Does ObamaCare Provide Orthodontic Coverage?
I have dental coverage through Delta Dental. My question is, I am 38 years old and need braces. My alignment and bite is off and causing medical problems such as biting inside of mouth and cheeks, TMJ with headaches. My insurance company will not cover anyone over the age of 26. I have started having problems back in 2011 but could not afford braces as I was a stay at home mom with 2 little kids. Since then I have continued to have TMJ problems and my teeth shifted to the point where my teeth are completely crooked. I have had 3 root canals and cavities b/c of my teeth shifting and causing cavities no matter what. In order to correct this problem and not have future issues with my teeth and jaw I need braces. Is there a plan that will assist me with this cost?
Answer
Children are required to be offered dental, but adults aren't. Medical coverage doesn't always extend to dental, this leaves major dental surgery uncovered for many. Unless your health plan considers the orthodontic work to be critical to your health it most likely wouldn't be covered under your health plan. A dental plan would cover it, however the cost sharing structure of dental insurance might not do much to pad the costs of your surgery. You can try talking to your dentist, doctor, and insurance about this issue and see if you can come up with a solution.
Learn more about ObamaCare and dental coverage.
Rate and Comment on the Answer
This site uses Akismet to reduce spam. Learn how your comment data is processed.
Many states require the jaw to be treated the same as any other joint by insurance. See the link for a list.
http://www.ada.org/~/media/ADA/Advocacy/Files/thirdparty_TMD_coverage.ashx
Great find. Thank you.
I have Blue Cross/Blue Shield medical insurance through my Texas employer and they are refusing to cover costs associated with my jaw because it is TMJ related. I do not currently have dental insurance. This issue is having a significant impact on my life due to having to eat soft foods, take anti inflammatory and pain medicine and muscle relaxers. I am also having jaw pain and headaches. I need an MRI and probably surgery.
Is Blue Cross legally allowed to deny coverage for this?
https://obamacarefacts.com/appeal-health-insurance-denial/
I’m 18 and on my own and I need Invisalign .. and I have Medicaid and they don’t cover braces or anything ! Where can I go to get Invisalign and who will cover me not as an adult
You can inquire about stand-alone dental plans, perhaps Medicaid has suggestions. You can also talk to local dental schools and see if they offer discounts for low income.