Does Dental Insurance Cover Invisalign for Adults?

Does Dental Insurance Cover Invisalign for Adults?

Fortunately, you may not be ready to pay for dental insurance, which can cost a few thousand dollars, including manufacturing costs and dentist’s office fees. It’s fairly expensive between all the visits, but Invisalign is an investment that can result in a forever-lasting, beautiful smile.

Although it depends on your specific plan and provider, this guide will help you navigate and understand the insurance details. Sometimes dental insurance plans cover Invisalign treatment.

The concise response might be that numerous dental insurance plans provide coverage for Invisalign treatment in a similar manner to braces. However, it is necessary to examine the orthodontic treatment policies specific to your insurance plan.

If you don’t have the luck of probably being out, there’s a good chance that your insurance will cover Invisalign. This includes them if your plan includes them. While they might fall under health insurance at other times, they might also fall under dental insurance at other times. Sometimes, orthodontic benefits fall under dental insurance and sometimes they fall under dental insurance. Sometimes, orthodontic benefits fall under dental insurance.

To ascertain the specifics of your plan or get in touch with your provider, the sole means of certainty lies in recognizing the individuality of each plan. It could pertain to a particular sum or proportion of your overall treatment expenses provided you avail the coverage. The essence remains the same.

What do orthodontic benefits cover?

Orthodontic treatments such as braces and Invisalign are partially covered by insurance benefits. In-office procedures incur costs, while at-home aligners also receive some coverage. There may be a maximum lifetime coverage limit, and some insurance plans may only provide coverage for children up to the age of 19.

How do I get dental insurance?

Many people are able to enroll in a dental insurance plan if their employer doesn’t offer dental insurance. Additionally, both individuals and families can also avail dental insurance plans, and some companies also provide dental insurance options.

Final Thoughts

Prior to commencing treatment, it is advisable to seek guidance from your dentist or orthodontist and discuss your plan’s specifics with your employer or insurance provider. Considering the nature of your particular plan, find solace in the possibility of receiving some aid from your dental insurance, despite the costly nature of Invisalign.

Which insurance companies cover Invisalign?

Just make sure you are aware of any age limits, lifetime maximums, and other restrictions. Almost every dental insurance company offers some type of orthodontic benefits with certain plans, including Invisalign. If your employer uses Delta Dental, Blue Cross Shield, MetLife, Aetna, Cigna, Guardian, UnitedHealthCare, Concordia, or Humana, there will likely be a plan option that offers orthodontic benefits.

How much of my treatment cost will dental insurance cover?

You can tell how much you can expect to receive in benefits from your plan’s summary by 50%. Some plans will cover a specific amount, such as $1,500 or $2,500, while others will depend on your particular plan.

Average Cost of Invisalign After Insurance

The expenses for orthodontic treatments, particularly teeth-straightening, have significantly increased over the years, leading many individuals to seek more affordable options. Between 1996 and 2016, the out-of-pocket costs for these treatments have more than doubled, making it difficult for people to pay for them on their own.

If you have orthodontic benefits, it is probable that they will cover 25% to 50% of the total price of Invisalign treatment. It is uncommon to find an insurance plan that includes coverage for orthodontics. Additionally, certain plans have a lifetime maximum that you will need to pay for. Once you reach the cap, you will be responsible for paying the remaining amount out of pocket, regardless of the percentage covered by your plan.

For example:.

Your insurance company will provide you with $3,500, and you will be responsible for paying $3,500 from your own funds towards your $7,000 medical procedure. However, there is no cap on the total amount that can be covered throughout your lifetime.

If you haven’t utilized insurance for any previous orthodontic treatments, you will have to pay $4,250 directly and will be reimbursed $2,000. Your insurance plan has a maximum coverage limit of $2,000 for lifetime, but it will bear 40% of the expenses for your Invisalign treatment, which amounts to $6,250.

