Is braces & orthodontics covered by insurance?
Braces and clear aligners. Here’s how each kind of plan usually handles it.
- Employer or MarketplaceUsually not covered
Usually not, except for a medical problem or through a dental plan with an orthodontic benefit, which usually pays about half up to a lifetime limit.
More details
Medical plans pay for braces only for a medical problem, such as after jaw surgery. Children’s dental benefits in Marketplace and small-employer plans cover medically necessary orthodontics; dental plans with orthodontics often limit it to children.
Cost: Lifetime orthodontic maximum; you pay the rest.
- Original MedicareUsually not covered
No, Medicare doesn’t cover orthodontics.
More details
Some plans may cover limited dental services, rarely orthodontics.
- Medicare AdvantageUsually not covered
No, Medicare doesn’t cover orthodontics.
More details
Some plans may cover limited dental services, rarely orthodontics.
- MedicaidCovered with conditions
Covered for children when medically necessary.
More details
States use severity scoring to decide.
What usually has to be true
- For children, braces are covered only when there’s a medical need, not for looks alone.
Good to know
- FSA/HSA funds can pay for orthodontics.
Related
- Dental care · Cleanings, fillings, extractions, and other dental work.
Sources
Typical rules for 2026 plans, checked against these sources on October 20, 2026. Your plan’s own documents decide.
- 1Dental coverage in the Marketplace
HealthCare.gov
Dental coverage for children is an essential health benefit and may be offered through a separate dental plan; adult dental coverage is not required.
- 2Dental services
Medicare.gov
Original Medicare does not cover most dental care, such as cleanings, fillings, extractions, dentures, or dental plates; it may cover dental services closely tied to certain covered medical procedures.
- 3Compare Original Medicare and Medicare Advantage
Medicare.gov
Medicare Advantage plans cover everything Original Medicare covers (except hospice, which Original Medicare continues to pay), usually use provider networks, often require referrals or prior authorization, and may offer extra benefits such as dental, vision, and hearing.
- 4Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Medicaid.gov
EPSDT requires Medicaid to cover screening, vision, dental, hearing, and all medically necessary services for children and adolescents under 21, even when the state does not cover the service for adults.
General information about how coverage usually works, not a decision about your plan. Your plan documents and insurer have the final word.