemnity plans. Coverage for adult braces may vary depending on the type of plan you have.
- Maximum Allowance: Most Delta Dental plans have a maximum allowance for orthodontic treatment, which is the most they will pay towards the cost of braces. This amount can vary significantly between plans.
- Age Limit: Some Delta Dental plans may have an age limit for orthodontic coverage, meaning that coverage may end after a certain age, typically around 18 or 19 years old.
- Pre-Existing Conditions: If you have a pre-existing condition that requires orthodontic treatment, coverage may be limited or excluded.
Seeking Approval for Coverage
Before undergoing orthodontic treatment, it’s essential to seek pre-authorization from Delta Dental to ensure that your treatment is covered. This process involves submitting a claim to Delta Dental, which will review your policy and determine the extent of coverage. Keep in mind that you may need to provide documentation from your dentist, such as treatment plans and cost estimates, to support your claim.
Alternatives to Delta Dental Coverage
If Delta Dental does not cover adult braces or if the coverage is insufficient, you may consider the following alternatives:
- Self-Pay: You can pay for the braces out of pocket. This option may be more expensive, but it can provide you with the flexibility to choose the type of braces and orthodontist you prefer.
- Flexible Spending Account (FSA) or Health Savings Account (HSA): If you have an FSA or HSA, you may be able to use these funds to pay for your braces.
- Orthodontist’s Payment Plan: Some orthodontists offer financing options or payment plans to help patients manage the cost of braces.
Conclusion
Whether Delta Dental covers adult braces depends on the specific plan you have and various factors such as age, maximum allowance, and pre-existing conditions. To determine your coverage, review your policy or contact Delta Dental directly. If you’re unable to find adequate coverage through Delta Dental, consider exploring alternative payment options to make your orthodontic treatment a reality.
