Do your children need braces or are you looking for orthodontic insurance for adults? This guide, written by an industry insider, will give you answers for questions such as:
Many parents wince when they realize their child will need braces. The average cost of braces, according to the American Dental Association's 2020 Annual Survey of Dental Fees was approximately $6,000 for adult braces, though it should be remembered that many factors can affect the total cost. These factors include not only the circumstances of the patient's dental situation, the type of braces used (see below), but also the region in which the patient receives orthodontic care (some areas have more expensive orthodontic care than others). Consumer Affairs reports that braces may cost as much as $13,000.
Braces are a form of orthodontic service, a sub-discipline within the field of dentistry. Orthodontia provides treatment for patients not only with improperly aligned teeth but also improperly aligned jaw or bite patterns. The four main categories of braces are:
Traditional braces are the metal variety with which most people are familiar. Generally this brace type is considered to be the least expensive of the four mentioned above and costs around $5,900 on average. Ceramic braces, which look like traditional braces but are transparent, are slightly more expensive. Invisalign braces are clear plastic shells that fit directly over the teeth. The price for Invisalign aligners vary by circumstances but the company website provides multiple scenarios that cost from $3,400 to $7,100. Less common in the United States than Europe, lingual braces are metal braces that attach to the back side of the teeth and, therefore, are invisible. Consumers who decide to use lingual braces should expect to pay more than the traditional meta version. The OralB webpage devoted to brace costs lists the price range for this option between $8,000 and $10,000.
What a patient pays for orthodontic care varies for several reasons. First, there is the cost of braces. There are several different types of braces and their prices differ among them. Another cost factor is the severity of teeth misalignment. The choice of orthodontist can also affect what is charged to the patient. Finally, there is out-of-pocket charges for braces under the insurance plan and the maximum limit the plan will pay toward orthodontic care in a single year and over a lifetime.
A nationwide study by DentalInsurance.com found only 28 percent of dental plans reviewed offered some level of orthodontic benefits. However, by reviewing a dental plan's summary of benefits (or plan brochure), you should be able to quickly identify if orthodontics are covered and under what conditions (including waiting periods). The bottom of the article has a list of plans with orthodontic benefits but before reviewing them, it is helpful to understand how orthodontic coverage varies among plans.
Below are a few examples of orthodontic benefit conditions observed in various dental plans offered in multiple states. They illustrate the lack of uniformity among orthodontic benefits and the need for careful shopping on the part of consumers.
Example 1
Orthodontic benefits are available to all ages under this plan
Orthodontia – 12-month waiting period
1st year of insurance enrollment – 0% (Not a covered service)
2nd year of insurance enrollment and after – 50% coverage after $150 Orthodontia deductible satisfied $1500 Lifetime Maximum per eligible dependent child
Example 2
Orthodontic benefits are only available for eligible dependent children up to age 19
1st year of insurance enrollment – 10%
2nd year of insurance enrollment – 25%
3rd year of insurance enrollment – 50%
$1200 lifetime maximum per person for this benefit
As demonstrated in Example 1, a dental plan that offers orthodontic coverage may use a "waiting period" that delays the benefit's availability.
An orthodontist is the most qualified person to answer when orthodontic care should begin. In the case of growing children, an orthodontist may suggest that care be delayed for several years. For adults, the right time for braces may be affected by surrounding oral health needs such as the need for a dental implant or crown.
Yes, in the case of HMO plans, PPO plans, and dental savings plans, there are in-network orthodontists and out-of-network orthodontists. Indemnity plans typically lack network restrictions.
Yes. Orthodontic benefits do not change the insurance application process. When presented, the coverage of braces is treated as a specific feature of the plan.
There are examples of both individual and family dental insurance offering orthodontic benefits. However, there are plans that limit orthodontic benefits to minor children enrolled in the dental plan.
The table toward the bottom of the page gives examples not only of insurers who offer coverage of braces but the specific plans that have orthodontic benefits.
There are consumer resources available from various professional societies. Examples of these include The American Association of Orthodontists (AAO) and the American Board of Orthodontics.
Our agents can:
Given the irregular coverage of orthodontic services among dental plans, a consumer can't apply for insurance and hope for the best. Instead, he or she must confirm not only the presence of orthodontic coverage but the specifics of that coverage. This can be accomplished through any one of the following resources:
If a consumer has a question regarding what he or she read about braces coverage, the consumer can also use the customer service number on our website (1-800-296-3800).
If you are an adult looking for coverage for braces in a dental plan, be certain to look for plan language that limits orthodontic services to dependents under a particular age (e.g. 19 years old).
