Orthodontic Insurance That Covers Braces for Adults

Orthodontic treatment as an adult might feel overwhelming, especially when navigating the complexities of dental insurance coverage. Fortunately, you don’t have to be a child to get insurance coverage for braces and aligners.

While most dental plans don’t automatically cover adult orthodontics, there are ways to reduce costs. In this article, we’ll go over how you can get insurance coverage for adult orthodontic treatment and what some of the best dental insurance plans are.

Can Adults Get Orthodontic Insurance?

Many dental coverage plans cover a portion of orthodontic services for children 19 years or younger. Insurance covering braces for adults is available, but it’s less common since it’s often considered cosmetic.

Finding dental insurance plans that include coverage for adult braces can be challenging. Some dental insurance policies set an age limit on orthodontic coverage, usually around 19.

If your insurance company offers coverage for adult braces, check the yearly maximum benefit or lifetime maximum for braces. Some dental policies pay a percentage of the dentist’s fees, while others cover a flat fee.

Top 6 Dental Insurance Plans for Adult Orthodontics

Here are some of the best dental insurance plans for adult orthodontics:

1. Delta Dental

Delta Dental is the biggest dental coverage provider in the United States. They offer many plan choices with different levels of orthodontic coverage at various price points. 

There are plans for basic orthodontic coverage (at a low cost) and comprehensive coverage (at a higher cost). Depending on where you live, you may be able to sign up for Delta Dental on your state’s health insurance exchange or healthcare.gov. 

Many Delta Dental plans include orthodontic benefits, but coverage varies by plan, and some offer no orthodontic benefit at all.

2. Aetna

Aetna is a major health and dental company acquired by CVS in 2018. Aetna offers discounts for orthodontics for less than $12 per month.

While not all dental plans provide orthodontic coverage, Aetna offers various discount plans that include orthodontic procedure coverage or discounts.

3. Aflac

American Family Life Assurance Company of Columbus (Aflac) provides dental insurance supplements with an optional rider for orthodontics.

However, policies and pricing are not available entirely online. You must fill out an online form or call Aflac for a quote, which is not ideal for many buyers.

Since Aflac offers dental insurance as a supplement and orthodontic coverage as a rider, you can create a customized insurance policy to meet your needs. Like other insurance companies, monthly costs and coverage differ by level.

4. Humana

Humana is a major insurance company in the U.S., providing medical and dental plans, among others. They offer several options for dental plans, which vary in costs and coverage.

The diversity of Humana’s dental plans allows you to choose the type of care you need. Your Humana plan may cover a portion of your adult braces or offer a discount, but not all of them will.

5. Cigna

Cigna is another major carrier of insurance plans in the US. They boast robust nationwide coverage and offer multiple tiers of dental policies.

One advantage of Cigna is that it’s easy to start a policy if you’ve recently lost coverage. Thanks to their wide network, it’s usually easy to find a dentist in your area that takes their insurance.

6. DentalPlans

DentalPlans helps you find dental discount plans or dental insurance policies more conveniently. While it’s not an insurance provider, it’s still a great place to find coverage or alternative payment options.

Just enter your location information on their website to browse available plans. Most plans are dental savings plans that allow you to receive dental care at a discounted rate from participating dentists.

How Does Dental Insurance Work?

Relatively few U.S. dental plans cover adult orthodontics, and benefits vary widely by plan. Treatment costs typically range from $3,000 to $7,500 before benefits, so understanding your coverage can help you manage expenses.

There are also plenty of ways for insurance to reduce the cost of dental work, for example:

• Premium: Monthly cost you pay to keep insurance active.
  
• Deductible: Amount you pay before insurance kicks in.
  
• Co-insurance: Your share of treatment costs after meeting the deductible, often 50% for orthodontics.
  
• Lifetime Maximum: The total amount insurance pays toward orthodontic treatment during your lifetime.

How Does Orthodontic Insurance Work for Adults?

Adult orthodontic insurance isn't standard in dental policies. Usually, it’s an optional rider you must explicitly select and purchase. 

Even if covered, policies typically enforce waiting periods, often between six and 12 months. Policies frequently exclude treatment already underway before coverage starts.

Insurance commonly covers orthodontics at 50% co-insurance with a lifetime maximum of $1,000 to $3,000. For instance, if your braces cost $6,000 and your plan pays 50% up to a lifetime max of $1,500, you’ll owe $4,500 out-of-pocket.

Plan Types and What They Cover

Adult orthodontic coverage differs widely depending on your dental plan type:

• Employer PPO dental plans — Typically feature broader provider networks and higher lifetime maximums, but come with higher premiums.
• Dental Health Maintenance Organization (DHMO) — Lower premiums, but restrict provider choices and often specify fixed co-pays rather than co-insurance.
• Marketplace or individual plans — Usually exclude adult orthodontic coverage or offer limited benefits and low caps.
• Stand-alone orthodontic riders — Optional add-ons purchased separately, explicitly for orthodontic treatment.
• Discount membership plans — Provide reduced fees rather than traditional insurance reimbursements.

In some cases, your insurance will cover orthodontic treatment deemed medically necessary (e.g., severe jaw issues, airway obstructions).

What Are Some Alternatives to Dental Insurance?

If you can’t afford dental insurance, there are plenty of other ways to reduce the cost of orthodontic treatment. These include:

• Dental schools — Most states have dental schools that welcome patients on specific days. They offer their services at reduced prices as part of the students’ dental training.
• Payment plans — Most orthodontic clinics provide payment plans for patients without dental insurance. Many clinics team up with financing companies to offer flexible payment options that cost less than conventional credit financing.
• Spending Accounts — Even if your dental plan does not pay for orthodontics, your employer may provide a flexible spending account (FSA) or health savings account (HSA).
• Dental assistance programs — Many states offer dental assistance programs to help low-income families receive necessary dental treatment. In some circumstances, not-for-profit organizations can help.