When considering dental braces, a key cost is the down payment needed to start treatment. This first cost can vary greatly depending on whether you have dental insurance.
With insurance, the down payment is often lower because many plans cover some orthodontic costs. Without insurance, the upfront fee is much higher, reflecting the full cost of the braces.
This article will look at standard down payments for dental braces, comparing insured and uninsured cases to help you plan better.
Some can get started without an upfront deposit.
Down Payment Without Insurance
First, we examine what uninsured patients should budget for their braces down payment. Expect the orthodontist to charge a sizeable percentage of the total treatment cost upfront.
Zero Down
Families without dental insurance have three ways to get braces with zero money down. However, these options do not involve finding a local orthodontist with lax billing.
A third party often provides the upfront funding.
Financing Programs
Payment plans for braces spread the upfront treatment costs over time. The orthodontist is not skipping the down payment. Most likely, a financing entity covers the deposit and bills the family in installments over time.
Personal loans, medical credit cards, and Flexible Spending Accounts use funding from a third party to cover the down payment. Patient families make smaller installment payments in the future.
Arrange the financing in advance. Begin treatment the same day you visit the orthodontist. This way, you can avoid filling out forms and waiting for approval.
Medicaid Recipients
Medicaid covers braces for young adults under 21 when medically necessary. Many states use a point system to measure the severity of malocclusion.
Medicaid pays all orthodontia costs when the point-scoring system suggests treatment is medically necessary. Therefore, low-income families do not need to make a down payment or fund other expenses.
Few orthodontists accept Medicaid due to low payments. However, finding them is easy. The Managed Care Organization (MCO) or Dental Benefits Manager (DBM) administering benefits should publish an online directory of participating providers.
Health Insurance
Health insurance covers braces using a stricter definition of medically necessary. The orthodontic services must prevent, diagnose, or treat an injury, disease, or symptoms.
For example, repositioning teeth after accidentally breaking your jaw might qualify. Treatment for Temporomandibular Joint Disorders (TMJ or TMD) or Sleep Apnea is often eligible.
Patients without dental coverage can avoid making a down payment in these instances. Many medical plans pay 100% of the allowed amount once the family meets the annual deductible.
Average Deposit
An average down payment without dental insurance is a good starting point for budgeting. However, the upfront amount depends on the braces type, malocclusion severity, and the patient’s age.
Uninsured families who do not qualify for financing should expect to pay about 20% of the entire treatment price upfront.
| Type | Average Cost | 20% Down |
|---|---|---|
| Metal | $4,500 | $900 |
| Ceramic | $6,000 | $1,200 |
| Lingual | $9,000 | $1,800 |
| Invisalign® | $5,700 | $1,140 |
Down Payment With Insurance
The down payment for patients with dental insurance depends on the estimated out-of-pocket costs. Consider two main factors.
- The price of the chosen appliance
- The cost-sharing features of the dental plan
Every dental insurance plan covers orthodontia differently. Here are three examples to estimate what the orthodontist might require upfront.
AFLAC
The down payment for braces is likely highest for families with AFLAC dental insurance. The AFLAC plan does not include Preferred Provider Organization (PPO) discounts. They pay a fixed benefit regardless of the orthodontist chosen by the patient.
An AFLAC orthodontia rider might offer benefits like these.
- $800 paid for the initial orthodontic treatment
- $250 every third month for ongoing adjustments, removal, etc.
- $1,500-lifetime maximum benefit
An orthodontist might subtract the $1,500 lifetime benefit from the total cost when calculating the 20% down payment for AFLAC patients.
| Type | Retail Cost | Left-Over Cost | 20% Down |
|---|---|---|---|
| Metal | $4,500 | $3,000 | $600 |
| Ceramic | $6,000 | $4,500 | $900 |
| Lingual | $9,000 | $7,500 | $1,500 |
| Invisalign® | $5,700 | $4,200 | $840 |
Spirit
The down payment for braces with Spirit dental insurance might be lower, even though the benefits are less generous. Orthodontists in the Spirit PPO network set lower treatment rates.
A Spirit dental orthodontic plan might have benefits similar to these.
- A one-time $100 deductible
- Coverage is 10% for year one, 25% for year two, and 50% for year three
- A $ 1,200-lifetime maximum per child
An in-network orthodontist might subtract the $ 1,200 lifetime benefit from the estimated 25% discounted cost when calculating the 20% down payment for Spirit patients.
| Type | Discounted Cost | Left-Over Cost | 20% Down |
|---|---|---|---|
| Metal | $3,375 | $2,175 | $435 |
| Ceramic | $4,500 | $3,300 | $660 |
| Lingual | $6,750 | $5,550 | $1,110 |
| Invisalign® | $4,275 | $3,075 | $615 |
BCBS FEP
The down payment for braces with dental insurance through the Blue Cross Blue Shield Federal Employee Program (BCBS FEP) should be the lowest. People affiliated with the world’s largest employer have the best benefits.
A BCBS FEP orthodontic plan might offer benefits like these.
- 50% coinsurance
- $3,500-lifetime maximum per person
An in-network orthodontist might subtract the 50% coinsurance from the estimated 25% discounted cost when calculating the 20% down payment for BCBS FEP patients.
| Type | Discounted Cost | Left-Over Cost | 20% Down |
|---|---|---|---|
| Metal | $3,375 | $1,688 | $338 |
| Ceramic | $4,500 | $2,250 | $450 |
| Lingual | $6,750 | $3,375 | $675 |
| Invisalign® | $4,275 | $2,138 | $428 |
