Orthodontic Insurance Coverage for Braces

Dental Health
By:Spirit Dental
September 6, 2016




Updated May 2022

Orthodontic care involves the use of braces and other appliances to straighten teeth and align the bite. For example, if there are gaps between your teeth, they’re crooked, or you have an overbite, you can consult with an orthodontist to see what can be done to perfect your smile. 

Although orthodontics can be used to achieve incredible results, many people find it hard to afford them because they’re expensive. Thankfully, there’s dental insurance for braces that can help reduce the out-of-pocket cost of orthodontics. 

Does dental insurance cover braces?

Yes! And, even though you might think that braces dental insurance is for families with kids, the truth is you can get coverage for adult orthodontics too.  

Why should you bother paying for this type of coverage? Put simply, it can help you save a lot of money. Orthodontics, such as ceramic braces or Invisalign, might cost up to $8,000 or more, on average. So, if you enroll in a plan that covers orthodontics at upwards of 50%, you might save hundreds or even thousands over the course of the treatment. 

What does orthodontic insurance cover? 

You can find affordable dental insurance that covers braces, retainers, and other appliances that help with straightening teeth, correcting malocclusion, and addressing other concerns. You might even find plans that cover Invisalign so you can take advantage of the perks of using clear aligners instead of traditional braces. 

In addition to covering the cost of orthodontic appliances, a good quality plan may also help you pay for exams, X-rays, and other treatments, such as extractions, that are necessary to ensure a patient will get the best results. 

Things to consider when shopping for orthodontic insurance

  • Not all dental policies will cover orthodontics, and some might only cover orthodontics for kids. 
  • Some insurers might only cover orthodontics if they’re deemed medically necessary rather than cosmetic. 
  • Check for restrictions, limitations, and out-of-pocket fees. For example, there might be a waiting period before you can receive orthodontic coverage, there might be pre-existing conditions exclusions, or you may be limited to choosing from a network of providers.
  • When it comes to out-of-pocket expenses, there may be a copay, deductible, or coinsurance that you’ll be responsible for. 
  • Check if there is an annual maximum and lifetime maximum that determine how much the insurer will pay for orthodontic treatment before you need to cover the balance.  

Note: You might be able to add on this type of coverage as a supplement to another policy. 

What do braces cost with insurance vs. without insurance?

What you’ll end up paying will depend on factors like your location, the length of treatment, if any other procedures are necessary, and the types of braces used. 

If you don’t have insurance, you’ll need to pay for orthodontic care completely out of pocket. This can be stressful because the average cost of braces might be anywhere from $3,000 to a whopping $10,000. 

By enrolling in dental insurance that covers orthodontics, you might potentially save hundreds or thousands, depending on the plan’s coverage details and limits, as well as the cost of the orthodontic treatment from start to finish. 

Example: If you have a plan that covers half of a $3,000 bill, you’d need to pay the remaining half, or $1,500. But, again, it’s important to keep in mind that annual and lifetime maximums, as well as other out-of-pocket costs, can impact how much you’ll end up paying in total.  

 

Spirit Dental offers the best dental insurance for braces

At Spirit Dental, we understand how important and necessary orthodontic care is. That’s why we offer plans that provide this type of coverage. Check out our network plans, such as our Network 1200/2500/5000 plan, to get the right amount of support for ultimate peace of mind. 

As an example, we offer plans that include a $1,200 orthodontia benefit that can help pay for an evaluation and treatments for dependent children. These have a $600 annual limit and a $1,200 lifetime maximum. 

Our plans can also provide 10% coverage for the first year, 25% for the second year, and 50% for the third year. Plus, they come with a low, one-time $100 deductible, and there are no waiting periods

Sign up for dental insurance for orthodontics today

If you’re interested in learning more about what Spirit Dental has to offer when it comes to insurance for braces, contact us anytime. You can also easily get a quote online to see which plans are available in your area. 

 

 

Sources:

https://www.cigna.com/individuals-families/understanding-insurance/orthodontic-insurance
https://www.dentaly.org/us/dental-insurance-usa/insurance-for-braces/
https://www.valuepenguin.com/average-cost-braces  
https://www.healthline.com/health/average-cost-of-braces
https://www.orthodonticspecialists.net/our-blog/does-my-insurance-cover-braces
https://www.orthodonticharmony.com/is-orthodontic-treatment-covered-by-insurance/ 

 



Search for Resources

Categories

Senior Dental Health
Procedures
Nutrition
Eye Health
Children's Dental Health
Dental Health