What Dental Insurance Covers Orthodontics?

What is orthodontia?

Orthodontia, or orthodontic services, helps straighten your teeth and align your bite. These treatments may be for either health- or cosmetic-related reasons. While these techniques are common, they can be very expensive. Not all types of dental insurance include coverage for orthodontic services, so it’s important that you read your dental plan materials carefully.

Take a look at what is considered an orthodontic service and how orthodontic treatments may be covered by your dental plan.

Traditional braces

Standard metal braces are still the most popular type of braces. Patients can choose different colored elastic bands to make them more unique.

Clear braces

Patients might also choose braces that have clear brackets. These braces function in the same way as traditional braces but may appear less noticeable.

Clear aligners

Clear aligners (such as Invisalign^®) are a clear set of custom-fitted trays that help straighten teeth. The trays fit closely to your teeth and are removable. Patients may choose clear aligners if they’re looking for an orthodontic treatment that’s less easy to see than traditional braces.

Retainers

Retainers are used in post-braces care to help keep teeth aligned. While the end result of braces is straighter teeth, retainers help teeth get settled into their new position.

Why should I see an orthodontist?

Orthodontists treat patients of all ages, though they frequently care for children and adolescents. Your child’s dentist may recommend that they see an orthodontist sooner rather than later to help correct teeth and alignment issues when their permanent teeth come in. Orthodontic care is frequently part of kids' oral health.

How do I find dental insurance that covers orthodontics?

If you do not currently have a dental plan, you can get dental coverage in one of three ways:

• Purchase through your employer - If you have an employer that offers dental you can choose a dental plan as part of your benefits.
• Purchase your own dental plan - If you do not have employer coverage, you can buy one on your own through a health insurance carrier that sells individual and family dental insurance plans.
• Purchase on your own through the Health Insurance Marketplace^® - You can purchase a health plan with dental benefits in the Health Insurance Marketplace. If you choose a health plan from the Marketplace that does not have dental benefits, you can still buy a separate dental plan at the same time. However, you cannot buy a dental plan on its own in the Marketplace.

With any type of plan, be sure to review how your dental insurance works 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 can I save costs on orthodontic services and treatments?

Orthodontic treatments can be very expensive. Here are a few ways to potentially reduce costs.

1. Check your orthodontic coverage. Make sure your dental insurance includes braces and other treatments you may need.
2. Wait before starting treatments (if needed). Some plans have waiting periods before they pay for dental treatments, such as braces.
3. Understand your dental plan benefits. Read the details so you can avoid potential extra costs.

How do I know if I need Invisalign or braces?

Are you happy with your smile? If you have an overbite, underbite, overlapping (or generally crowded) teeth, an orthodontist can come up with a treatment plan to help straighten your teeth. This plan may include braces, clear aligners such as Invisalign, or other types of dental appliances. Be sure to check your specific plan documents to see if these treatments are covered.

How do I choose the right dental insurance that covers orthodontics?

If you know you are in need of orthodontic services and treatments, or may need them in the future, here are steps to help you choose dental insurance.

1. Confirm the dental insurance plan provides orthodontic coverage

You can review the dental plan materials to learn about covered and non-covered services, such as braces and other orthodontic treatments. Full-coverage dental insurance plans, for instance, often include orthodontic insurance coverage.

2. Review the dental plan’s network

Most dental plans come with a network of dental providers and orthodontists. 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.

3. Check the dental insurance plan for any coverage limits

Your dental plan may have a maximum or exclusions on the amount you spend on orthodontic services. 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 dental insurance plan.

4. Learn if you’re eligible for orthodontic services discounts

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.