What Insurance covers braces?
January 31, 2025
If you or your child need braces, one of the first questions that likely comes to mind is: Will my insurance cover it? Braces are an investment in both oral health and confidence, but their cost can be a concern for many families. The good news? Many dental insurance plans offer partial coverage for orthodontic treatments—especially for children and teenagers.
However, understanding insurance policies can be tricky. Coverage varies widely based on your provider, plan type, and whether the treatment is considered medically necessary. Some plans offer substantial assistance, while others might only cover basic dental care without orthodontic benefits.
So, how can you determine if your insurance covers braces? What options do you have if it doesn’t? And how can you maximize your benefits to make orthodontic treatment more affordable? In this guide, we’ll walk you through everything you need to know—from insurance types that cover braces to practical tips for reducing out-of-pocket costs.
Types of Insurance That May Cover Braces
If you're considering braces, it's important to understand what insurance options are available to help reduce costs. Not all dental plans include orthodontic benefits, but several options may provide partial coverage, making treatment more affordable. Below are the main types of insurance and financial programs that can assist with braces:
1. Dental Insurance with Orthodontic Coverage
Many dental insurance plans offer partial coverage for braces, but the extent of coverage varies depending on the provider and the specific plan. Key factors to consider include:
- Coverage percentage: Most plans cover 25%–50% of orthodontic treatment costs.
- Lifetime maximum benefit: Many policies have a cap on orthodontic coverage, typically ranging from $1,000 to $3,000.
- Age restrictions: Coverage is often limited to dependents under 18, though some plans may offer partial coverage for adult orthodontics.
- Waiting periods: Some plans require a waiting period before orthodontic benefits become available.
At Parsons Orthodontics, we accept a wide range of dental insurance providers, including:
- Aetna
- Cigna
- Delta Dental
- Florida Blue (Blue Cross Blue Shield)
- Guardian
- MetLife
- United Healthcare
- Humana
- GEHA
- Anthem Blue Cross Blue Shield
- Dentemax
- United Concordia
- Solstice
- Connection Dental
- Florida Combined Life
- Dentegra
- Assurant
Tip: If you're unsure whether your plan covers braces, our team can help verify your insurance benefits and explain your options.
2. Medicaid and CHIP (For Eligible Patients)
For families with lower incomes, Medicaid and the Children’s Health Insurance Program (CHIP) can sometimes cover the cost of braces. However, coverage is typically available only if the treatment is considered medically necessary due to severe dental conditions such as:
- Significant bite misalignment (e.g., overbite, underbite, or crossbite).
- Difficulty chewing, swallowing, or speaking due to jaw misalignment.
- Structural dental issues that affect oral health.
Since Medicaid and CHIP coverage varies by state, it's best to check with your provider or contact us to explore your options.
3. Flexible Spending Accounts (FSA) & Health Savings Accounts (HSA)
Even if your insurance doesn’t fully cover braces, you can still reduce your out-of-pocket costs by using:
- Flexible Spending Accounts (FSA) – Available through many employer-sponsored plans, FSAs let you set aside pre-tax dollars to pay for orthodontic care.
- Health Savings Accounts (HSA) – If you have a high-deductible health plan (HDHP), an HSA allows you to use tax-free funds for medical and dental expenses, including braces.
At Parsons Orthodontics, our team is happy to provide you with the necessary documentation for easy reimbursement through your FSA or HSA, helping you make the most of these savings options.
4. Orthodontic Discount Plans
Some patients opt for orthodontic discount plans, which are not traditional insurance but offer significant price reductions on braces and other dental treatments. These plans work by:
- Providing pre-negotiated discounts with participating orthodontists.
- Having no waiting periods or deductibles.
- Allowing you to combine with other payment options to lower costs further.
If you don’t have orthodontic insurance, Parsons Orthodontics offers affordable payment plans and financing options to make your treatment more manageable.
Navigating insurance for braces can be overwhelming, but you don’t have to do it alone. At Parsons Orthodontics, our team is happy to assist with insurance verification, explain your coverage options, and help you find the most cost-effective way to achieve your dream smile.
How to Check If Your Insurance Covers Braces
Before committing to orthodontic treatment, it's important to determine whether your insurance plan includes orthodontic benefits and how much coverage you can expect. Many plans vary in terms of eligibility, percentage of costs covered, and maximum lifetime benefits. Follow these steps to get a clear understanding of your coverage:
- Review Your Policy
Start by thoroughly reading your dental insurance policy. Look for details on:
- Orthodontic coverage – Some plans include it as an additional benefit, while others do not.