The below list includes dental plans in each state (and Washington D.C.) that have some level of coverage for orthodontia. Some of these plans may not be available within all regions of the state for which it is listed.
If you are interest in a plan, READ THE PLAN DETAILS BECAUSE OF DIFFERING LEVELS OF ORTHODONTIC COVERAGE AS WELL AS WAITING PERIODS BEFORE SERVICES LIKE BRACES ARE COVERED. Additionally, some dental plans limit their orthodontic benefits to dependent children under the age of 19. Consequently, reading the plan details for the specifics of orthodontic coverage is essential for the savvy shopper.
If you see a plan you like, you can get a dental plan quote in a few clicks. Be certain to click the Plan Details rate quote page for more information on the orthodontic coverage conditions summarized below.
| Insurance Company | Plan | Coverage Information |
| Alabama | ||
| Guardian | Advantage Diamond | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit year maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| Alaska | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| Arizona | ||
| Renaissance Dental | MAX Choice Plus | Orthodontic benefits are restricted to eligible dependent children up to 19 years of age. The amount of orthodontic service cost coverage increases across the first three years of enrollment: 1st Year – 10%, 2nd Year – 25%, 3rd Year – 50%. There is a $1200 lifetime maximum per person for this benefit. |
| Arkansas | ||
| Guardian | Advantage Achiever | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is active (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit annual maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| California | ||
| California Dental Network | Plan 595 | $1695 copayment for comprehensive orthodontic treatment of the child dentition. $1695 copayment for comprehensive orthodontic treatment of adult dentition. Covered for up to 24 months of active treatment but only when provided by participating orthodontist. |
| Colorado | ||
| Anthem | Essential Choice Incentive | Orthodontic services (braces and retentions) are covered for children through the age of 18. There is a $1000 lifetime benefit maximum on orthodontic services. Coinsurance fees are normally 50% of the cost after $150 lifetime deductible is satisfied. No waiting period on coverage. |
| Connecticut | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| Delaware | ||
| Delta Dental | Dental for Everyone Diamond Premier | Orthodontic coverage for eligible dependent children only. 12-month waiting period before coverage is available. In 2nd year of enrollment, 40% of costs (up to $450 annually) are covered after the $150 lifetime deductible is satisfied. In the third year and after, cost coverage increases to 50% and the $450 annual maximum remains. There is a $1500 lifetime maximum benefit for orthodontic services. Deductibles and lifetime maximums are per eligible dependent. |
| Florida | ||
| Delta Dental | Dental for Everyone Platinum | Orthodontic coverage for eligible dependent children only. 12-month waiting period before coverage is available. In 2nd year of enrollment, 40% of costs (up to $350 calendar year maximum) are covered after $100 lifetime deductible is satisfied. In the third year and after, cost coverage increases to 50% and the $350 per calendar year maximum remains. There is a $1000 lifetime maximum benefit for orthodontic services. Deductibles and lifetime maximums are per eligible dependent. |
| Georgia | ||
| Renaissance Dental | Max Choice | Orthodontic benefits are restricted to eligible dependent children up to 19 years of age. The amount of orthodontic service cost coverage increases across the first three years of enrollment: 1st Year – 10%, 2nd Year – 25%, 3rd Year – 50%. There is a $1200 lifetime maximum per person for this benefit. |
| Hawaii | ||
| Guardian | Advantage Diamond | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit year maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| Idaho | ||
| Careington | 500 Series Dental Savings (Discount Program, Not Insurance) | 20% discount on standard dental provider rates for braces and other orthodontic services. No waiting period on coverage. |
| Illinois | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| Indiana | ||
| Anthem | Essential Choice Incentive | Orthodontic services (braces and retentions) are covered for children through the age of 18. There is a $1000 lifetime benefit maximum on orthodontic services. Coinsurance fees are normally 50% of the cost after $150 lifetime deductible is satisfied. No waiting period on coverage. |
| Iowa | ||
| Renaissance Dental | MAX Choice Plus | Orthodontic benefits are restricted to eligible dependent children up to 19 years of age. The amount of orthodontic service cost coverage increases across the first three years of enrollment: 1st Year – 10%, 2nd Year – 25%, 3rd Year – 50%. There is a $1200 lifetime maximum per person for this benefit. |
| Kansas | ||
| Careington | 500 Series Dental Savings (Discount Program, Not Insurance) | 20% discount on standard dental provider rates for braces and other orthodontic services. No waiting period on coverage. |
| Kentucky | ||
