It would be unusual for a group of kids to not include at least a few who are wearing braces on their teeth. In fact, 2015 research found that 80% of teens were seeing an orthodontist.
How much does all this tooth straightening cost – and who’s paying for it? In this article, we’ll look at how much you can expect to pay for orthodontic services, for your kids or for yourself, and what your coverage options are if you’re looking for insurance to help with costs.
How Much Are Braces?
The cost of braces can depend on the kind of prep work that might be needed (such as extractions), how long the treatment lasts and what each orthodontist charges. As such, the overall cost of tooth realignment for kids may be less than for adults.
The type of braces can also affect the price – check out the following estimates:
- Metal braces: $4,400 to $5,300
- Ceramic braces: around $4,600
- Lingual braces, which are behind your teeth: $5,000 to $13,000
- Invisible braces (a series of clear plastic aligners) such as Invisalign: $3,000 to $5,000
Adult Tooth Realignment
Did you miss out on braces as a kid? Maybe you didn’t wear your retainer like you should have or your teeth just shifted a bit. If so, you may be facing the prospect of getting braces as an adult.
And there’s a little more bad news…
Because the duration of treatment is one of the determining factors in the price of treatment, adult braces may end up costing more than children’s. The process may take longer for an adult than for a child.
And because adults’ bones have stopped growing, some changes may require surgery. While the time varies from person to person, on average, adult orthodontic treatment lasts about two years.
Because of the duration and complexity of teeth straightening later in life, adult braces may cost more.
Does Insurance Cover Braces?
First off, since major medical insurance does not include coverage for dental services in most instances, it also generally does not cover braces or other orthodontic services.
Instead, you’ll likely need to look to dental insurance.
Dental insurance typically covers a range of services – from preventive care (routine exams) and basic procedures (fillings, extractions) to major treatment (crowns, root canals).
Usually, these levels of dental care are covered at different rates. A typical dental plan provides levels of coverage known as “100/80/50 coverage:”
- Preventive care is covered 100%
- Basic procedures are covered 80%
- Major procedures are covered 50%
Remember, in addition to the cost-sharing, you’re responsible for paying your dental insurance deductible before your insurance company begins paying a portion of covered services.
So, does dental insurance cover braces? The answer is sometimes – so it’s critical to check any dental policies you’re considering if your goal is to get help paying for braces. When dental insurance covers braces, it often does so at the 50% coverage level.
Coverage for orthodontics usually has a separate lifetime maximum, which applies to the entire course of treatment and is not part of your annual maximum for other dental services.
So, verify if the dental policy you’re considering has a waiting period before being able to obtain braces.
What’s the best dental insurance for braces?
If you expect your kids may need orthodontic work, the best dental insurance may depend on how you prioritize choice compared to cost. Depending on the type of dental plan you have, you may pay different out-of-pocket costs for orthodontic services.
Lower costs + in-network providers: With a health maintenance organization (HMO) plan you will usually have a copay for different types of orthodontic treatment. You are required to stay within a network of providers with which discounted rates have been negotiated.
Balancing cost + provider choice: With a preferred provider organization (PPO), the most common type, you pay lower fees to see in-network or “preferred” providers. You can see “out of network” providers, but you’ll probably pay more. PPO plans often come with annual maximums and some procedures may not be covered or have a waiting period before coverage starts.
Higher cost + more provider choice: With an indemnity, or fee-for-service plan, you usually are not required to stay within a network, but the lifetime benefits maximum may be lower and you will have to pay for any treatments over that limit. A fee-for-service plan might also pay less for out-of-network services than in-network services.
Other Options to Curb Out-of-Pocket Costs for Braces
Even with coverage, orthodontic services usually come with significant out-of-pocket costs. If your dental insurance plan does not cover braces completely (or at all), there may be ways to cut your out-of-pocket costs:
- Financing through your orthodontist: Find out if your orthodontist offers a discount for paying the full cost up front or if they offer an option to pay in installments.
- HSA or FSA funds: If you have a flexible spending account (FSA) or health savings account (HSA) through your employer, you may be able to use it.
- Medicaid: Covers braces for children (under the age of 19) if they are determined to be medically necessary. Most states provide emergency dental services for adults, and some provide limited care beyond that, but less than half of the states currently provide comprehensive dental care.
- Orthodontics students: Some orthodontic school clinics take patients. Students perform supervised treatments that usually come at a reduced cost.
Summary + Next Steps
Traditional metal braces can cost from $4,400 to $5,300. Dental insurance will sometimes cover braces for kids — but adult orthodontic coverage is less common. If you think you’ll need orthodontic coverage, check:
- If and how your dental policy covers orthodontic services
- At what rate orthodontics care is covered
- If there’s a waiting period to get braces
Call (888) 855-6837 to speak with an insurance agent to discuss your options for coverage.