Does Your Health Insurance Cover Braces?

• Written by Nidhi Goyal

  Reviewed by Munmi Sharma

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A beautiful smile with properly aligned teeth enhances your appearance and boosts confidence. Not only is it aesthetically pleasing, but also promotes oral health and prevents tooth decay. Lately, there has been an increased demand for teeth alignment procedures to achieve a perfect smile among people of all ages. Braces are the most common way to align your teeth. However, the cost of getting braces is high and ranges from ₹ 25000 to ₹ 1.2 lakh in India, depending on the type and material of the braces.

But are braces covered by insurance?

If you are planning to get braces for teeth alignment but are worried about the cost, keep reading to learn about dental insurance, what is covered under it, and whether health insurance covers braces for adults.

What is Dental Insurance?

Dental insurance is the coverage available to provide financial assistance for specified dental treatments or procedures under a health insurance plan. Most health insurance providers offer dental insurance for braces either as a part of the health insurance coverage or as an add-on benefit available at an additional cost. Some common features of dental insurance coverage are

• It provides coverage for preventive care (routine check-ups, x-rays and cleanings), basic care (fillings and extractions) and major procedures (root canal treatments, crowns, etc.).
• It may not fully cover the costs associated with dental care and may provide coverage as per policy limitations.

Note: Orthodontic treatments, implants and cosmetic procedures are not covered.

Also Read: Is ENT Treatment Covered Under Health Insurance?

Does Dental Insurance Cover Braces?

If you are looking for dental insurance plans for braces, note that braces come under orthodontic treatment, which is not typically covered by dental insurance since it is considered a cosmetic procedure. However, if any dental injury caused by an accident requires corrective surgery, it is covered by a health insurance plan up to the specified limits. So, the answer to the question of whether insurance covers braces or not depends on your health insurance coverage and the purpose of dental treatment. It may not be covered if you are only getting a treatment done for aesthetic purposes.

Also Read: 10 Types of Dental Problems and Solutions

Dental Insurance Coverage under Care Health Insurance

Care health insurance covers some specified dental treatments through Care Plus Complete and Care Plus Youth health insurance. The scope of coverage includes the cost of OPD consultations up to the limit specified in the health insurance plan and may include routine check-ups, cleaning, root canal treatments, extraction, etc. Let’s understand the braces covered by dental insurance here:

Care Plus is a comprehensive health insurance plan that covers out-patient dental and ophthalmic consultations up to ₹ 1500 for sum insured options of ₹ 5 lakh and ₹ 7 lakh and up to ₹ 2500 for sum insured options of ₹ 10 lakh and ₹ 25 lakh. This plan covers expenses incurred on acute treatment of natural teeth or the services and supplies provided by a licensed dentist up to the limit specified in the policy.

Tips to Maximise the Benefits of Your Dental Insurance

Here are some tips you should follow to maximise the benefits of your dental coverage:

• Ensure you renew your health insurance plan on time and have continuous coverage without any breaks.
• Maintain good oral hygiene, take care of your oral health to prevent tooth decay, and use your health insurance coverage for preventive dental care.
• Explore available dental insurance plans and choose the right coverage.
• Understand the inclusions and exclusions of your health insurance plan to avoid claim rejection.
• Maintain your health records and medical documents required for filing a claim.

Also Read: What are the benefits of health insurance?

To Conclude

If you are looking for the best health insurance plans with dental coverage, the Care Plus Complete plan can be a good option. The policy comes with multiple sum insured options ranging from 3 lakh to 25 lakh. As mentioned above, out-patient dental and ophthalmic treatments are covered up to the specified sum insured limit. For detailed information, kindly contact our experts at 1800-102-4499.

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.