It doesn’t matter if your doctor doesn’t accept treatment starting before, but your plan might cover Invisalign. Ensure to verify with your dentist or orthodontist’s office to confirm their acceptance of your insurance.

How Do Orthodontic Benefits Work?

It is natural to assume that every dental insurance plan incorporates orthodontia, however, this is not always the case. Certain plans provide orthodontic advantages while others do not. Additionally, even the plans that encompass orthodontia may come with certain limitations.

You can enroll in a dental insurance plan either on your own or through your employer, which will cover a certain percentage of the orthodontic treatment costs, up to a certain amount. However, there is usually a waiting period, unless you have insurance and can use it for whichever treatments you need, often later on.

Which Companies Cover Orthodontic Treatment?

Our supplier guides, have a look if you need further details on particular insurance firms. Occasionally, at-home aligners, Invisalign, and braces frequently provide coverage for these advantages. Certain orthodontic advantages encompass a scheme or schemes that majority of dental insurance firms offer.

  • Does Delta Dental provide coverage for braces and clear aligners?
  • Does Blue Cross Blue Shield provide coverage for braces and clear aligners?
  • Does Aetna provide coverage for braces and clear aligners?
  • Does MetLife provide coverage for braces and clear aligners?
  • Does Cigna Provide Coverage for Braces & Clear Aligners?
  • Does Guardian Insurance Cover Braces and Clear Aligners?
  • Does United Concordia provide coverage for braces and clear aligners?
  • How to Get Orthodontic Benefits

    To obtain orthodontic benefits, there is only one approach – enrolling in an insurance plan that covers them. There are two methods to achieve this: either buying an individual plan on the insurance marketplace or accessing a plan through your or your spouse’s employer.

    April marks the arrival of tax season, wherein a portion of your income is withheld from your wages to fulfill your tax obligations. Obtaining dental coverage can alleviate the financial strain, and your employer may assist in covering a portion of the premiums through employer-sponsored plans. Both options can serve as excellent means to access the necessary care.

    Of course, there is no perfect option, and the biggest drawback of employer-sponsored plans is that you are limited to the plans your company offers, assuming they have any dental policies available. You can enroll, cancel, modify, or enroll in employer-sponsored insurance policies when the open enrollment period for the next year begins on January 1st and the changes and policies take effect. Usually, this falls around the end of the year.

    It is just a matter of looking at the terms and selecting the best plan for your needs. There are hundreds of options on the insurance marketplace, in case they don’t have a good fit for you or if your employer doesn’t offer any dental plans.

    Save on Orthodontics Without Traditional Insurance

    This service helps connect individuals with dental savings plans, which can provide more flexibility than traditional insurance and cover orthodontic treatments for those without dental insurance or those who are not satisfied with their current dental plan.

    These plans are designed to meet the needs of those struggling with high out-of-pocket costs for orthodontic treatments, offering up to 25% savings potential. They take into consideration your unique circumstances to help identify the most suitable plan for you.

    Factors That Affect Invisalign Insurance Coverage

    Many insurance plans cover Invisalign, which is a clear aligner treatment that can be an alternative to traditional braces. However, it is important to note that more comprehensive plans tend to be more expensive and may not include orthodontic coverage. The coverage for orthodontic benefits depends on the specific insurance plan.

    You should make sure to double-check with your insurance provider and dentist/orthodontist. Coverage can also extend to other in-office treatments like Smiles Month Six and ClearCorrect aligner.

    Amount Covered

    When you are in the process of purchasing dental insurance and signing up for a plan, it is important to consider certain limitations. Occasionally, there may be a cap on the extent of coverage you can receive over your lifetime, and on certain occasions, they may provide coverage for up to half of your treatment expenses. It is worth noting that numerous plans offering orthodontic benefits will only partially cover your treatment costs.

    In-Network vs. Out-of-Network

    Dentists who are part of the dental plan network are authorized to file coverage claims. If you choose an in-network orthodontist or dentist, you will receive treatments outlined in the plan. However, if you don’t prefer any of the in-network dentists, you can always go to an out-of-network dentist. Just keep in mind that you won’t receive the same level of coverage.

