Navigating Benefits

Is Orthodontic Coverage a Good Fit for Your Organization?


  • More than 4 million people currently receive orthodontic treatment and, out of that number, around 1.5 million are adults

  • When adding orthodontic coverage to your organization's benefits plan, you'll have to decide if it is just for dependents or includes adults, too

  • Employees love having orthodontic coverage, but may not understand how the benefits are paid

Posted by March 18, 2019

Dental insurance is almost always a standard employee benefit. But a plan that also includes orthodontic coverage? Not typically.

When you consider that more than 4 million people—in the United States and Canada combined—are currently in the care of an orthodontist, adding this kind of coverage to your organization’s employee benefits package may be worth mulling over. In fact, you may already be getting questions from colleagues as to whether or not the company’s dental plan covers orthodontic treatment.

Just like any other employee benefit, orthodontic coverage comes with many pros and cons, and, ultimately, it might not be worthwhile for your business to offer it. So, here are a few things you should consider before adding the benefit to your organization’s current plan.

What Falls Under Orthodontic Coverage?

It’s safe to say that most people associate orthodontics with braces. And they’re correct! But while the act of straightening teeth seems strictly cosmetic because of its confidence-boosting results, orthodontic treatment also helps to prevent dental disease.

Misaligned, protruded or crooked teeth are often harder to keep clean and can put people at risk for tooth decay, gum disease and tooth loss. Additionally, when teeth don’t meet properly, it can lead to abnormal wear and tear of tooth enamel, as well as chewing and jaw problems and even speech difficulties.

Being able to help improve employees’ self-esteem is a great reason to consider offering orthodontic coverage in and of itself; and for many individuals, a healthy, attractive smile can be a career-booster as well. Providing this benefit may even give your organization’s recruitment efforts a competitive edge.

Deciding Who Gets Coverage

Children, teens and adults can all benefit from braces and general orthodontic services. In fact, the American Association of Orthodontics estimates that almost 1.5 million adults are currently receiving orthodontic treatment. While adults tend to have denser enamel, their teeth can still be moved, and outcomes can be just as successful as with adolescents—it just takes a little longer, depending on the difficulty of the case.

In the past, most dental plans only provided orthodontic coverage for dependents under the age of 18. But with an increased interest from employees (and the knowledge that it’s never too late to reap the benefits of healthy straight teeth), many employers have now opted to cover orthodontics for adults.

So, who will be eligible for coverage if your company decides to add orthodontics to the dental plan? Employees with young families will find the addition to be a valuable, cost-savings benefit, even if coverage is limited to only dependents. But adult coverage could be a huge perk for mothers and fathers who’ve been putting off their orthodontic needs—and it’s definitely a desirable benefit for young hires.

However, if you’re a small company with only a handful of older employees, offering full orthodontic coverage might not be worthwhile because the cost may not equate to the benefit reaped. And there’s no sense in providing something that employees don’t need or want!

Explaining How Are Benefits Paid

Even though your colleagues may appreciate having coverage for orthodontic treatment, some might experience confusion regarding how the benefits will be paid—and when. For example, orthodontic benefits are subject to a lifetime maximum, whereas payments for other covered dental services are based on a yearly maximum.

Also, there may or may not be a separate orthodontic deductible, and payments are typically based on a set percentage paid out during the course of the treatment or until the lifetime maximum is met. If your dental plan uses a broad network of providers, you’ll also want to make sure it includes participating orthodontists in locations that are convenient for your fellow employees.

Investing in Your Colleagues

You likely know your company’s workforce well, but before adjusting the existing benefits package, you might want to consider holding a meeting (or conducting an employee survey) to evaluate everyone’s needs and wants. This can effectively gauge interest in proposed offerings, and open the door for employees to suggest any other benefits they may like to see in the future, too.

Interested in comparing different dental benefits packages to find the best fit for your organization? Explore the Dental Plan Navigator on United Concordia Dental’s website.

You may also like