If you or your child have been diagnosed with scoliosis, you’re not alone. Scoliosis affects up to 9 million people in the United States. Four out of five of these cases are idiopathic scoliosis, meaning they don’t have an obvious cause.
Idiopathic scoliosis usually appears between the ages of 10 and 15. Because kids in this age range are still growing, early medical intervention can prevent their spines from curving further, or even make their spines straighter.
One go-to intervention for idiopathic scoliosis is bracing. Scoliosis braces come in all shapes and sizes, but they all work basically the same: by applying pressure and tension to your body, they push and pull your spine into alignment, similar to how a gardener might bend a tree or vine to grow a certain shape.
While braces can support your spine, they can also be a heavy burden on your bank account. Scoliosis braces can cost anywhere from $20 to $12,000, with most of them falling on the higher end of this range.
Here’s a basic guide to what different braces cost, which braces insurance will cover, and how using your brace correctly can save you money down the road. (A note: For the purposes of this article, we are covering only braces for adolescent idiopathic scoliosis, not infant scoliosis or adult scoliosis.)
How much does a brace cost?
A brace’s cost depends a lot on what kind of equipment you’re getting.
Off-the-shelf
At the cheaper end, you have off-the-shelf braces. They often look like vests with adjustable, criss-crossing straps. You don’t need a doctor’s prescription for these — you can simply get them for around $20-$40 off Amazon or another online retailer.
Some off-the-shelf braces can make big claims about their therapeutic benefits but lack the evidence to back them up. In fact, if these braces don’t fit right or put pressure in the wrong place, they can actually make your scoliosis worse.
Standard
To get a medical-grade brace, you’ll need a prescription from your physician. Then you’ll visit an orthotist, a professional who specializes in braces and similar medical devices.
The orthotist will scan and measure your body to determine the most effective way to straighten your specific spine. Then, they may order a brace with prefabricated (already-made) parts matching your body and give you a fitting session in their office. An orthotist might also order a brace made entirely from scratch, called a custom-fabricated brace.
According to Bloomberg, standard braces can cost anywhere between $2,000 to $10,000.
Why such a wide range? Because there are many different braces, and they each have their own niche in scoliosis treatment. Some of the most common ones are:
- The Boston brace is a plastic jacket that reaches from your armpits to your hips. Doctors may recommend it if you have multiple moderate curves in your rib cage and lower spine. As of 2021, the average cost of a Boston Brace starts at $2,500.
- The Wilmington brace is very similar to the Boston brace, but it opens in the front instead of the back.
- The Rigo-Cheneau type of brace, which is manufactured by several companies, is a plastic jacket with cut-out holes, resembling Swiss cheese. These holes are meant to help you breathe easier, especially when doing physical therapy. There is no price listed on manufacturer or provider websites; anecdotal data suggests that the price can range from $6,000 to $8,500. We spoke to the Rigo-Cheneau manufacturer National Scoliosis Center, but they said they could not provide a firm price range for their braces, as they say they negotiate a unique contracted rate for each insurance plan.
- The Charleston is also a plastic jacket, but worn only at night. Its structure is bent in the opposite direction of your curve to “over-correct” your spine’s growth. It’s recommended if you have a C-shaped curve in your lower back. The Charleston manufacturers did not respond to a request for a price.
- The Providence Brace is another night brace that over-corrects your posture. But instead of bending at the top, one side extends past your hip at the bottom. It’s suitable for mild to moderate spinal curves under 35 degrees. The Providence manufacturer did not respond to a request for a price.
Older brace models, like the Milwaukee brace or Risser Jacket, are still available, though they tend to cost more than modern braces. Because these models tend to be very restrictive and uncomfortable, few people get them anymore.
Non-traditional
Many start-up companies are working to develop custom braces outside of the traditional plastic jacket. Newer brace types may be sleeker or more comfortable, but they don’t have as much evidence supporting their effectiveness as traditional braces do.
The prices for non-traditional braces vary widely depending on the company. For example, Mign sells 3D-printed braces with a lattice structure instead of a solid jacket form. They charge between $800 and $1,650 to clinics.
Green Sun Medical, meanwhile, has developed another non-traditional brace, constructed of springs and hoops that can bend with your body as it moves. They charge up to $12,000 per brace.
Will insurance cover my scoliosis brace?
Most private insurance companies, like United Health Group and Aetna, say they fully cover scoliosis braces. However, there is no guarantee they will be in network for a particular clinic or cover the specific type of brace you want.
Furthermore, there may be some hoops you have to jump through before insurance covers your brace – if indeed it does.
First, your physician needs to confirm that you have scoliosis and that your curve is severe enough to benefit from a brace. Typically this means your curve is between 25 and 40 degrees. If you have mild scoliosis, with curves between 10 and 25 degrees, it may be harder to convince insurance that you need a brace.
