Orthodontic Insurance - Dental Plans that Cover Braces
Do your children need braces or are you looking for orthodontic insurance for adults? This guide, written by an industry insider, will give you answers for questions such as:
- What's the average cost of braces?
- Does dental insurance cover braces?
- What kind of orthodontic benefits are covered by dental insurance?
- How do I confirm dental insurance coverage of braces?
- Which dental insurance covers braces?
How Much Do Braces Cost?
Many parents wince when they realize their child will need braces. The average cost of braces, according to the American Dental Association's 2020 Annual Survey of Dental Fees was approximately $6,000 for adult braces, though it should be remembered that many factors can affect the total cost. These factors include not only the circumstances of the patient's dental situation, the type of braces used, but also the region in which the patient receives orthodontic care. Consumer Affairs reports that braces may cost as much as $13,000.
Braces are a form of orthodontic service, a sub-discipline within the field of dentistry. The treatment provides treatment for patients not only with improperly aligned teeth but also improperly aligned jaw or bite patterns. The four main categories of braces are:
- Traditional braces
- Invisalign braces
- Ceramic braces
- Lingual (a.k.a. "invisible") braces
Traditional braces are the metal variety with which most people are familiar. Generally this brace type is considered to be the least expensive of the four mentioned above and costs around $5,900 on average. Ceramic braces, which look like traditional braces but are transparent, are slightly more expensive. Invisalign braces are clear plastic shells that fit directly over the teeth. The price for Invisalign aligners vary by circumstances but the company website provides multiple scenarios that cost from $3,400 to $7,100. Less common in the United States than Europe, lingual braces are metal braces that attach to the back side of the teeth and, therefore, are invisible. Consumers who decide to use lingual braces should expect to pay more than the traditional meta version. The OralB webpage devoted to brace costs lists the price range for this option between $8,000 and $10,000.
Does Dental Insurance Cover Braces?
So do but many dental plans exclude services provided by an orthodontist. However, by reviewing a dental plan's summary of benefits (or plan brochure), you should be able to quickly identify if orthodontics are covered and under what conditions (including waiting periods). The bottom of the article has a list of plans with orthodontic benefits but before reviewing them, it is important to understand how orthodontic coverage varies among plans.
Different Schemes of Orthodontic Coverage
Below are a few examples of orthodontic benefit conditions observed in various dental plans offered in multiple states. They illustrate the lack of uniformity among orthodontic benefits and the need for careful shopping on the part of consumers.
Orthodontic benefits are available to all ages under this plan
Orthodontia – 12-month waiting period
1st year of insurance enrollment – 0% (Not a covered service)
2nd year of insurance enrollment and after – 50% coverage after $150 Orthodontia deductible satisfied $1500 Lifetime Maximum per eligible dependent child
Orthodontic benefits are only available for eligible dependent children up to age 19
1st year of insurance enrollment – 10%
2nd year of insurance enrollment – 25%
3rd year of insurance enrollment – 50%
$1200 lifetime maximum per person for this benefit
As demonstrated in Example 1, a dental plan that offers orthodontic coverage may use a "waiting period" that delays the benefit's availability.
Confirming Orthodontic Coverage
Given the irregular coverage of orthodontic services among dental plans, a consumer can't apply for insurance and hope for the best. Instead, he or she must confirm not just the presence of orthodontic coverage but the specifics of that coverage. This can be accomplished reviewing one of the following resources:
- An online "plan details" button
- A summary of benefits
- A plan brochure
If these resources aren't available or have vague information, the consumer can also use the customer service number on our website.
Orthodontic Insurance for Adults
If you are an adult looking for coverage for braces in a dental plan, be certain to look for plan language that limits orthodontic services to dependents under a particular age (e.g. 19 years old).
Which Dental Plans Cover Braces?
The below list includes dental plans in each state (and Washington D.C.) that have some level of coverage for orthodontia. Some of these plans may not be available within all regions of the state for which it is listed.
