Does Insurance Cover Braces In Utah?

Braces can be a life-changing investment in both health and confidence — but they also come with a financial commitment. One of the first questions families in Utah ask is: does insurance cover braces? The answer is yes... sometimes.

Understanding how dental insurance works, what types of braces are eligible, and how to maximize your benefits can make the process less overwhelming and more affordable. Whether you're planning treatment for your child, teen, or yourself, this guide will break down what you need to know about orthodontic insurance coverage in Utah.

Does Dental Insurance Usually Cover Braces?

Some dental insurance plans include orthodontic coverage, while others don’t. When orthodontic benefits are included, they typically help cover a portion of the treatment cost — often between 25% and 50%, up to a lifetime maximum.

Coverage may vary based on:

• Your insurance provider and plan type
• Whether the patient is a child or adult
• The type of treatment (traditional braces, clear braces, clear aligners, etc.)
• Whether treatment is considered medically necessary or cosmetic

Are Braces for Kids Covered by Insurance in Utah?

Yes — many dental plans in Utah offer orthodontic coverage for children under 18. Pediatric orthodontic benefits are often more generous than adult coverage, especially if the treatment is deemed medically necessary.

Plans that include children’s braces may:

• Cover 50% of the cost (after a deductible is met)
• Provide up to $1,000–$3,000 in lifetime orthodontic benefits per child
• Require treatment to be done by an in-network orthodontist

Is Adult Orthodontic Treatment Covered?

In some cases, yes — but not always. While pediatric orthodontics is more commonly covered, adult orthodontic benefits are often optional or less comprehensive.

For adults with coverage, benefits might:

• Be capped at a lower amount (e.g., $1,000 lifetime max)
• Cover only specific treatments (like metal braces or medically necessary corrections)
• Require a waiting period before benefits begin

What About Clear Braces or Clear Aligners?

Coverage for alternative treatments like clear braces or clear aligners varies by plan. Some insurance providers treat them the same as traditional braces, while others view them as cosmetic upgrades and may not cover them at all.

It’s always a good idea to ask your provider:

• Are clear aligners covered under my orthodontic benefit?
• Will I need to pay the difference out of pocket if I choose a more aesthetic option?
• Is pre-approval or a referral required?

How Much Do Braces Cost Without Insurance in Utah?

If you don’t have orthodontic coverage, braces can range from:

• $4,000 to $6,000 — for traditional metal braces
• $5,000 to $7,000+ — for clear braces or clear aligners

These costs depend on the complexity of your case, the length of treatment, and the technology used. While insurance can help, many practices also offer flexible financing, in-house payment plans, and health savings account (HSA) options.

What Insurance Providers Cover Braces in Utah?

The following dental insurance providers may offer orthodontic coverage in Utah:

• Delta Dental — Often includes child orthodontics; adult coverage varies by plan
• MetLife — Some plans include ortho benefits with waiting periods
• Cigna — Offers both family and adult orthodontic options
• EMI Health — Popular in Utah with orthodontic add-ons available
• UnitedHealthcare — Coverage available depending on plan type
• Blue Cross Blue Shield — Plans vary, but many offer child coverage

Remember: coverage depends on your specific policy. Two people with the same provider can have very different benefits.

How to Find Out If Your Braces Are Covered

Here’s how to verify your orthodontic insurance benefits:

1. Review your dental insurance plan documents — Look for an orthodontic section outlining what’s included.
2. Call your insurance provider — Ask directly about orthodontic coverage, age limits, and eligible treatment types.
3. Ask your orthodontic provider to help — Many offices can perform a benefits check or submit a pre-authorization request on your behalf.

Tips for Using Insurance to Pay for Braces

To get the most from your dental insurance in Utah, keep these tips in mind:

• Use in-network orthodontists to maximize coverage
• Confirm if there’s a waiting period before benefits start
• Check for age limitations or lifetime maximums
• Ask if payment plans can be used alongside your insurance
• Use FSA or HSA funds to pay for out-of-pocket expenses tax-free

Need Help Navigating Insurance and Braces?

At Albrechtsen & Fanelli Orthodontics, our team is here to help you understand your insurance benefits and create a treatment plan that fits your needs and your budget. We work with many major insurance providers in Utah and offer flexible financing options to make your smile transformation as accessible as possible.

Schedule your free consultation today — and let us help you get the most out of your orthodontic insurance coverage!