    Explore alternative methods to handle the expenses if you’re determined to see a dentist who is not part of your insurance network. It should be feasible to discover a suitable option, particularly if you possess a PPO scheme, since the majority of insurance companies maintain considerably extensive networks.

    Age Limits

    This restriction is one of the most frequently encountered limitations on orthodontic benefits. Typically, insurance plans with age restrictions will provide coverage for orthodontic treatment up until age 19, but not for adults. It is advisable to thoroughly review your insurance plan to ensure there are no age limitations.

    Lifetime Maximum

    The limits may vary depending on your chosen plan, but typically range from $1,000 to $3,000. These limits will provide coverage for orthodontic treatment throughout your lifetime, and many plans include this benefit as well.

    Waiting Periods

    Additionally, there may be some plans that have a waiting period before you can benefit from their use. These waiting periods can occur anywhere between a few months and a full year. You might have to put your treatment on hold for a few months or be aware of any potential waiting periods if you choose to enroll in a specific plan solely to get Invisalign. So, it is important to be conscious of the waiting periods before making any decisions.

    Other Ways to Save on Orthodontic Treatment

    With your budget, you have options to simplify the treatment process. Although you still need to be concerned as the expenses that you need to pay personally are still excessively steep, there is a possibility that it covers benefits for adult orthodontics. But what if you already possess a plan that does not encompass adult orthodontic benefits?

    Take a look at the Plan Discount Dental, which offers coverage alternatives like insurance from various companies. Enroll in this plan to receive discounts on specific designated procedures from dentists. You can choose to pay annually or monthly for these subscription-based services. Additionally, this plan extends discounts to orthodontic procedures.

    Shop around to ensure that you are getting the right price when choosing an insurance provider that offers coverage within your network. Different orthodontists and dentists may offer varying price points, so it is important to get estimates from different providers to make sure you are getting the best deal. Additionally, keep in mind that prices for in-office treatments may differ between orthodontists and dentists.

    Verify with your administrator account before using Invisalign for funds. If your case isn’t cosmetic and orthodontics can be used for most cases, then apply those funds to qualify for medical expenses. Let these accounts, both FSA or HSA accounts, save you pre-tax income.

    To obtain more information, please refer to our guides on utilizing an HSA or FSA for Invisalign treatment.

    Online Clear Aligners are often a more cost-effective option in situations where Invisalign is not feasible within your budget, yet you still desire clear aligners. Additionally, if you opt for Byte or SmileDirectClub, you can receive aid in submitting insurance claims.

    Discover more in our analysis of the top 5 online transparent aligner services.

    Frequently Asked Questions

    Average Cost of Invisalign (Before Insurance)

    The exact price of your orthodontist’s fees and location depends on your condition. If you have already received an estimate for Invisalign treatment, you can expect to pay somewhere between $8,000 and $3,000. If you have already received an estimate for Invisalign treatment, you know how costly it can be.

    If you have a particularly complicated or easy condition, the range can fall outside even if it’s not expected. For instance, in the case of minor spacing issues, it may take less time to correct and therefore cost less. However, in the case of severe crowding and overbite, it may require a higher financial and time commitment.

    Concerned About the Cost of Invisalign?

    If you are interested in straightening your teeth without breaking the bank, visiting our review of the best alternatives to Invisalign is a must. It’s important to note that Invisalign is not the only clear aligner brand available, and it may not be the most affordable option. However, fortunately, you might not be intimidated by the price of Invisalign treatment if your insurance plan covers some of it.

    How much does Invisalign cost?

    Check out our True Cost of Invisalign guide for more information. The exact cost depends on your dentist’s rates, your location, and your condition. Treatment with Invisalign typically costs anywhere between $3,000 and $8,000, before insurance.

    Can I add orthodontic benefits later?

    Not typically. Some companies may provide orthodontic advantages as an optional extra, but these choices are rare.