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Orthodontic treatment can be life-changing – for both smiles and self-confidence – but the price tag can be daunting. Whether you’re a parent navigating braces for your child or an adult exploring clear aligners, understanding how dental coverage works for orthodontics is essential.
Insurance for braces isn’t always straightforward. That’s why this guide breaks down how orthodontic care is typically covered, what to expect from insurance versus dental savings plans, and how to choose the most cost-effective route to a straighter smile.
Understanding Orthodontic Coverage in Dental Plans
How Braces Are Categorized
Orthodontic treatment – braces, clear aligners, retainers – is generally considered a separate benefit within dental insurance policies. It’s often not included in basic preventive or restorative dental coverage and frequently limited to dependent children under 19. This makes understanding the fine print of your plan essential, especially for adults or those seeking cosmetic options.
Common Limitations in Insurance Coverage
Many traditional dental insurance plans have several built-in restrictions for orthodontic benefits:
- Age caps: Some policies only cover treatment for dependents under 19
- Waiting periods: New enrollees often must wait 6–12 months before coverage kicks in
- Lifetime maximums: Orthodontic benefits typically max out at $1,000–$2,000 per person, for life
- Partial reimbursement: Coverage is often 50% of costs after meeting the deductible
- Exclusions for adults or alternative options: Treatments like clear aligners may not be covered at all
Cost Snapshot
The cost of orthodontic treatment varies depending on the method and complexity. Here’s what you can expect:
- Traditional metal braces: $4,000–$6,000
- Ceramic braces or lingual braces: $5,000–$8,000
- Clear aligners (e.g., Invisalign): $4,000–$7,000
Without adequate coverage, families can face significant out-of-pocket expenses.
Comparing Dental Savings Plans for Braces
Dental savings plans offer a different model: no reimbursements or claim forms. Instead, members receive discounted rates at participating dentists and orthodontists.You pay a discounted fee directly to your provider. And there are no waiting periods or spending limits to worry about.
Insurance vs. Savings Plans: How to Choose
So, which path makes the most sense for your orthodontic needs? That depends on your situation, goals, and timeline.
Dental Insurance May Be Best If:
- You’re enrolling children who meet age restrictions.
- You already have a policy and are past the waiting period.
- Your provider is in-network and accepts the insurance terms.
- You’re comfortable with maximum spending caps and co-pay structure.
A Dental Savings Plan May Be Best If:
- You need treatment sooner rather than later
- You’re an adult seeking braces or aligners
- You’re looking for flexibility and no annual limits
Consider Using Both If:
- Your insurance only covers part of your treatment
- You want to minimize out-of-pocket costs for uncovered portions
- You’re seeking coverage for treatments like clear aligners
Dental savings plans can complement dental insurance, offering discounts on services excluded or partially covered by insurance. Note that you cannot use dental insurance and a dental savings plan simultaneously for the same procedure. You typically can use your dental savings plan to get dental care after you’ve reached your annual maximum spending limit and to reduce the costs of treatment that dental insurance typically doesn’t fully pay for or may not be covered by dental insurance at all.
You can also use your dental savings plan to reduce the cost of procedures that are subject to a waiting period under your dental insurance. Your dentist can help you determine how to best use your insurance and your dental savings plan, and it’s best to check your insurance policy for any restrictions.
Best Braces Savings Options
Orthodontic coverage varies widely across dental plans – especially when it comes to age, treatment type, and how benefits are structured. The right option for you will depend on your timeline, budget, and whether the plan includes the treatments you need.
Whether you’re planning for a child’s braces or exploring adult orthodontics, DentalPlans.com makes it easy to compare insurance and dental savings plans side by side. With transparent cost comparisons, real-time provider participation info, and plan details at your fingertips, you’ll be empowered to make the best decision for your smile—and your wallet.
For a quick look at how much you can save on orthodontic treatments and other dental treatment with a dental savings plan, use the calculator below.
Disclaimer: Savings may vary by provider, location, and plan. All cost averages obtained from DentalPlans.com procedure search tool, and independent research.
