How to Get Braces Covered by Medical Insurance?

Does Health Insurance Cover Braces? Here's What You Need to Know

Braces can surely enhance your smile, but dental costs can be expensive. So, if you are planning to get one, the smart option would be to get the expenses covered under your insurance plan. This way, you get a straighter and healthier smile while protecting your savings for the future.

Keep reading to learn about the steps to get your braces covered by your medical insurance!

7 Steps to Get Your Braces Covered by Medical Insurance

Following are some hassle-free steps that will help you get your braces covered under your insurance plan:

Step 1: Go Through Your Policy

First and foremost, review your policy to learn the terms and conditions related to coverage. This will help you understand the deductible and co-payment options, as well as the network hospitals and associated clauses.

Step 2: Have a Word with Your Insurer

If you have any doubts or queries, contact your insurance provider right away. Their representative will help you clarify the policy terms and provide you with updated information, which you can use to proceed with the implantation of your braces.

Step 3: Submit the Necessary Documents

You need to prove to your insurance provider that the braces are not just to enhance your appearance but are essential for various health reasons. For this, you may have to submit your prescriptions, detailed explanations, and images from your dentist if needed.

Step 4: Select Network Doctor and Hospital

It is essential to note that your insurer will only approve your claim if you get your treatment done at a network hospital. So, go through your policy to check the partnered hospitals in your locality and then connect with them for further discussions.

Step 5: Request for a Pre-Treatment Estimate

A pre-treatment estimate will help you calculate the expense share for you and your insurance provider as per your insurance policy. For assured claim approval, you can submit this estimate to your insurer so they will have an idea of how much they will have to pay.

Step 6: Get Pre-authorization from Insurer

Pre-authorization from your insurer bestows you a claim settlement guarantee. So, you can request your orthodontist to get you a treatment plan and other relevant documents that you can submit to your insurer.

Step 7: Calculate Your Out-of-Pocket Expenses

Remember, in addition to the estimates provided by your doctor, various unplanned expenses can occur. So, keep a note of the co-payments, deductibles, and co-insurance, alongside the limits and grace periods available.

Before proceeding with the steps, make sure you understand the situations when health insurance will cover the expense of the braces.

Scenarios When Health Insurance Covers Braces

Health insurance will cover your braces if you can prove to your insurer that straighter teeth will treat one of the following conditions or provide you temporary relief from them:

● Temporomandibular Joint Disorders (TMD)-associated symptoms

● Non-biting accidents that primarily occur due to the positioning of the teeth

● Restricted airflow due to crooked teeth, which can cause sleep apnea

Apart from covering braces expenses, dental health insurance plans can offer you several other benefits. Read ahead to learn them in detail.

Benefits of Dental Health Insurance Plans

Advantages of buying dental health insurance plans from reputed insurers like Star Health include:

● Substantial savings on dental treatments and oral surgeries

● Going for regular teeth cleaning and check-ups to maintain dental health

● Ensuring that you stay prepared for unplanned expenses related to your teeth

● Availing cashless treatments at network hospitals during planned treatments and emergencies

● Getting coverage on consumables that are used during hospitalization

● Availing of dental examinations when going for your periodic preventive health check-ups

● Saving on taxes as per Section 80D of the Income Tax Act

Also, several inclusions under dental insurance plans can help you maximize your benefits.

Inclusions under a Dental Insurance Plan

Standard inclusions under the dental insurance plans are as follows:

● Dental injury due to accidents

● Tooth extractions and fillings

● Oral X-rays

● Preventive health check-ups

Once you decide to invest in a dental insurance plan, remember these specific essential pointers to get the maximum benefit from your purchase.

Things to Remember While Buying Dental Insurance

The following are some essential things that you should remember when you buy a dental insurance plan:

● Choose the policy that offers the most coverage

● Find out your insurer's claim settlement ratio

● Compare plans to find the most suitable plan

● Check the plan inclusions and exclusions

● Locate your nearest network hospital

These are the simple and smart steps to help you fix your smile without putting a burden on your pocket. So, make sure to follow them diligently and maintain a thorough record of pre-authorization forms and payment receipts.

At Star Health, we also offer coverage for dental treatment and expenses under our Star Outpatient Care Insurance Policy. This is sure to help you settle your claim in an instant and get a charming smile on the go.