Would orthodontic surgery usually be covered under your medical benefits?

[hongkongfever]

I may be in a position to move into full time at my current job in the coming months. That means I'll be receiving full medical benefits. I have always planned to get my jaw realigned and my teeth straightened. When and if I get full medical benefits, would these kind of procedures be covered? I am almost positive braces won't be covered (or partly will be) since it's somewhat cosmetics. But my jaw is somewhat shifted as well (felt it shifting during the teen years). Would surgery to realign it also be considered cosmetics?

 

[ingenuiti]

Actually, most dental insurance cover orthodontic work like braces. They usually cover 50% of the cost up to a limit of $2500. Anything over that and the excess will come out of your pocket.

 

[Babbles]

Braces will be under dental insurance, not the other health insurance. If your dentist/orthadontist refers you to a maxillofacial surgeon, which is a MD not DDS, I think dental insurance will pick it up. If you don't have dental the other health insurance may instead.

You have to look at how your policy is set up. If it is recommended by a doctor then it may not be considered cosmetic, and even if it is you should have some provision in there to cover elective surgeries.

You really need to look at your policy and/or ask your HR person in charge of benefits.

 

[Zebo]

It depends... I've noticed in about 15 years of working dental plans getting weaker. Usually orthodontic work is 50% up to $5000. The maxillofacial surgery is covered under medical insurance depending.. and depending on plan would most likly cover the whole shabang with minimal co-pay. gluck..i don't envy you...

What you need is a wife so her plan(s) covers the balance

 

[hongkongfever]

So worst comes to worst, I will at least be covered 50% of the cost up to a certain amount?

 

[BustaBust]

Dental coverage for me is "optional"

 

[ingenuiti]

The best thing you can do is wait until you have access to a customer service agent of your employer's dental plan. Explain to them what you plan on doing and they will specifically tell you what they will cover.

 

[exorr]

It depends. As everyone said this would be dental insurance. However, depending on the reason your doing it they may not cover it (or not much of it). If your doing it for health reasons, then yes, I would assume they'll cover probably 75-90% (after your deductible).

 

[rh71]

covered for up to $2500 worth of major work lifetime (one-time) for me.

 

[hongkongfever]

I'm pretty sure my medical benefits will include a dental and vision plan as well. Pay isn't great but it makes up for it with one of the best medical/dental/vision plans according to a few co-workers.

 

[LethalWolfe]

Originally posted by: hongkongfever
So worst comes to worst, I will at least be covered 50% of the cost up to a certain amount?

Worst comes to worst insurance won't cover it at all. Years ago my ortho recommended I have surgery to correct my underbite and my insurance at the time wouldn't cover it (by their standards it was cosmetic). Cost woulda been around $15,000.


Lethal