Dental Blog / Does Insurance Cover Braces?

Does Insurance Cover Braces?

Does dental insurance cover braces? Unfortunately, not all plans automatically come with this level of coverage. This means that, without the right braces insurance, you could be hit hard if you or your kids ever need orthodontics. 

How much do braces cost? And are the costs different for kids than they are for adults? We break it down for you below to give you an idea of what you should look for when shopping for the best dental insurance for braces.  

How Much Do Braces Cost a Month?

Because it’s often necessary to wear braces for years (the average is two years), it’s important to realize the long-term costs of this treatment. This will help you calculate the monthly cost more accurately. How long you’ll be required to wear the braces, and how much you’ll pay for them, will depend on various factors, such as the condition of your teeth and the reason for the braces, as well as the types of braces you’ll need. 

How much will braces cost without insurance?

Here are some average prices:

  • Metal braces, which are the most affordable, might cost $3,000 to $7,000.
  • Ceramic braces might cost anywhere from $4,000 to $8,000.
  • Lingual braces might cost $8,000 to $10,000.
  • Invisalign might cost $3,000 to $8,000.

How much will braces cost with insurance?

Well, it depends on the plan you signed up for. If your insurance provider covers a percentage of the care, such as 50%, you’ll need to budget so you can cover the rest, along with any deductibles and copays that you’re also required to pay. No matter what, though, if you have insurance that covers orthodontics, you can save hundreds or even thousands of dollars.   

Braces for Kids

Kids might need braces for a variety of reasons, from fixing a bite to straightening teeth that are misaligned due to crowding or spacing problems.  

Does insurance cover braces in this case? Yes, as long as you sign up for the right plan. Beware that some insurance plans will only cover braces if they’re deemed medically necessary, such as if your child has trouble chewing.    

How much do braces cost for kids?

On average, braces can cost $5,000 to $6,000. But it really depends on how long the treatment will last. 

For example, if treatment costs around $2,500 per year, if your child needs to wear the braces for three years, the total cost would be $7,500. And if there are any complications along the way, that can affect the cost as well.  

Braces for Adults

Even though you might think that braces are only used in kids and teens, the truth is that adults sometimes need orthodontics as well. 

You might need braces if you never got them when you were younger but you aren’t happy with the way your teeth look because they’re misaligned. Or, you might find it difficult to keep misaligned teeth as clean as they need to be. And you might need braces to fix a problem with your teeth or your bite in order to make it easier to chew your food. 

Regardless of the reason for wanting braces, if you don’t have the right dental insurance that covers braces for adults, the cost alone might hold you back from getting the treatment you need. And, as is the case with braces for kids, an insurance company might deny coverage if you want orthodontics just for cosmetic reasons, so enrolling in the right plan is key. 

How much do braces cost for adults?

Depending on how long you need to wear your braces, they might cost anywhere from $2,500 to $10,000. 

Compared to braces for kids, those for adults tend to be a bit pricier. On average, it’s around 3.6% higher. This means you might need to pay several hundred dollars more than you would for treating a child with similar needs. 

Things to Keep in Mind When Shopping for Dental Insurance for Braces

Searching for the right dental insurance plan is easy when you use a resource like the Direct Benefits Marketplace, where you can compare plans that are available in your area and see if supplemental orthodontic insurance is an option. 

As you shop, keep the following in mind:

Dental insurance plans will differ based on where you’re located. Some might only offer discounts on orthodontics. Plans also vary when it comes to annual maximums and lifetime maximums that can affect how much support you’ll receive, as well as out-of-pocket costs like copays that you’ll be responsible for.   

Some plans might not cover braces for adults. And, even when it comes to coverage for orthodontics for children, options can vary widely. 

There might be limits to the amount of coverage provided for orthodontics, or there might be a waiting period before you can get braces. 

There might be restrictions on the types of orthodontics that are covered. For example, if you want Invisalign rather than traditional braces, read the fine print to be certain this will be covered too. 

You might be restricted when it comes to selecting an orthodontist, especially if you need to stick with in-network dental pros to save the most money. 

Overall, the goal is to find a plan that won’t only cover the braces themselves, but will also be there to help cover the costs of examinations and other treatments that you’ll need before, during, and after orthodontic care. Once you’ve found the perfect provider and policy, you’ll be on your way to sporting the perfect smile!