Does Dental Insurance Cover Braces?

If you or your child need braces to correct a misaligned bite or crooked teeth, you may wonder if dental insurance covers the cost. The answer is, it depends on your specific policy and the type of treatment you need. In this article, we will explore the different types of dental insurance coverage for braces, what you can expect to pay out of pocket, and some frequently asked questions about orthodontic treatment.

Types of Dental Insurance Coverage for Braces

There are typically two types of dental insurance coverage for braces:

1. Orthodontic coverage
2. Comprehensive coverage

Orthodontic Coverage

Orthodontic coverage is a type of dental insurance that specifically covers the cost of braces and other orthodontic treatments. This type of coverage is usually offered as a separate plan or as an optional add-on to a dental insurance policy. If you have orthodontic coverage, your insurance company will typically pay a certain percentage of the cost of braces, up to a specified lifetime maximum amount. You will be responsible for paying the remaining balance.

Comprehensive Coverage

Comprehensive coverage, on the other hand, is a type of dental insurance that covers a broad range of dental services, including preventive care, restorative treatments, and orthodontic care. If you have comprehensive coverage, your insurance company may cover a portion of the cost of braces, but it may be subject to a waiting period or other limitations. You will need to check your specific policy to see what is covered.

What to Expect to Pay Out of Pocket

Even if you have dental insurance coverage for braces, you will likely still need to pay some out-of-pocket expenses. This can include deductibles, co-payments, and any costs that exceed your insurance company’s lifetime maximum benefit. The exact amount you will need to pay will depend on your specific policy and the type of treatment you need.

It is important to note that some orthodontic treatments, such as clear aligners, may not be covered by insurance at all. In these cases, you will need to pay the full cost of treatment out of pocket or look into financing options.

Frequently Asked Questions

Do all dental insurance plans cover braces?

No, not all dental insurance plans cover braces. You will need to check with your specific insurance company to see what orthodontic benefits are included in your policy.

What is the average cost of braces without insurance?

The average cost of braces without insurance can range from $3,000 to $7,000 or more, depending on the type of treatment you need and where you live.

Can adults get braces covered by insurance?

Yes, adults can get braces covered by insurance, but it depends on the specific policy they have. Some insurance companies may have age restrictions or other limitations on orthodontic coverage. You will need to check your policy to see what is covered.

What types of braces are covered by insurance?

The types of braces that are covered by insurance will depend on your specific policy. Traditional metal braces are usually covered, but clear aligners or other types of orthodontic treatments may not be covered. You will need to check your policy to see what is covered.

Conclusion

If you are considering braces for yourself or your child, it is important to understand your dental insurance coverage and what you can expect to pay out of pocket. Be sure to check your specific policy to see what orthodontic benefits are included, and consider financing options if necessary. With the right coverage and a little planning, you can get the orthodontic care you need without breaking the bank.