Is Invisalign Covered by Delta Dental Insurance Plans Explained

If you're considering Invisalign treatment, you're likely wondering if Delta Dental insurance plans will cover the cost. Fortunately, Delta Dental insurance plans do offer coverage for Invisalign, but the extent of coverage varies depending on your plan.

Delta Dental insurance plans typically cover a portion of the Invisalign treatment cost, but the specific coverage amount can range from 20% to 50% of the total cost. This means you'll still need to pay out-of-pocket for a portion of the treatment.

Some Delta Dental insurance plans may have specific requirements or restrictions for Invisalign coverage, such as requiring a referral from a participating dentist or having a waiting period before coverage kicks in. It's essential to review your plan details to understand what's covered and what's not.

Insurance coverage for Invisalign can be a bit complex, but the good news is that many dental plans cover it the same way they cover traditional braces. You may qualify for up to $3,000 in coverage for orthodontic treatment, including Invisalign aligners.

Most Delta Dental plans include comprehensive orthodontic treatment, which covers Invisalign as a standard benefit. This means that if your plan includes adult orthodontic coverage, you're likely covered for Invisalign.

The specifics of your plan will determine the exact amount of coverage you're eligible for. Some plans may have age limitations or pre-existing condition exclusions, so it's essential to review your plan details carefully.

Delta Dental plans usually cover a range of orthodontic services, including pre-orthodontic treatment visits, exams, X-rays, and tooth extractions. You can expect to have some costs covered, but the exact amount will depend on your plan.

Here are some services that are typically covered by Delta Dental plans:

Keep in mind that coverage can vary depending on your specific plan, so it's crucial to verify the details directly with Delta Dental.

The cost of Invisalign can vary depending on several factors, including the complexity of the case and the location of the dental office. The average cost of Invisalign is between $4,000 and $8,000.

Data from OrthoFi shows that the average coverage amount for orthodontic treatment is $1,772 USD, with 92% of patients qualifying for up to $3,000 USD and 77% qualifying for up to $2,000 USD. This means that with Delta Dental insurance, you can expect to pay significantly less out-of-pocket for Invisalign treatment.

The cost of Invisalign can also vary depending on the location of the dental office. For example, in a high-cost-of-living area like Long Island City, NY, the price can range from $6,000 to $8,000.

Here are some estimated costs of Invisalign without insurance:

Keep in mind that these are just estimates, and the actual cost of Invisalign may vary depending on your individual needs and the dental office you choose.

Delta Dental offers various plans with different benefits, so it's essential to choose the right one for your Invisalign treatment. Every insurance plan under Delta is different, with different benefit amounts and exclusion criteria.

To position yourself for the maximum amount of orthodontic coverage, look for a plan that has orthodontic benefits, a high coverage percentage, and no age limitation on the benefit. Most plans offer 50% coverage, but you can find higher coverage plans if you look for them.

Here are the key criteria to consider when choosing a Delta Dental plan for orthodontic coverage:

By considering these factors, you can choose a plan that provides the best coverage for your Invisalign treatment.

Treatment options for Invisalign can vary depending on your age and insurance coverage. If you're a younger individual, robust orthodontic benefits might make Invisalign an accessible and affordable option.

Consider seeking a pre-treatment estimate to clarify coverage expectations for Invisalign at your current age. This will help you understand what's covered and what's not.

Delta Dental plans, such as Delta Dental PPO Premium and Delta Dental PPO Plus Premier, cover traditional orthodontics or braces, including lingual braces, which are estimated to be 50% covered with a waiting period of 6 months. The maximum lifetime benefit is $1,500.

Here's a brief overview of what Delta Dental covers for orthodontic treatment:

Keep in mind that coverage details can vary depending on your specific plan and orthodontist. Always check the specifics of your Delta Dental plan to understand age limits and coverage details.

Braces? Traditional braces are the mainstay of orthodontic correction, but they can be a bit noticeable. Delta Dental PPO Plus Premier and Delta Dental PPO Premium plans offer 50% coverage for traditional braces, with a 6-month waiting period and a maximum lifetime benefit of $1,500.

You'll receive the $1,500 calendar year maximum when visiting a PPO orthodontist. This means you'll get the most out of your coverage. Some plans, like Delta Dental PPO Plus Premier and Delta Dental PPO Premium, cover traditional orthodontics or braces.

In fact, most pre-determination claims from Delta Dental don't specifically mention braces or Invisalign, they just say "approved orthodontic treatment." So, yes, braces are a covered treatment.

Age can significantly impact your orthodontic treatment options, especially when it comes to Invisalign. Some dental insurance plans have age limitations, which can affect the cost and accessibility of treatment.

If you're a younger individual, you may be eligible for robust orthodontic benefits that make Invisalign an affordable option. However, if you're an adult, you may face limited coverage or higher out-of-pocket costs.

Always check the specifics of your dental plan to understand age limits and coverage details. This will help you make an informed decision about your treatment options.

