Adult Braces Insurance: What You Need to Know

Braces aren’t just for kids anymore. More and more adults are turning to orthodontic treatment to improve their smiles, correct bite issues, and alleviate jaw pain. But with the cost of braces reaching thousands of dollars, many wonder if their insurance will cover the procedure. In this article, we’ll explore everything you need to know about adult braces insurance.

Types of Braces and Cost

Before we dive into insurance coverage, let’s first discuss the different types of braces and their associated costs. Traditional metal braces are the most common type and can cost anywhere from $3,000 to $7,000. Ceramic braces, which are less noticeable, can range from $4,000 to $8,000. Lingual braces, which are attached to the back of the teeth, can cost anywhere from $8,000 to $10,000. And clear aligners, such as Invisalign, can range from $3,000 to $8,000.

It’s important to note that the cost of braces can vary depending on the severity of the orthodontic issue and the length of treatment. Insurance coverage can also play a role in reducing the overall cost.

Does Insurance Cover Adult Braces?

Whether or not insurance covers adult braces depends on the specific plan. Some insurance plans have exclusions for orthodontic treatment or may only cover it for children. It’s important to review your plan’s benefits and contact your insurance provider to determine coverage.

However, many plans do offer coverage for adult braces, although it may be limited. For example, some plans may cover a specific percentage of the cost or only cover certain types of braces. Always verify coverage with your insurance provider before beginning treatment.

How to Maximize Insurance Coverage

If your insurance plan does cover adult braces, there are a few ways to maximize your benefits:

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Get a pre-treatment estimate
Before beginning treatment, ask your orthodontist to provide an estimate of the cost and submit it to your insurance provider for approval. This can help avoid unexpected expenses.
Meet deductibles and co-pays
Make sure to meet any deductibles or co-pays required by your plan before beginning treatment.
Stay in-network
Choosing an in-network provider can lead to lower out-of-pocket costs.

Frequently Asked Questions

Can I get braces if I don’t have insurance?

Yes, you can still get braces even if you don’t have insurance coverage. Some orthodontists offer payment plans or financing options to make treatment more affordable.

What if my plan doesn’t cover adult braces?

If your plan doesn’t cover adult braces, you may be able to purchase supplemental insurance or a discount plan specifically for orthodontic treatment. Your orthodontist may also offer payment plans or financing options.

What if my orthodontist is out-of-network?

If you choose an out-of-network orthodontist, your insurance coverage may be reduced or even eliminated. Always check with your insurance provider before choosing a provider.

How long will I need to wear braces?

The length of treatment depends on the severity of the orthodontic issue and the type of braces. On average, treatment lasts between one and three years.

Will braces hurt?

Braces can cause some discomfort, especially when first applied or after adjustments. However, over-the-counter pain relievers and orthodontic wax can help alleviate any pain or irritation.

Conclusion

Adult braces can be a worthwhile investment in your dental health and confidence. Knowing your insurance coverage and maximizing your benefits can make treatment more affordable. Contact your insurance provider and orthodontist to determine coverage and begin your journey to a straighter smile.