Dental insurance coverage for braces

Most dental insurance plans focus coverage on preventive, basic and major dental treatments. However, some plans do provide benefits and discounts for orthodontic care, like braces.

Here’s a look at the definition of orthodontic care, if dental insurance covers orthodontics and more.

What is orthodontic care?

Orthodontic care is a field of dentistry that fixes alignment issues in teeth and jaws. Common treatments include different types of braces, clear aligners and retainers that help improve oral health and function.

While some orthodontic treatments are optional or cosmetic, many cases are medically necessary to correct severe oral issues.

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Age

Does dental insurance cover orthodontics?

Many dental plans provide some level of orthodontic coverage, but it can vary depending on the provider and type of plan. Here’s a general breakdown:

Child orthodontics—Most insurance plans cover a portion of braces costs for dependents under the age of 18. Coverage typically includes initial consultations, the orthodontic appliance (braces) and adjustments.

Adult orthodontics—Fewer plans offer coverage for adults. If available, adult orthodontics coverage often comes with higher premiums.

Medically necessary braces—Coverage may depend on whether the braces are for cosmetic reasons or health reasons.

What is the best dental insurance for braces?

In general, preferred provider organization (PPO) plans offer the most orthodontic benefits. Some dental health maintenance organization (DHMO) plans could offer benefits or discounts as well.

Plans with orthodontic benefits usually offer partial coverage for braces, especially for dependents under the age of 18. If adult orthodontic coverage is available, it may be more limited.

How to know if it’s time to invest in orthodontics and braces

Orthodontic treatment is typically necessary when there’s a noticeable issue with the teeth, bite or jaw. Common reasons include:

Teeth that are crooked or crowded
Difficulty chewing or speaking
Early or late loss of baby teeth
Teeth that don’t align properly during a bite

For young children, experts recommend asking your dentist about orthodontics as early as possible—usually when permanent teeth begin to appear.

Humana can help with the cost of braces

If you need orthodontic care, Humana can help. We offer a Dental Savings Plus dental discount plan that may provide discounts on braces. To see plans and prices in your area, check out our Dental Savings Plus plan.

Frequently asked questions

1. What qualifies as medically necessary braces?

To be medically necessary, the braces must be used to treat severe conditions of the mouth and jaw. Examples include severe overbite, underbite, crossbite or significant crowding.

2. What is a dental insurance waiting period?

A dental insurance waiting period is the amount of time you must be enrolled in a plan before you can access benefits for certain types of care. Waiting periods can range from a few months to over a year depending on the insurance provider and plan.