Second, the person who fits you for your brace needs to have a license in orthotics or prosthetics. Unless your primary care physician also has an orthotics license, you’ll need to see a specialist. You’re unlikely to get reimbursed for an off-the-shelf brace from Amazon. If you’re trying to buy a brace from a start-up that doesn’t have an orthotist on staff, insurance won’t cover that either.
Lastly, many insurance plans practice step protocol, also called a “fail first requirement.” Basically they’ll want you to try the cheapest possible option to treat your symptoms before they’ll approve more expensive treatments.
For example, before you get a custom-fabricated brace, your insurance may ask you to try a prefabricated brace, as they tend to be cheaper. If the prefabricated brace doesn’t work, then they may pay for a custom brace designed to fit your exact measurements. Of course, by then you’ve lost several valuable months of growing time wearing a product that didn’t fit well enough to work.
Furthermore, insurance companies may need extra convincing before they will approve non-traditional braces. While it’s not impossible to get a non-traditional brace approved, your insurance company is unlikely to pay for one until you’ve tried a standard brace first.
Even if you meet all these requirements, and they decide to cover your brace, it won’t necessarily be free. If you haven’t paid your deductible yet, you may be responsible for the brace’s full cost. Even after you’ve paid your deductible, your insurance plan may assign you a copay or co-insurance to contribute to the brace’s cost.
Given a choice, you may want to seek out a brace made via 3-D printing rather than molds. Computer-aided manufacturing tends to be more cost-effective than the traditional manufacturing processes. While insurances say they will pay the same rate regardless, there is no guarantee because insurance companies love to deny claims. And there is no guarantee that if the final product is cheaper, you will pay less out of pocket.
What about Medicare and Medicaid?
Public insurance plans also pay for scoliosis braces, using much the same criteria as private insurance plans. However, every state plan pays a different amount.
As of April 2023, traditional Medicare will pay between $1,680 and $2,240 for most prefabricated braces. If you require add-on pads or extensions for your brace, those may cost a few hundred dollars extra.
If you get a custom-fabricated brace, traditional Medicare plans will pay between $1,791 and $2,388, according to the Centers for Medicare and Medicaid Services website. The cost is determined by your location, and also type of brace (not all will be covered). Most traditional brace types, from Boston to Charleston, will cost the same.
Like private insurance, traditional Medicare plans have a deductible. They may also require a Medigap plan to cover what’s not covered by the plan. As of 2023, the deductible for Part B is $226, and the copay is typically 20% of the brace’s total cost. Again, non-traditional braces are not likely to be covered.
So if you need a custom-fabricated Boston brace from Alabama, your care team is allowed to charge you and your insurance $1,791, according to the C.M.S. spreadsheet for durable medical equipment reimbursement. Assuming you’d already paid your deductible, you would pay $358 of coinsurance, and Medicare would pay the remaining 80%.
Because the Medicaid program is a federal-state partnership, the Medicaid rates vary greatly from state to state. For example, California’s Medicaid plan would pay $1,026 for a custom-fabricated brace, while Medicare would pay $2,388 in California, according to the C.M.S. spreadsheet. Meanwhile, Alabama’s Medicaid plan would charge $1,006 for the same brace (compared to $1,791 via Medicare).
Why it’s important to wear your brace as instructed
Scoliosis bracing is a big commitment. You need to wear night braces like the Providence each night for the seven to 10 hours you are asleep. Full-time braces like the Wilmington need to be worn between 16 and 23 hours a day.
When worn consistently, braces can stop your curve from progressing to the point where you need surgery. The type of spinal surgery you need depends on your curve, but some can cost over $86,000. So while scoliosis braces aren’t exactly cheap, they may save you a lot of money in the long run.
Depending on how quickly you grow during puberty, and how much your curve changes, you may need to adjust or even replace your brace. According to our contact at the National Scoliosis Center, “Our patients usually require adjustments to their brace after approximately 9-12 months. Sometimes, a new brace may have to be created to account for the patient’s growth.”
Every patient’s situation is different. If you don’t have much growing left to do and your brace still mostly fits, your orthotist may be able to adjust your brace in the office. But if you’re still at the starting line of puberty, and x-rays show your curve has a high risk of progressing, you may need to buy a second brace.
What you can do
If you’re having trouble affording a brace, consider asking your provider if they offer payment plans or a financial assistance program.
The Align Scoliosis Foundation and the Brace for Impact initiative say they will help pay for some scoliosis braces. The Children’s Scoliosis Foundation has a grant program for families traveling long-distance to get scoliosis care, paying up to $750 per trip for travel expenses (but not the brace itself).
Some children’s hospitals that offer braces, like Children’s Mercy of Kansas City or Boston Children’s Hospital, also offer patient assistance plans for families that have trouble paying for their child’s care. However, you will likely need to provide proof that your income is below a certain threshold, like tax returns or pay stubs.
Some patients have run a GoFundMe campaign to raise money for a brace.