| Delta Dental of Kentucky | Bright Smiles | Orthodontic coverage for eligible dependent children only. 12-month waiting period before coverage is available. In 2nd year of enrollment and after, 50% of costs are covered in-network after the deductible is satisfied. There is a $1000 lifetime maximum benefit for orthodontic services. Deductibles and lifetime maximums are per eligible dependent. |
| Louisiana | ||
| Guardian | Advantage Achiever | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is active (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit annual maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| Maine | ||
| Anthem | Essential Choice Platinum | Orthodontic services (braces and retentions) are covered for children through the age of 18. There is a $1000 lifetime benefit maximum on orthodontic services. Coinsurance fees are normally 50% of the cost after $150 lifetime deductible is satisfied. 12-month waiting period on coverage. |
| Maryland | ||
| Dominion National | Select Plan Premium | $3,658 in copayments for comprehensive orthodontic treatment of adult dentition. $3,422 in copayments for comprehensive orthodontic treatment of adolescent dentition. No waiting period on coverage. |
| Massachusetts | ||
| Renaissance Dental | MAX Choice Plus | Orthodontic benefits are restricted to eligible dependent children up to 19 years of age. The amount of orthodontic service cost coverage increases across the first three years of enrollment: 1st Year – 10%, 2nd Year – 25%, 3rd Year – 50%. There is a $1200 lifetime maximum per person for this benefit. |
| Michigan | ||
| Guardian | Advantage Diamond | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit year maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| Minnesota | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| Mississippi | ||
| Delta Dental | Immediate Coverage Plan | 12-month waiting period for coverage (other dental services have immediate coverage). For covered dependents under age 19 years old when the active orthodontic appliance is first placed. Starting in the 2nd year of enrollment, 50% of costs are covered (after deductible and up to $500 annual benefit maximum). There is also a $1000 lifetime benefit maximum. |
| Missouri | ||
| Careington | 500 Series Dental Savings (Discount Program, Not Insurance) | 20% discount on standard dental provider rates for braces and other orthodontic services. No waiting period on coverage. |
| Montana | ||
| Delta Dental | Dental for Everyone Platinum | 12-month waiting period for orthodontic coverage. For eligible dependent children only. In 2nd year of enrollment, 40% cost coverage after $100 lifetime orthodontia deductible is satisfied. $350 calendar year maximum on orthodontic contributions by plan and a $1000 lifetime maximum benefit. Deductible and maximums are per eligible dependent child. |
| Nebraska | ||
| Renaissance Dental | MAX Choice Plus | Orthodontic benefits are restricted to eligible dependent children up to 19 years of age. The amount of orthodontic service cost coverage increases across the first three years of enrollment: 1st Year – 10%, 2nd Year – 25%, 3rd Year – 50%. There is a $1200 lifetime maximum per person for this benefit. |
| Nevada | ||
| Anthem | Essential Choice Incentive | Orthodontic services (braces and retentions) are covered for children through the age of 18. There is a $1000 lifetime benefit maximum on orthodontic services. Coinsurance fees are normally 50% of the cost after $150 lifetime deductible is satisfied. No waiting period on coverage. |
| New Hampshire | ||
| Anthem | Essential Choice Platinum | Orthodontic services (braces and retentions) are covered for children through the age of 18. There is a $1000 lifetime benefit maximum on orthodontic services. Coinsurance fees are normally 50% of the cost after $150 lifetime deductible is satisfied. No waiting period on coverage. |
| New Jersey | ||
| Guardian | Advantage Diamond | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit year maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| New Mexico | ||
| Careington | 500 Series Dental Savings (Discount Program, Not Insurance) | 20% discount on standard dental provider rates for braces and other orthodontic services. No waiting period on coverage. |
| New York | ||
| Anthem BlueCross BlueShield | Essential Choice Platinum | Orthodontic services (braces and retentions) are covered for children through the age of 18. There is a $1000 lifetime benefit maximum on orthodontic services. Coinsurance fees are normally 50% of the cost after $150 lifetime deductible is satisfied. 12-month waiting period before orthodontic coverage is available. |
| North Carolina | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| North Dakota | ||
| Guardian | Advantage Achiever | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is active (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit annual maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| Ohio | ||
| Renaissance Dental | MAX Choice Plus | Orthodontic benefits are restricted to eligible dependent children up to 19 years of age. The amount of orthodontic service cost coverage increases across the first three years of enrollment: 1st Year – 10%, 2nd Year – 25%, 3rd Year – 50%. There is a $1200 lifetime maximum per person for this benefit. |
| Oklahoma | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| Oregon | ||
| Dental Health Services | Super SmartSmile | $2,175 in copayments for full-banded adult braces. $1,975 in copayments for full-banded child braces (up to age 19). |
