Does Dental Insurance Cover Braces?

A great man once said that nothing is certain except death and taxes, but there’s at least one more certainty in this world: orthodontics are expensive. Even the cost of regular metal braces ranges from about $3,000 to $7,000, and the cost for more sophisticated procedures can be even higher. Because of these infamously prohibitive prices, many people forgo the orthodontic care they want or even need, but cannot afford. Of course, the natural question to ask is “would dental insurance cover orthodontic care like braces”? The question is not as easy to answer as you may think. The short of it is that some insurance plans may partially cover orthodontic care, but many will not. And certain plans may cover some orthodontic services but not include braces. If this vague answer has only got you scratching your head, here are a few pointers that might help shed some light on the situation:

  • Kids usually have it easier than adults. This is true in regards to orthodontic care, too. Most dental health plans will not cover orthodontic care for adults, but children under 18 have a higher chance of being covered.
  • If you’re looking to have the most beautiful smile possible, you will be disappointed to find out that, for both kids and adults, teeth straightening for purely cosmetic purposes is usually not covered. If an orthodontist deems your treatment to be medically necessary, however (for example if you have trouble chewing), your dental insurance has a higher chance of covering it.
  • Medicaid may provide coverage for orthodontic care if you qualify and if the procedure is medically necessary, but unfortunately not in all states. Check if Medicaid covers specialty services in your state.
  • If you have no dental insurance or if your dental insurance does not cover braces, you can still deduct the cost from your taxes if the procedure is medically necessary and if the cost exceeds 7.5 percent of your adjusted gross income.
  • Even if you are covered, insurance will typically not pay the entire cost of the procedure. You should usually be prepared to pay at least half of the cost out of pocket – possibly significantly more, especially for the fancier, more expensive types of braces like Invisalign – keep that in mind before dismissing the good old-fashioned metal braces because they’re “uncool.”

The bottom line is, you should always make sure your policy is adapted to your needs. If your current insurance policy does not cover orthodontics, you can always buy supplemental orthodontic insurance. Need a helping hand to guide you through the entire process? Book an appointment with us today and let and find the best policy for you.