Thinking about getting braces, but not sure what your insurance will cover? You’re not alone. One of the most common questions we hear at Artemis Smiles Orthodontics is: “Does my insurance cover braces?”
The answer? It depends. But don’t worry—we’re here to break it down for you.
Whether you’re an adult exploring Invisalign or a parent considering braces for your teen, understanding how PPO dental plans work for orthodontic care can help you plan smarter, save money, and get the treatment you need with confidence.
How PPO Dental Insurance Works for Orthodontics
PPO (Preferred Provider Organization) dental plans are among the most common types of dental insurance. These plans give you flexibility to choose your provider—and offer significant savings when you use an in-network orthodontist (like Artemis Smiles Orthodontics!).
Here’s what typically matters most when it comes to orthodontic coverage under a PPO plan:
1. Orthodontic Coverage Must Be Included in Your Plan
Not all dental insurance automatically includes braces or Invisalign. You’ll want to check:
- Is orthodontics included in your plan?
- Is coverage available for both adults and children?
- Does it cover traditional braces, Invisalign, or both?
Some plans cover orthodontics only for dependents under 18, while others offer broader options.
2. Lifetime Maximums Apply
Unlike general dental services, orthodontic benefits usually come with a lifetime maximum—not an annual one.
For example, your plan might pay up to $1,500 or $2,000 per person toward orthodontic treatment. Once that max is reached, you’re responsible for the remaining cost, even if your treatment isn’t finished.
3. Coverage Is Usually a Percentage
Most PPO plans cover a percentage of your orthodontic costs, such as:
- 50% coverage after deductible
- Up to the lifetime maximum
That means if your braces cost $5,000 and your plan covers 50%, you’d receive $2,500 in benefits—unless the lifetime max is lower, in which case that’s the limit your insurance will pay.
4. There May Be a Waiting Period
Some dental insurance plans include a waiting period for orthodontic coverage—typically 6–12 months after your policy begins. Be sure to verify this before starting treatment.
We’re In-Network with Major PPO Plans
At Artemis Smiles Orthodontics, we’re in-network with many major PPO dental providers that offer orthodontic benefits, including:
- Delta Dental (PPO, Premier Plus)
- MetLife Dental (PPO)
- Anthem BCBS Dental (PPO)
- Aetna Dental (PPO)
Being in-network means you pay less out of pocket and enjoy a smoother billing process with no surprise charges.
Not Sure What Your Plan Covers? We’ll Help You Find Out.
Understanding the ins and outs of your dental insurance can feel overwhelming—but you don’t have to figure it out alone.
Our team will:
- Verify your orthodontic benefits before your first visit
- Explain exactly what’s covered and what’s not
- Provide a customized cost estimate
- Handle insurance paperwork and claims on your behalf
Ready to Explore Braces or Invisalign?
If you have a PPO dental insurance plan with orthodontic coverage, you may be closer to a straighter smile than you think. At Artemis Smiles Orthodontics, we make it easy to get the answers you need—and the treatment you deserve.