If you are interest in a plan, READ THE PLAN DETAILS BECAUSE OF DIFFERING LEVELS OF ORTHODONTIC COVERAGE AS WELL AS WAITING PERIODS BEFORE SERVICES LIKE BRACES ARE COVERED. Additionally, some dental plans limit their orthodontic benefits to dependent children under the age of 19. Consequently, reading the plan details for the specifics of orthodontic coverage is essential for the savvy shopper.
If you see a plan you like, you can get a dental plan quote in a few clicks.
|Alabama||Guardian Direct||Advantage Diamond|
|Alaska||MetLife||TakeAlong Dental High|
|Arizona||Renaissance Dental||MAX Choice Plus|
|Arkansas||Guardian Direct||Advantage Achiever|
|California||California Dental Network||Plan 595|
|Colorado||Anthem||Essential Choice Incentive|
|Connecticut||MetLife||TakeAlong Dental High|
|Delaware||Delta Dental||Dental for Everyone Diamond Premier|
|Florida||Delta Dental||Dental for Everyone Platinum|
|Georgia||Renaissance Dental||Max Choice|
|Hawaii||Guardian Direct||Advantage Diamond|
|Idaho||Careington||500 Series Dental Savings (Discount Program, Not Insurance)|
|Illinois||MetLife||TakeAlong Dental High|
|Indiana||Anthem||Essential Choice Incentive|
|Iowa||Renaissance Dental||MAX Choice Plus|
|Kansas||Careington||500 Series Dental Savings (Discount Program, Not Insurance)|
|Kentucky||Delta Dental of Kentucky||Bright smiles|
|Louisiana||Guardian Direct||Advantage Achiever|
|Maine||Anthem||Essential Choice Platinum|
|Maryland||Dominion National||Select Plan Premium|
|Massachusetts||Renaissance Dental||MAX Choice Plus|
|Michigan||Guardian Direct||Advantage Diamond|
|Minnesota||MetLife||TakeAlong Dental High|
|Mississippi||Delta Dental||Immediate Coverage Plan|
|Missouri||Careington||500 Series Dental Savings (Discount Program, Not Insurance)|
|Montana||Delta Dental||Dental for Everyone Platinum Premier|
|Nebraska||Renaissance Dental||MAX Choice Plus|
|Nevada||Anthem||Essential Choice Incentive|
|New Hampshire||Anthem||Essential Choice Platinum|
|New Jersey||Guardian Direct||Advantage Diamond|
|New Mexico||Careington||500 Series Dental Savings (Discount Program, Not Insurance)|
|New York||Empire BlueCross BlueShield||Essential Choice Platinum|
|North Carolina||MetLife||TakeAlong Dental High|
|North Dakota||Guardian Direct||Advantage Achiever|
|Ohio||Renaissance Dental||MAX Choice Plus|
|Oklahoma||MetLife||TakeAlong Dental High|
|Oregon||Dental Health Services||Super SmartSmile|
|Pennsylvania||Dominion National||Select Plan Premium|
|Rhode Island||Careington||500 Series Dental Savings (Discount Program, Not Insurance)|
|South Carolina||Guardian Direct||Advantage Diamond|
|South Dakota||MetLife||TakeAlong Dental High|
|Tennessee||Delta Dental of Tennessee||Brighter Advantage|
|Texas||Delta Dental||Immediate Coverage Plan|
|Utah||Renaissance Dental||Max Choice|
|Vermont||Guardian Direct||Advantage Achiever|
|Virginia||Dominion National||Select Plan Premium|
|Washington State||MetLife||TakeAlong Dental High|
|Washington D.C.||Dominion National||Select Plan Premium|
|West Virginia||Careington||500 Series Dental Savings (Discount Program, Not Insurance)|
|Wisconsin||Anthem||Essential Choice Incentive|
|Wyoming||MetLife||TakeAlong Dental High|
Click our Dental Insurance link here and find plans available in your zip code.