One of the most common questions families ask when considering braces is whether dental insurance will help cover the cost. Orthodontic benefits can vary significantly depending on the insurance plan, provider, and even the patient’s age. Whether you are exploring treatment for your child or considering braces or aligners for yourself, it is important to understand how your insurance coverage works and what steps to take before beginning treatment.
Let’s take a closer look at what you need to know about dental insurance and braces.
Does Insurance Cover Braces for Children?
Yes, sometimes. Many dental insurance plans include partial orthodontic coverage for dependents under 18. These benefits are typically offered as part of a larger dental policy or through supplemental orthodontic coverage.
Common Coverage Details for Kids:
- A lifetime maximum benefit (often between $1,000–$3,000)
- Coverage of 50% of treatment costs, up to that lifetime maximum
- May require a waiting period (e.g., 6–12 months after enrolling in the plan)
- Must be deemed medically necessary in some cases
It is essential to verify your benefits in advance, as coverage is not always automatic and not all orthodontists are in-network with all plans.
What about Braces for Teens?
For teens who are still covered under their parent’s insurance plan, coverage generally follows the same guidelines as for children. However, teens may also be candidates for more discreet treatment options, such as clear aligners, which may or may not be fully covered depending on the specific plan.
Note: Some policies only cover traditional metal braces, while others may provide an allowance for Invisalign® or ceramic brackets. Be sure to check the fine print.
Are Adults Covered for Orthodontics?
This is where things can get tricky. Most standard dental plans do not cover braces for adults unless you have an upgraded or premium policy that includes adult orthodontics.
For adults:
- Coverage is less common, but not impossible
- You may have to purchase a separate orthodontic rider
- You may benefit from HSA or FSA funds to cover out-of-pocket costs
If you are over 18 and considering braces or aligners, ask your insurance provider directly if adult ortho treatment is included and if so, under what conditions.
Why Pre-Treatment Verification Matters
Before beginning any orthodontic treatment, it is crucial to verify your insurance coverage. This protects you from unexpected bills and helps you plan financially.
At Tebo Orthodontics, we offer:
- Complimentary insurance benefit checks before your first appointment
- Transparent treatment plans with clear cost breakdowns
- Flexible payment options to help close the gap between insurance coverage and total cost
We will work directly with your insurance provider to determine:
- What type of treatment is covered
- How much of the cost is your responsibility
- Whether a pre-authorization or referral is required
What If I Don’t Have Orthodontic Coverage?
No insurance? No problem. We believe every patient deserves access to a healthier , confident smile. That’s why we offer:
- Flexible monthly payment plans
- Low down payment options
- Guidance on using HSA/FSA funds tax-free
- Transparent pricing with no hidden fees
Have Questions? Contact Us to Get Started
Orthodontic treatment is a valuable investment in long-term dental health, but it is important to understand costs and coverage before beginning. Whether you are a parent navigating coverage for your child, or an adult considering treatment for yourself, the team at Tebo Orthodontics is here to support you.
We will help you review your benefit options, clearly explain all treatment costs upfront, and develop a plan that fits both your budget and your smile goals.
Have questions about insurance or braces? Schedule a free consultation today. We are happy to guide you through your options and ensure you feel confident before starting treatment.
