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Will My Dental Insurance Cover Braces?

By Insurance Industry Expert & Author
Updated on

Dental Insurance & Orthodontic Benefits

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 adults, 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.

In this article, the following topics will be reviewed to help you with your questions about orthodontic benefits within dental coverage:

  • Types of braces and price implications
  • Do braces cost more for adults?
  • Dental insurance and orthodontic benefits
  • A list of dental plans with coverage for braces and other orthodontic care

Types of Braces & Price Implications

Braces are a form of orthodontic service. Orthodontics, a sub-discipline within the field of dentistry, provides treatment for patients not only with improperly aligned teeth but also improperly aligned jaw or bite patterns. Braces have evolved with the times and now there are several kinds of braces available as opposed to a few generations ago when people were essentially limited to metal braces or nothing. The four main categories of braces are:

  • Traditional braces
  • Invisalign braces
  • Ceramic braces
  • Lingual (a.k.a. "invisible") braces

Average Cost of 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. 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. Costs vary by circumstances but the Invisalign website provides multiple cost scenarios ranging 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.

For more detailed information on your options for braces, see our article "Orthodontia Services."

Do Braces Cost More for Adults?

While braces are associated with childhood, adults can also wear braces to improve their smiles. Braces applied to adults may take longer to straighten teeth and may require a longer treatment period. A longer treatment period, in turn, may mean higher costs for the patient.

Other Orthodontia Services

Orthodontic services extend beyond merely the installation and maintenance of braces. They also include surgical options to address severe jaw alignment issues. Palatal expanders, which expand the size of the upper jaw in a child's mouth and reduce crowding among teeth, are another service covered under orthodontia (palatal expanders are also used for adults but less commonly).

Dental Insurance and Orthodontic Benefits

Many dental plans do not have coverage for 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). Below are a few examples of 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.

Example 1

Orthodontic benefits are available to all ages under this plan

Orthodontia – 12-month waiting period

In-network coverage:
1st year of insurance enrollment - Not covered service
2nd year of insurance enrollment and after – 50% after deductible

Out-of-network coverage:
1st year of insurance enrollment – Not covered service
2nd year of insurance enrollment and after – 40% after the deductible is satisfied
$1000 lifetime maximum

Example 2

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

Example 3

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

As demonstrated in a couple of the above examples, a dental plan that offers orthodontic coverage may use a "waiting period" that delays the benefit's availability for a year.

How to Confirm 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 several ways. First, the consumer can investigate the specific conditions of the dental plan using 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 for the website providing the dental information they are reviewing.

Dental Insurance Covering 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.

State Insurance Company Plan
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

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