Insurance for orthodontic treatment

Orthodontic treatment can be a significant investment, but insurance can help reduce the financial burden. Whether you’re considering braces or Invisalign^® treatment, understanding your coverage options is key to managing costs. Learn how insurance for orthodontic treatment works, if you are covered, and affordable options for getting the treatment you need.

Are orthodontic services covered by insurance?

Orthodontic coverage depends on your dental insurance plan and which treatments are included, such as braces or Invisalign aligners.¹ Preferred Provider Organization (PPO) plans typically cover 100% of preventive care, 80% of basic care, and 50% of major procedures.² These plans allow you to visit out-of-network orthodontists, but you may need to pay more.² Alternatively, Dental Health Maintenance Organization (DMHO) plans require you to use in-network providers and offer set rates and copays, but they do not cover out-of-network care.²

How can you get insurance for orthodontic care?

You can get insurance for orthodontic treatment in two ways. One option is through your employer, as part of an employee benefits package. Many employers offer dental coverage plans, which may include orthodontic treatments.³

Alternatively, if you are self-employed, you can purchase an individual dental plan directly from a health insurance carrier, where you pay the monthly premium out of pocket. This gives you more control over the plan you choose, however, it requires managing the costs independently.³

Does health insurance cover orthodontic treatments?

Health insurance typically does not cover orthodontic treatments, as it is intended to cover health related services. However, some health insurance plans may include dental coverage as part of the overall package.⁴ To be certain about your coverage, contact your insurance carrier and speak with an agent to find out if orthodontic treatment is covered by your insurance plan.

Orthodontic insurance for adults

If you’re considering getting orthodontic treatment for yourself, check with your dental insurance carrier and ask if orthodontic treatment is covered for adults. If it does not, you may need to consider getting a full-coverage dental plan or a supplemental plan that includes orthodontic coverage for adults. This can help you to avoid paying out-of-pocket for treatment.⁵

While many dental insurance plans cover orthodontic treatments, like Invisalign aligners, for children under 18, coverage for adults is less common.⁶ Some dental plans offer orthodontic coverage for adults, but it is not as widely available, so it’s important to check with your insurance carrier before starting treatment.

Dental insurance that covers orthodontics

Several insurance providers offer dental insurance coverage, including Anthem, Aflac, Cigna, Humana, and UnitedHealthcare.⁷ To determine if your dental plan covers treatments like Invisalign aligners, check with your provider. The My Invisalign App is a useful tool to help you find out if your dental insurance covers Invisalign treatment.⁸

Supplemental orthodontic insurance

Supplemental orthodontic insurance is designed to cover braces and other orthodontic treatments in addition to your regular dental plan. These plans typically have a waiting period before coverage starts and may cover up to 50% of the treatment cost.⁹ There is often a lifetime maximum benefit that applies. Additionally, some providers offer supplemental insurance that works alongside your primary dental plan to help cover extra costs.⁵

How orthodontic coverage works

What’s covered by orthodontic insurance?

Orthodontic insurance typically covers a range of treatments for children and teens, as these are often considered part of standard oral healthcare.¹⁰ Treatments commonly covered for young patients include:

For adults, coverage for orthodontic treatment depends on your specific insurance plan and provider. It’s a good idea to consult with your dental insurance provider to determine whether your plan includes coverage for adult orthodontics and if you qualify.

Affordable alternatives for orthodontic treatment

There are several options that can help make your orthodontic treatment more affordable, especially if your insurance doesn’t cover all the costs. Here are some ways you can manage the expenses:

Talk to an orthodontist

Ready to learn more? Try talking to your local orthodontist. They can review your situation, answer your questions, and help come up with a treatment plan that works for your smile and your wallet. Interested in exploring Invisalign aligners? Use the Doctor Locator tool to find a provider near you.