Here are some age-related factors to consider:

Consult with your orthodontist about the most cost-effective treatment options, taking into account your insurance coverage and age.

If you're considering Invisalign but find out your Delta Dental plan doesn't cover it, don't worry, there are still alternatives and options available.

You can explore other orthodontic options that may be covered under your plan, such as clear aligners and traditional braces. Delta Dental values your oral health and aesthetic aspirations, hence, they offer coverage options for various orthodontic alternatives.

Some popular clear aligner systems that are covered by Delta Dental include ClearCorrect, SLX Clear Aligner System, SureSmile, and 3M Clarity Aligners. However, DIY invisible aligners like SmileDirectClub, Candid, Byte, ALIGNERCO, and NewSmile are not covered.

To ensure clarity on the extent of coverage for various orthodontic options, review your plan details thoroughly for clauses about orthodontic treatments and consult with Delta Dental customer service.

You can also discuss with your orthodontist at Open and Affordable the most suitable and cost-effective treatment under your Delta Dental plan. Additionally, consider seeking a pre-treatment estimate to clarify coverage expectations for Invisalign at your current age.

Some alternative treatments that may be covered by Delta Dental include traditional metal braces, ceramic braces, and lingual braces. Ceramic and lingual braces may require you to meet specific plan stipulations or opt for particular types of policies.

Here are some key points to consider:

Filing a claim for Invisalign through Delta Dental is relatively straightforward. Most dental offices will take care of the paperwork for you, submitting the claim electronically on your behalf.

You likely filled out some forms during your first visit, which will be used to file the claim. Your dentist will handle everything, so you won't need to sign anything or submit any paperwork yourself.

If your dental office doesn't submit the claim for you, you'll need to fill out a claim form and submit it for reimbursement by check.

Most dental offices will file insurance claims on your behalf, so you don't have to submit any paperwork.

You'll usually fill out forms during your first visit, and that's all the information your dentist needs to submit the claim electronically.

There's an exception, though - some dental offices may not submit claims on your behalf, in which case you'll need to fill out the claim yourself and submit it for reimbursement.

To submit a claim for Invisalign, use the ADA code D8090, which is all-inclusive for moving your teeth.

You can find a copy of the American Dental Association dental claim form online, so it's easy to get started.

If you believe your case warrants coverage, you can appeal a decision by reviewing your policy to understand the specific reasons why Invisalign is not covered.

To start, collect any relevant medical records or letters from your orthodontist to support your appeal. This documentation can help make a strong case for coverage.

You'll also need to submit a formal appeal letter to Delta Dental, requesting reconsideration of coverage. This letter should clearly explain your situation and why you believe Invisalign should be covered.

Here are the steps to follow:

Orthodontists often offer flexible payment plans, letting you pay for your treatment in monthly installments over a set period of time.

These plans typically involve setting up a financing agreement with your orthodontist and making a down payment, followed by monthly payments for the duration of the plan. Discuss the details with your orthodontist to understand your options for payment term, the number of monthly installments, and any interest or fees involved.

Delta Dental plans, including group and individual plans, often cover orthodontics, including Invisalign treatment as a standard benefit. This means you may not have to pay out of pocket for Invisalign aligners if you have a Delta Dental plan that includes orthodontic coverage.

Flexible spending accounts (FSAs) and health savings accounts (HSAs) are also options to consider when paying for orthodontic treatment, such as Invisalign aligners. By using these accounts, you can set aside pre-tax dollars for eligible medical expenses, including orthodontic treatment, and save on Invisalign aligners.

Monthly payment plans are a great option for financing orthodontic treatment, allowing you to pay in monthly installments over a set period of time.

You can set up a financing agreement with your orthodontist and make a down payment to get started.

The number of monthly installments will depend on the plan you choose, so be sure to discuss the details with your orthodontist.

Interest or fees may be involved, so ask your orthodontist about these costs upfront.

Delta Dental plans often cover Invisalign treatment as a standard benefit, but it's essential to check your specific plan to confirm coverage.

If your plan doesn't cover orthodontic treatment, Delta Dental may still cover some costs, so it's worth inquiring about potential coverage.

Flexible spending accounts (FSAs) and health savings accounts (HSAs) can be valuable tools for paying for orthodontic treatment, including Invisalign aligners.

By using FSAs or HSAs, you can set aside pre-tax dollars for eligible medical expenses, including orthodontic treatment, which can help you save on Invisalign aligners.

Consult your employer or financial advisor to determine your eligibility for these accounts and to understand their guidelines and limitations.

Delta Dental is a well-established insurance provider that offers various dental plans to its members.

Delta Dental offers a range of dental plans, including Delta Dental PPO, Delta Dental Premier, and Delta Dental Individual.

Invisalign is a popular orthodontic treatment for straightening teeth.

Delta Dental may cover some or all of the costs associated with Invisalign treatment, but the extent of coverage varies depending on the plan and provider.

Delta Dental's coverage for Invisalign typically includes a portion of the treatment costs, but the exact amount covered depends on the individual's plan.