3 Orthodontic Insurance Tips

Orthodontic Insurance

These three orthodontic insurance tips will help you prepare for your orthodontic consultation. At KCC Orthodontics, we accept most insurances and we want you to understand more about how orthodontic insurance works. 

  1. Dental insurance plans cover orthodontic treatment, not medical plans.

There is a misconception that medical insurance will cover all orthodontic treatment. Oftentimes, this is incorrect. There are few orthodontic treatments that your medical plan will cover. These are typically orthodontic cases requiring some type of surgery.

It is primarily dental insurance that covers orthodontic insurance benefits. But, not all dental insurance plans cover orthodontics! If you are considering metal braces, clear braces (LightForce), or Invisalign, we recommend you research your dental plan coverage.

You will want to choose a dental plan that specifically covers orthodontics. Another detail to research is whether there is an age limit for orthodontics. Some plans have age limits starting as young 19 up to 26, while others have no age limit for benefits. Lastly, you must make any dental insurance decisions during your open enrollment period. Orthodontic coverage cannot be added in the middle of a term.

Our insurance coordinator will verify your benefits before your consultation at KCC Orthodontics. We will then explain the benefits at your appointment.

  1. Orthodontic insurance is paid out over the course of treatment.

In Orthodontics, insurance pays out differently than you’re probably used to. Most insurance coverage is paid out at one time for dental services you receive. However, insurance companies pay out your orthodontic benefit over the course of treatment. Orthodontic treatment length is usually 18-24 months. To receive your full benefit, the policy must remain active for the entire length of your orthodontic treatment. Any benefit not paid becomes your responsibility.

The frequency that insurance pays varies from plan to plan. If you are a current patient and have questions about how often your insurance plan pays, please call us. You may ask for our Insurance Coordinator, Annie by calling (281) 392-0888.

  1. Orthodontic insurance may have a contracted rate.

Your orthodontic providermay have a contracted rate, if they are in network with your insurance. There may also be a lifetime maximum that will be paid. The policy must stay active. Once that maximum is met, there are no additional orthodontic benefits. At the consultation, we will discuss your specific cost, including any specific details.


If you have any questions about your insurance plan, please call our office at (281) 392-0888. You may also contact your insurance provider. We offer free consultations in Katy, Texas every week and would love to meet you to discuss YOUR options! We will provide you with estimated treatment fees at the end of your consultation.

Request a free consultation and we will call you to schedule! Dr. Gutierrez & all of us on the KCC Orthodontics team look forward to meeting you.

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