Medicare considers braces a dental procedure and does not cover dental procedures except in very rare circumstances.
Braces are orthodontic treatments used to help straighten and realign teeth. They are often used for elective and cosmetic reasons. Original Medicare (parts A and B) generally doesn’t cover this type of dental care.
Some Medicare Advantage (Part C) plans may offer coverage for orthodontics as part of a dental package.
Read on for more information about Medicare coverage for braces and how you might be able to get help paying for braces.
Typically, Original Medicare (Part A and Part B) won’t cover the cost of braces. But Medicare might pay for braces in some rare situations.
If your teeth become damaged as a result of an accident or an underlying health condition, orthodontics may be deemed medically necessary. In that case, Medicare Part B might pay for braces as part of your Medicare-covered care as an outpatient.
If your condition is an emergency or requires hospitalization and medically necessary orthodontic treatment is performed in a hospital setting, Medicare Part A might cover it.
Private insurance companies administer Medicare Advantage (Part C) plans. Some Advantage policies may include dental coverage, and plans that offer specialized dental care may cover some of the cost of braces.
You can search for Medicare Advantage plans offered in your zip code to see whether any include orthodontics coverage. You may be required to pay additional costs, such as copayments, deductibles, and expenses beyond the policy limits.
When does Medicare cover dental services?
Medicare may cover the cost of some dental procedures if you:
- are admitted to the hospital as an inpatient for a dental procedure because of an underlying medical condition
- need a dental procedure that can be performed only in a hospital setting
- need a dental service so that another Medicare-covered medical treatment will be successful, such as:
- if you need dental care before a transplant (of bone marrow, a kidney, or another organ) or a heart valve replacement
- if you need dental care, such as an extraction, to prevent infection before starting cancer treatment
- if you need dental treatment because of a complication that occurred during head and neck cancer treatment
The cost of braces can range from $3,000 to $10,000, depending on your location and the type of braces you select.
Options for paying for braces
If you’re looking for assistance with paying braces, these resources may be able to help:
- Discount plans: Some dental or orthodontics practices offer discount plans for dental care if you subscribe or pay a monthly or yearly “membership” fee.
- Dental assistance programs: Many states have dental assistance programs through Medicaid that help people with low incomes get dental care and treatment. In rare cases, these programs may cover braces.
- Dental school clinics: Some dental schools offer low cost options for dental care and treatment if you agree to allow supervised students to perform the care. The Commission on Dental Accreditation has a list of dental schools you can search to find one near you.
- Private dental insurance: Many insurance companies offer private dental insurance that you can buy. Some may also offer dental coverage on the Healthcare Exchange.
- Charitable programs: Some charities help individuals and families afford dental and orthodontic work, but most of these programs are for children.
Why won’t Medicare pay for my braces?
Medicare considers braces an elective dental procedure, and Original Medicare (parts A and B) doesn’t cover dental procedures. You may be able to find a Medicare Advantage (Part C) plan in your area that includes this coverage.
Does Medicare pay for Invisalign?
No. Original Medicare doesn’t cover the costs of Invisalign braces. You might be able to find a Medicare Advantage (Part C) plan in your area that includes braces in its dental plan coverage.
What is the age limit for getting braces?
There is no age limit for getting braces on your teeth. However, because children have more rapid bone growth than adults, braces may take longer to straighten an adult’s teeth.
In general, Original Medicare does not cover the cost of getting braces on your teeth. But you may be able to find a Medicare Advantage plan that offers dental care and includes coverage for braces.
You can search for Medicare Advantage plans in your area to see whether a plan in your zip code covers braces.