| Pennsylvania | ||
| Dominion National | Select Plan Premium | $3,658 in copayments for comprehensive orthodontic treatment of adult dentition. $3,422 in copayments for comprehensive orthodontic treatment of adolescent dentition. No waiting period on coverage. |
| Rhode Island | ||
| Careington | 500 Series Dental Savings (Discount Program, Not Insurance) | 20% discount on standard dental provider rates for braces and other orthodontic services. No waiting period on coverage. |
| South Carolina | ||
| Guardian | Advantage Diamond | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit year maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| South Dakota | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| Tennessee | ||
| Delta Dental of Tennessee | Brighter Advantage | 12-month waiting period on orthodontic coverage. 2nd year of enrollment and after: 50% of costs covered in-network (40% out-of-network). There is a $1,000 lifetime maximum benefit for orthodontic services. |
| Texas | ||
| Delta Dental | Immediate Coverage Plan | 12-month waiting period for coverage (other dental services have immediate coverage). For covered dependents under age 19 years old when the active orthodontic appliance is first placed. Starting in the 2nd year of enrollment, 50% of costs are covered (after deductible and up to $500 annual benefit maximum). There is also a $1000 lifetime benefit maximum. |
| Utah | ||
| Renaissance Dental | Max Choice | Orthodontic benefits are restricted to eligible dependent children up to 19 years of age. The amount of orthodontic service cost coverage increases across the first three years of enrollment: 1st Year – 10%, 2nd Year – 25%, 3rd Year – 50%. There is a $1200 lifetime maximum per person for this benefit. |
| Vermont | ||
| Guardian | Advantage Achiever | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is active (6 months for VT residents). 50% of costs are covered in-network and out-of-network (after deductible), up to $500 benefit annual maximum and $1000 lifetime maximum. Comprehensive orthodontic treatment of adolescent dentition. For covered dependents under age 19 years old when the active orthodontic appliance is first placed. |
| Virginia | ||
| Dominion National | Select Plan Premium | $3,658 in copayments for comprehensive orthodontic treatment of adult dentition. $3,422 in copayments for comprehensive orthodontic treatment of adolescent dentition. No waiting period on coverage. |
| Washington State | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
| Washington D.C. | ||
| Dominion National | Select Plan Premium | $3,658 in copayments for comprehensive orthodontic treatment of adult dentition. $3,422 in copayments for comprehensive orthodontic treatment of adolescent dentition. No waiting period on coverage. |
| West Virginia | ||
| Careington | 500 Series Dental Savings | 20% discount on standard dental provider rates for braces and other orthodontic services. No waiting period on coverage. |
| Wisconsin | ||
| Anthem | Essential Choice Incentive | Orthodontic services (braces and retentions) are covered for children through the age of 18. There is a $1000 lifetime benefit maximum on orthodontic services. Coinsurance fees are normally 50% of the cost after $150 lifetime deductible is satisfied. No waiting period on coverage. |
| Wyoming | ||
| MetLife | TakeAlong Dental High | Orthodontic services are considered major care in this plan and they have a 12-month waiting period before coverage is available (6 months for VT residents). Orthodontic coverage restricted to dependent child up to age 19. In Network – 50% of costs covered until lifetime maximum. Out-of-network – 50% of the Maximum Allowed Charge* covered. Lifetime maximum benefit for orthodontic services is $1000 |
Click our Dental Insurance link here and find plans available in your zip code.
When you are comparing rates, click on the More Details section of a plan that interests you. When the information plan information displays, go to the bottom and click the button labeled “See Full Plan Information.” This will display a webpage dedicated to the plan and its benefits and conditions. On this page there is a section named “Details” and within it is listed “Braces / Orthodontia.” This will list whether there is coverage for braces and any limits or waiting periods for this coverage.
The main cost drivers for orthodontic care are the type of braces chosen, the degree of teeth misalignment to be corrected, the need for surgical services such as tooth extraction, and the contributions of insurance toward orthodontic costs. Another factor that may influence costs is whether your dental plan has a negotiated rate for orthodontic services.
Only an orthodontist is qualified to determine the correct timing of braces. If you are contemplating the timing for orthodontics for yourself or child, you should schedule an evaluation with your local orthodontist. Some dentists may raise the subject of braces discussions after your child's permanent teeth start to emerge because of crooked or crowded teeth and the interest in the proper alignment of your child’s teeth and bite.
Our knowledgeable customer service team will assist you with any questions you may have prior to enrolling in a dental plan. They can guide you through the process of choosing coverage that matches your needs as well as your budget.
