Braces can completely transform your smile, but they also come with a price tag that makes many people pause before starting treatment. One of the first questions most people ask is, “Does dental insurance cover braces?” The answer depends on your specific plan, your age, and the reason you need orthodontic treatment. Let’s break it down in simple terms so you know what to expect before you or your child starts the journey to a straighter smile.
Understanding How Dental Insurance Works for Braces
When it comes to dental insurance and braces, coverage can vary a lot from one plan to another. Most dental insurance plans help with preventive care—things like cleanings, exams, and X-rays. However, orthodontic care (which includes braces, retainers, and aligners) is usually treated as a separate category.
Some dental insurance plans include orthodontic coverage automatically, while others don’t cover it at all unless you purchase an add-on or premium plan. That’s why it’s so important to review your plan details before you begin treatment.
In general, dental insurance that covers braces will only pay a percentage of the cost—usually up to a specific lifetime maximum limit for orthodontic treatment.
How Much Does Dental Insurance Cover for Braces?
If your plan includes orthodontic benefits, most dental insurance coverage for braces pays around 50% of the total treatment cost, but only up to a certain limit. The typical lifetime maximum ranges between $1,000 and $3,000 depending on your policy.
For example, if braces cost $5,000 and your insurance covers 50% up to $2,000, you’ll still have to pay the remaining $3,000 out of pocket.
It’s also worth noting that some dental insurance plans only cover braces for children under 18. Adults often need to choose higher-tier plans or supplemental orthodontic insurance to receive coverage.
Types of Braces Covered by Dental Insurance
Another factor to consider is the type of braces you’re getting. Traditional metal braces are more likely to be covered by insurance since they are considered the standard treatment.
However, clear aligners like Invisalign or ceramic braces are sometimes seen as “cosmetic” and might not be fully covered. Some plans may reimburse part of the cost, but you’ll need to check with your provider.
If you’re leaning toward Invisalign, ask your dentist or orthodontist to provide a cost estimate and contact your insurance company directly to confirm how much will be covered.
When Dental Insurance Does Not Cover Braces
Unfortunately, not every insurance policy includes orthodontic benefits. Some basic or low-cost dental plans focus only on preventive and restorative care, such as fillings, cleanings, or crowns.
If your plan doesn’t include orthodontic coverage, you’ll have to pay the full cost out of pocket. Another common limitation is age restrictions—many insurance providers won’t cover braces for adults, even if the plan includes orthodontic benefits for children.
Additionally, insurance companies may deny coverage if braces are considered purely cosmetic and not medically necessary. For example, if the treatment is done only to slightly improve appearance and not to correct a functional bite issue, you may not qualify for coverage.
How to Find Dental Insurance That Covers Braces
If you don’t already have a plan that includes orthodontic benefits, you can still find dental insurance that covers braces by comparing providers and plan tiers.
Look for plans that specifically mention orthodontic coverage in their policy details. Some insurance companies that often provide orthodontic coverage include:
- Delta Dental
- Cigna
- MetLife
- Humana
- Guardian
You can also check if your employer-sponsored dental plan includes orthodontic benefits. If not, consider adding supplemental orthodontic coverage or using a dental discount plan, which offers reduced rates with participating orthodontists.
Other Ways to Save on Braces Without Full Insurance Coverage
Even if your dental insurance doesn’t cover braces, there are several ways to reduce the cost of treatment. Many orthodontists understand that braces can be expensive and offer flexible payment options.
You can ask about:
- Payment plans: Monthly installment options that spread out the cost over time.
- Dental discount programs: Membership-based plans that provide discounts on braces and aligners.
- Health Savings Account (HSA) or Flexible Spending Account (FSA): You can use pre-tax dollars to pay for orthodontic treatment.
- Special promotions: Some orthodontic offices offer discounts for upfront payments or family members receiving treatment at the same time.
These options can help you manage the cost, especially if your insurance only covers part of the treatment.
Does Dental Insurance Cover Braces for Adults?
Adult orthodontics has become more common, but dental insurance for braces in adults is still limited. While many policies cover children, adults often need to buy specialized plans.
However, some insurance companies have started offering more flexible coverage that includes adult braces and clear aligners. It’s worth shopping around and comparing policies before committing to one. Even if you don’t find full coverage, a plan that offers partial reimbursement can still help you save significantly.
The Importance of Checking Your Plan Before Starting Braces
Before you start treatment, always ask your dentist or orthodontist for a pre-treatment estimate. They can submit a request to your insurance provider to confirm how much of the cost will be covered and what you’ll be responsible for.
This step ensures you know the exact amount before treatment begins and helps avoid any billing surprises. It’s also a good time to ask your provider about the waiting period, as some dental insurance plans require you to wait several months before orthodontic coverage kicks in.
Final Thoughts on Dental Insurance and Braces
So, does dental insurance cover braces? In many cases, yes—but not always completely. Most plans with orthodontic benefits cover a portion of the treatment cost, often up to a set lifetime maximum. However, you’ll still need to pay some out-of-pocket costs, especially for adult treatment or cosmetic aligners.
If your current insurance doesn’t offer orthodontic coverage, consider looking into supplemental plans or discount programs to reduce your expenses. Straightening your teeth is not just about appearance—it’s also about improving your bite, oral health, and confidence.
Before you start your braces journey, make sure you understand what your insurance covers, what it doesn’t, and how you can make the most of your benefits.