Does Dental Insurance Cover Braces and Orthodontist Services?
Published on April 21, 2015
Major medical insurance plans do not typically include dental coverage. It is most often a supplemental plan that you need to purchase separately.
When it comes to braces and orthodontics, it is important to know what your dental insurance covers and what different coverage exists for both children and adults.
If you have children under 18, insurance companies must offer an option to purchase dental insurance that meets the criteria of the Affordable Care Act (ACA) when you are purchasing health insurance. But whether or not you purchase it is up to you. There is also no ACA tax penalty if your children don’t have dental insurance.
Dental policies for children differ from state to state and cover different services. For example, some plans pay the entire cost for topical fluoride, sealants, and preventive care but the patient’s parents are partially responsible for fillings.
Dental insurance for braces
For children, dental insurance for braces may be required in some states, but this does not cover every situation. For example, braces could be covered if they are necessary to improve a child’s ability to chew his food properly.
For adults, the ACA does not require insurance companies to offer dental insurance, even as more adults seek orthodontia than ever before. Some adults seek treatment so they can better chew their food, but others are primarily concerned about the way their teeth look.
Dental insurance plans may cover orthodontics for adults, but if the treatment is desired for purely cosmetic reasons it is usually not covered.
Alternatives to braces
One alternative to metal braces is Invisalign. This option tends to be slightly more expensive than traditional braces, but some dental insurance policies will cover a portion of the cost.
Even if Invisalign is not specifically covered under a dental insurance plan, some insurance companies will contribute a fixed amount of money toward the cost.
What plans cover orthodontics?
In some cases, private individual and family plans offer dental insurance for braces. Employer-sponsored dental insurance plans sometimes contain this optional coverage. If you discover that your current policy does not cover orthodontics, you can supplement it with a more inclusive dental plan.
Some standard plans include the following orthodontic services for adults and children:
• Orthodontic treatment
• Pre- and post-orthodontic treatment
But not every stand-alone plan will cover braces and Invisalign, so we recommend you confirm these procedures are covered before you purchase your policy.
Dental insurance that includes coverage for braces and orthodontics might be something worth researching for you, especially if your coverage is for multiple family members, in which case the costs could add up very quickly.
You can explore all of your options for affordable dental insurance by visiting our Dental Insurance page.
Note: This information includes just some factors to consider when selecting insurance and may not reflect the provisions of any particular insurance product. Always carefully check the provisions of any insurance product you have or may consider purchasing.