Thinking about straightening your teeth as an adult? Before you decide on treatment, you probably want to know:
“Will my insurance help pay for adult braces or clear aligners?”
It’s one of the most common questions we hear from adults considering braces or Invisalign®.
It depends on your dental insurance plan. Some plans help pay for adult braces or clear aligners. Others only cover orthodontics for children, or don’t include orthodontic coverage at all.
You don’t need to sort through all the details before calling us.
At Just for Grins Orthodontics in Montgomery, Millbrook and Wetumpka, AL, we’ll look over your insurance with you and explain what it may pay toward treatment.
Quick Answer: Does Insurance Cover Adult Braces or Clear Aligners?
- Some dental insurance plans include adult orthodontic benefits; others limit coverage to children.
- Some plans cover braces, clear aligners, or both.
- A lifetime orthodontic maximum limits how much your plan pays and usually does not reset each year.
- Some plans have waiting periods or age limits.
- If your insurance doesn’t cover treatment, 0% interest financing and HSA/FSA funds may help make treatment more affordable.
- Bring your insurance information to your consultation, and we’ll help you check.
Does Dental Insurance Cover Adult Braces or Clear Aligners?
Sometimes, yes. Having dental insurance doesn’t always mean you have orthodontic benefits, and having orthodontic benefits doesn’t always mean they cover adults.
If your orthodontic insurance covers adult treatment, it may help with:
- Metal self-ligating braces
- Clear self-ligating braces
- Clear aligner treatment with Invisalign
- Other orthodontic treatment recommended by Dr. Dunn or Dr. Schreiber
The treatment your plan covers and the amount it pays depend on your policy.
Even if you and a coworker have insurance through the same company, you could have different benefits. That’s why it helps to check your own plan.
Does Insurance Cover Clear Aligners for Adults?
It may. To help pay for clear aligners, your plan needs to cover both adult orthodontics and clear aligner treatment.
Some plans cover braces and Invisalign, while others have restrictions. We can check those details with you before you get started.
Dr. Dunn or Dr. Schreiber will explain which options suit your teeth and bite. Knowing what your insurance may pay can help you compare the costs.
How Does Orthodontic Insurance Actually Work?
There are a few terms you’ll probably see when checking your benefits. Here’s what they mean for your treatment costs.
If you have adult orthodontic coverage, your plan may pay part of the cost of braces or clear aligners. You’ll be responsible for the amount it doesn’t cover.
Many plans pay a percentage of covered treatment costs, up to a lifetime maximum. Think of that maximum as the most the plan can pay for orthodontics. It doesn’t mean you’ll automatically receive that full amount. It generally doesn’t reset each year, and orthodontic benefits you’ve already used under the plan may leave you with less available.
Your insurance may also spread its payments out over treatment instead of paying everything at once. If you change plans or lose coverage along the way, the amount still available may change.
A few other things to check:
- A waiting period before orthodontic benefits begin
- An age limit for orthodontic coverage
- A lifetime maximum benefit
- Coverage for both braces and clear aligners, or one treatment over another
We can give you an estimate of what your insurance may pay, but the insurance company makes the final decision. That amount depends on your coverage and your plan’s rules.
What If My Insurance Doesn’t Cover Adult Orthodontics?
You can still explore braces or clear aligners without orthodontic insurance.
A payment plan can help you spread out the cost, whether your insurance pays part of it or none of it.
At Just for Grins Orthodontics, we offer 0% interest in-house financing and CareCredit financing. We’ll talk through the down payment and monthly payments with you so you know what to expect. Family and pay-in-full discounts are also available.
Have a Health Savings Account (HSA) or Flexible Spending Account (FSA)? You may be able to use that money for eligible orthodontic expenses. These accounts let you set aside money before taxes to help pay for qualifying care.
You can’t use HSA or FSA funds for a cost your insurance has already paid. Check with your account administrator about when you can use the funds and what receipts or paperwork you’ll need.
We’ll Help You Navigate Your Orthodontic Insurance Benefits
Bring us your insurance information and your questions. Here’s what we can help with:
- Check your orthodontic benefits
- Explain what your plan may pay
- File eligible insurance claims
- Check how much of your orthodontic benefit is still available
- Talk through payment plans and HSA/FSA options
We work with a range of insurance plans and file eligible claims for you. We’ll check whether we participate in your specific plan and whether it includes adult orthodontic coverage.
Is It Too Late for Adult Orthodontics?
No. You don’t have to be a teenager to get braces or clear aligners.
According to the American Association of Orthodontists, an estimated 1 in 3 orthodontic patients today are adults.
If you’ve been thinking about treatment for a while, a consultation is a chance to ask questions and find out what’s involved.
Let’s Find Out What Your Insurance Covers
Not sure where to start? Bring your insurance information and your questions to your complimentary consultation.
We’ll check your teeth and bite, talk through braces or Invisalign, and explain the costs and expected insurance benefits. You’ll have a chance to ask about monthly payments, too.
You can visit us at our orthodontic offices in Montgomery, Millbrook and Wetumpka.
Schedule your complimentary consultation today. We’ll help you figure out your next step. Start grinning!
Frequently Asked Questions About Using Dental Insurance for Adult Orthodontics
Does dental insurance usually cover adult braces or Invisalign?
Some plans do, and others only cover orthodontics for children. We’ll help you check whether your plan includes adult braces or Invisalign and estimate what it may pay.
Can I use my HSA or FSA to pay for braces or clear aligners?
Often, yes, for eligible orthodontic expenses that insurance hasn’t paid. Check with your HSA or FSA administrator about payment timing and the paperwork you’ll need.
Can I use insurance and a payment plan together?
Yes. We can work your estimated insurance benefits into your payment plan and explain your expected monthly payments. Your insurer may send its payments during treatment. We offer 0% interest in-house financing and third-party financing through CareCredit.
Will Just for Grins Orthodontics verify my insurance benefits?
Yes. Bring your insurance information, and we’ll check your orthodontic benefits, explain what your plan may pay, and estimate your share of the cost before treatment begins.
What if my insurance doesn’t cover adult braces?
You still have options. We can talk through payment plans, 0% interest in-house financing, CareCredit, and whether HSA or FSA funds may help with eligible costs.