- Coverage percentage – Most plans cover a portion of the cost, typically between 25% and 50%.
- Lifetime maximum benefit – Many policies have a set limit, often between $1,000 and $3,000.
- Age restrictions – Some plans only cover braces for dependents under 18, while others provide limited adult coverage.
- Waiting periods – Some insurance plans require a waiting period before orthodontic benefits become available.
If you have access to your policy online, check the benefits breakdown or download the Summary of Benefits and Coverage (SBC) document.
- Call Your Insurance Provider
Once you have reviewed your policy, it’s best to call your insurance provider directly to confirm your benefits. Be sure to ask:
- Does my plan cover orthodontic treatment?
- What percentage of the cost is covered?
- What is the lifetime maximum for orthodontic coverage?
- Are there any age restrictions on coverage?
- Is pre-authorization required before starting treatment?
- Are there any waiting periods before orthodontic benefits apply?
- Can I use an FSA or HSA to help cover costs?
Having these answers will help you avoid surprises and plan for out-of-pocket expenses.
- Ask Your Orthodontist for Help
At Parsons Orthodontics, we work with various insurance providers and can assist in verifying your benefits. Our team can:
- Contact your insurance company on your behalf.
- Help you understand what costs are covered and what you’ll need to pay out of pocket.
- Provide a detailed treatment estimate based on your plan’s benefits.
- Offer flexible payment plans if your insurance doesn’t fully cover treatment.
If you’re unsure about your coverage, we encourage you to schedule a free consultation so we can review your insurance and discuss your options.
Ways to Maximize Your Orthodontic Insurance Benefits
Making the most of your orthodontic insurance benefits requires careful planning and understanding how your policy works. Since orthodontic coverage often comes with limitations, such as lifetime maximums and waiting periods, taking strategic steps can help reduce out-of-pocket costs and maximize your savings.
One of the most important things to consider is your lifetime orthodontic maximum. Many dental insurance plans have a set dollar amount that they will cover for orthodontic treatment over a lifetime, rather than renewing annually like general dental benefits. If your policy includes a lifetime maximum, make sure you fully utilize it. This means coordinating treatment within the time frame when benefits are available and ensuring that all eligible costs are covered before reaching the limit.
If you have access to multiple insurance plans, you may be able to take advantage of dual coverage. For example, if both parents have dental insurance, some plans allow coordination of benefits, meaning that one plan can cover costs that the other does not. This can significantly reduce out-of-pocket expenses for braces. However, not all insurance policies allow this, so it’s important to check with both insurance providers to see if dual coverage applies to orthodontic treatment.
Timing is also a key factor in maximizing your benefits. Some dental insurance policies include waiting periods before orthodontic coverage becomes available, which can range from several months to over a year. If you are considering braces, it’s best to review your policy early to determine whether you need to wait before starting treatment. Additionally, if your plan is set to renew or change, you may want to start treatment before any modifications to coverage take effect, especially if your current plan offers more comprehensive benefits.
By understanding these aspects of your insurance plan, you can make informed decisions and take full advantage of the coverage available to you. At Parsons Orthodontics, we are happy to help you navigate your insurance benefits and develop a financial plan that works for you. If you have questions about coverage or payment options, reach out to our team for personalized assistance.
What If My Insurance Doesn’t Cover Braces?
If your insurance plan doesn’t include orthodontic coverage, that shouldn’t stop you from getting the smile you deserve. At Parsons Orthodontics, we believe that financial concerns shouldn’t be a barrier to high-quality care, which is why we offer multiple payment options to make treatment accessible and affordable.
We provide flexible payment plans tailored to fit different budgets, ensuring that you can spread out the cost of braces over time. For patients looking for an even more convenient option, our in-house financing program offers 0% APR with no credit check, making it easier than ever to start treatment immediately without worrying about high-interest rates or loan approvals. Additionally, we work with third-party financing options such as CareCredit, which allow you to manage payments on a schedule that works best for you.
A confident, healthy smile is an investment in yourself, and we are here to make it happen—no insurance, no problem. Contact Parsons Orthodontics today for a free consultation, and let’s create a personalized plan that works for you. Your dream smile is within reach—let’s get started!
