insurance

Orthodontic Coverage

A dental insurance benefit that helps pay for braces, retainers, and other treatments to correct misaligned teeth and bite problems. This coverage is often separate from basic dental benefits and may have its own deductible, waiting periods, and lifetime maximums.

Example

“The Johnsons were relieved their dental plan included orthodontic coverage when their daughter needed braces, as it would pay 50% of the $4,500 treatment cost.”

Memory Tip

Think 'ORTHO = STRAIGHT' - orthodontic coverage helps pay to make crooked teeth straight.

Why It Matters

Orthodontic treatment can cost thousands of dollars, making this coverage valuable for families with children who need braces. Without coverage, many families might delay necessary treatment, potentially leading to more serious dental and health problems later.

Common Misconception

Many people assume orthodontic coverage works like regular dental benefits with annual maximums, but it typically has a separate lifetime maximum per person. Some also think it covers cosmetic procedures for adults, when most plans only cover medically necessary treatment and may have age limits.

In Practice

The Martinez family's dental plan includes orthodontic coverage with a $1,500 lifetime maximum per child and 50% coinsurance after a $50 deductible. When their 12-year-old needs $3,200 worth of braces, the insurance pays $1,575 (50% of $3,150 after the deductible), and the family pays $1,625 out of pocket. Their 14-year-old later needs $2,800 in treatment, and the insurance again pays the maximum $1,575, leaving the family to pay $1,225. Once each child reaches their lifetime maximum, no further orthodontic benefits are available.

Etymology

From Greek 'orthos' meaning 'straight' and 'odont' meaning 'tooth,' the term orthodontic was first used in 1909, with insurance coverage for these treatments becoming common in the 1970s.

Common Misspellings

orthodontric coverageorthodontic coveregeorthondontic coverageorthodantic coverage

More in insurance

Other insurance terms you should know

deductibleThe amount you pay out-of-pocket before your insurance begin…insurance premiumThe amount paid periodically to an insurance company in exch…deductibleThe amount a policyholder must pay out of pocket before insu…copayA fixed amount paid by an insured person at the time of a me…coinsuranceA cost-sharing arrangement where the insured pays a percenta…out-of-pocket maximumThe most an insured person will pay for covered healthcare s…