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Can You Get Braces Free If You Have Health Insurance?

Depending upon the type and quality of your plan, your health insurance policy may cover part or all of the cost of certain medically-necessary procedures and devices. For instance, you might be able to avoid paying $50,000 or more for cardiovascular surgery, tumor removal, gastric bypass surgery, hernia repairs and other invasive medical procedures. Instead, you might only be required to pay the value of your policy's deductible and certain non-core expenses related to the primary procedure. If you're unsure about the specific provisions of your health insurance policy, you should take the time to read through it or contact your provider directly. A customer service representative should be able to walk you through the ins and outs of your plan.

Although your health insurance policy is liable to cover the costs associated with many "medically necessary" procedures, it may not offer solid coverage for non-essential procedures. If you wish to undergo a cosmetic surgical procedure like liposuction, hair implantation or breast enhancement, you'll have to pay most or all of the associated costs out of your own pocket. Before agreeing to honor claims, most health insurance companies require their policyholders to provide clear evidence that the desired procedure is absolutely essential. A qualified medical doctor or specialist must certify that this is the case.

Unfortunately, most orthodontic procedures are deemed to be cosmetic in nature. If you want to get braces or straighteners and can't prove their necessity, there's a good chance that your health insurance provider will refuse to cover the associated costs. Since such implants typically cost between $3,000 and $10,000, this might put you in a tight financial spot.

If you don't want to pay for the full cost of your braces or straighteners out of your own pocket, you may have a couple of options at your disposal. For starters, you could visit multiple orthodontists or medical doctors in an attempt to prove that your desired orthodontic procedure is medically necessary. Depending upon the condition of your mouth and facial bones, this might be a tall order.

Alternatively, you could add comprehensive dental coverage to your health insurance plan. While this will raise the overall cost of your policy in the short term, it might save you a significant amount of money in the long run. Most dental insurance plans pay for 30 to 70 percent of the cost of orthodontic work. This could reduce your out-of-pocket costs by $3,000 or more.


This article contains general legal information but does not constitute professional legal advice for your particular situation. The Law Dictionary is not a law firm, and this page does not create an attorney-client or legal adviser relationship. If you have specific questions, please consult a qualified attorney licensed in your jurisdiction.

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