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Article | July 2018

Orthodontic Coverage: What Dental Insurance Plans Cover Braces?

Orthodontic services include things like braces and other specialty dental treatments to help straighten teeth. Not all dental insurance plans cover braces. Here’s what you need to know to help find the right dental plan for you.

What are orthodontic services?

Orthodontic services would include braces and some other specialty dental care and treatments. Not all dental plans include coverage for orthodontic services, so it’s important that you read your plan materials carefully.

How do I know if I need braces?

Are you happy with your smile? If you have an overbite, under bite, overlapping, or generally crowded teeth, an orthodontist can come up with a treatment plan to help straighten your teeth. This plan may include braces, as well as other types of dental appliances, such as space maintainers and retainers.

How do I find dental insurance that covers braces?

You can get dental coverage in one of two ways. If you have an employer that offers dental insurance you can choose a dental plan as part of your benefits. If not, you can buy one on your own through a health insurance carrier that sells individual and family dental insurance plans, or through the Health Insurance Marketplace.

With any type of plan, be sure to check if orthodontic coverage is included. There are usually limits, and not every plan includes coverage for braces and other orthodontic services. For example, a plan may cover braces for children, but not for adults.

How do I choose the right dental plan for orthodontic care?

  • Confirm that the dental plan you’re considering covers orthodontic services. You can review the plan materials to learn about covered and non-covered services, such as braces and other orthodontic treatments.
  • Most dental plans come with a network of dental providers. Make sure that if there’s a certain orthodontist you want to see that they participate in your plan’s network. You’ll save money when you stay in-network.
  • Check your plan for any coverage limits – for example, you may only have a certain amount of money you can spend per year and be covered for orthodontics, or there may be a waiting period between dental treatments. Many plans also apply a lifetime maximum to orthodontic treatment, if this coverage is included with the plan.
  • If a dental plan doesn’t cover orthodontic services, you may still be eligible for discounts on these types of services. Discounts might require you to use an orthodontist in your plan’s network. Contact the dental plan or insurance provider for details.

What are some dental insurance cost-savings tips?

First, make sure your orthodontic coverage is in place and you satisfy any waiting periods before any treatment begins. Make sure you clearly understand the details of your dental plan so you don’t have to pay for unexpected costs.

Knowing exactly what treatments you need will help you find dental insurance that covers braces. While many dental insurance plans include coverage for braces, be aware of any additional costs that may be a part of your treatment. Once your orthodontic treatment begins, closely follow the terms of your plan so that you can take advantage of any discounts your plan qualifies you for.

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