Average Braces Costs in 2021 With & Without Insurance.
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Table of Contents
- Why Need Braces?
- Braces & Cost
- Location & Cost
- Insurance Coverage
- Health Care Competition
- Funding Options
When you think about braces, do you also think about dollar signs? It's natural to worry about the cost. Few families plan ahead for this dental expense, and most feel certain that insurance won't help to cover the cost.
On average, braces cost about $5,000 to $6,000 without insurance. But your costs may rise and fall due to your oral health, the type of braces you need, the length of your treatment plan, and where you live.
Insurance plans will typically only offer coverage for children whose orthodontic needs are considered medically necessary. Since braces are frequently deemed to be more for cosmetic purposes, they are often not covered.
There are also alternatives to traditional braces that can reduce the overall cost of your bill. Aligners may be able to straighten your teeth for a fraction of the cost of braces.
Why do people need braces?
Braces pull your teeth into proper position. Orthodontists apply the gear, and they tighten it periodically until the teeth are tugged into the right spot.
The same type of braces could be used to treat many different oral issues. But sometimes, doctors must add to their basic braces plan, and those revisions can come with added costs.
Your orthodontist might recommend braces to treat:
Overbite (also known as "deep bite")
Type of braces and your bill.
Braces once came in one basic shape (rough) and one standard color (silver). A lot has changed.
As more adults are choosing to wear braces, and as social media sites encourage all of us to share our smiles with the world, customers demand more control. Companies have responded by creating a plethora of braces options.
Be aware that some of these alt braces types are more expensive than their traditional counterparts. But some of the alternatives could save you money.
The placement of the braces can impact the price as well. Lingual braces, for example, are placed behind the teeth and typically cost about 30% more than traditional metal braces that are put on the front of your teeth.
Your orthodontist may choose to improve your smile with:
Doctor-Monitored At-Home Aligners
Location plays a role in your cost.
Orthodontist fees vary from coast to coast. Orthodontists can't control some costs, including office rentals. In some communities, high demand can translate into a larger customer pool and a higher fee.
Traveling for braces isn't reasonable. You must visit your doctor regularly for tightening, checkups, and maintenance. But understanding how your costs can vary can help you prepare to cover your fees.
Does insurance help cover the cost?
Health insurance companies use complex formulas to determine if procedures are mandatory (to preserve health or function) or elective (to improve appearance). Braces often fall into a grey area, and that means some policies won't help you pay your bill.
Research published in Pediatric Dentistry Today suggests that about 85 percent of orthodontic cases are considered aesthetic or optional. But there are exceptions. Your doctor might consider your braces medically necessary due to:
- Cleft lip or palate.
- Crouzon syndrome.
- Hemifacial hypertrophy.
- Parry-Romberg syndrome.
Your doctor works directly with your insurance company. Radiographs, test results, and notes from your appointment all head from your doctor's office to the insurance company. Reviewers notify both you and your doctor if the treatment is accepted as a medically necessary intervention. You'll also get notified if your claim is rejected.
If your braces aren't medically necessary, your insurance company may still step up and help with the bill. Some dental insurance plans offer coverage for orthodontics. In a review of plans, for example, experts found that one company in four offered orthodontic coverage. People with this plan got help with half of the bill through their plans.
But AAO points out that dental plans can come with limitations, including:
Orthodontists and insurance companies can form partnerships with agreed-upon pricing. Choose an orthodontist who doesn't participate in this plan, and you could get hit with a bigger fee.
When insurance does offer some coverage for orthodontic treatment, generally, only the cost of traditional metal braces will be considered. Aesthetic options are usually not covered.
Health care competition and your benefits.
In the world of business, competition drives down price and boosts benefits.
Research from the Health Policy Institute says some states, such as Nevada and Oregon, are wildly competitive. On the flip side, these are the least competitive states:
- New Hampshire
- North Dakota
What funding options can you try?
If you're planning to spend money to improve your smile, you're not alone. Researchers say spending for dental procedures rose 4.6 percent in 2018. Even if your insurance company can't help you, there are plenty of options to try. Some providers offer the option for financial assistance that you can apply for if you can demonstrate financial need.
Cover your braces bill with:
Your Health Savings Account (HSA)
Your Flexible Spending Account (FSA)
If you have a health plan through your employer, they can also offer an FSA. This is an account that you can put money in to pay for out-of-pocket medical expenses, which can often include orthodontic treatment, on a tax-free basis. Employers may also contribute to your FSA, depending on your company and their arrangement.
To use your FSA, you will submit a claim to it through your employer, proving the medical expense, as well as a statement that it is not covered by your insurance plan. You can then be reimbursed for your costs.
These accounts are limited to $2,750 per year per employer. In most cases, the funds must be used within the same calendar year.
You can also take out a personal loan to cover the cost of braces. Orthodontists will often offer a discount if you can pay for the entire treatment up front. You can use a loan to do this and then pay the loan back, with a small interest fee, through affordable monthly payments.
Some loans are specifically for dental procedures. Many different financial institutions offer this option.
Dental Discount Plans
Even if your dental insurance does not offer coverage for braces and orthodontic treatment, there are many different types of dental discount plans that can offer a lower rate or a discount on braces. These plans may offer a certain percentage off when you use specific providers that are within their set network.
Generally, these plans have a low-cost monthly fee that you will pay as well.
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