Check whether your plan covers orthodontic treatment
Review your policy’s dental and medical benefits
Confirm whether braces are covered for medical necessity
Get a diagnosis from a dentist or orthodontist
Ask for documentation showing functional problems
Obtain records of jaw pain, bite issues, speech problems, or chewing difficulty
Request a referral from your primary care doctor if needed
Verify whether preauthorization is required
Submit all required forms before treatment starts
Ask the orthodontist to code the claim correctly
Use medical codes if the braces are tied to a medical condition
Provide X-rays, exams, and treatment plans with the claim
Appeal any denial with additional medical evidence
Ask your insurer for the exact criteria for coverage
Keep copies of all bills, records, and correspondence
Check whether your employer offers supplemental orthodontic benefits
Compare in-network and out-of-network coverage
Ask about payment plans if coverage is partial
If denied, request a written explanation of benefits
File a formal appeal within the insurer’s deadline
Consult a benefits specialist if the case is complex