Posted by Does dental insurance cover Invisalign? We will be unveiling the truth behind dental insurance coverage for Invisalign. Did you know that the average cost of Invisalign ranges between $3,000 to $8,000? This has made a lot of people believe that insurance doesn’t cover it.
In this article, we’ll go beyond informing you that dental plans cover Invisalign. We’ll tell you more about the reason Invisalign is chosen by the majority to make their smiles firmer, factors that affect your level of coverage, how to know your plan covers Invisalign, and how much coverage to expect.
So let’s go.
Table of Contents
Does Dental Insurance Cover Invisalign?
Yes, many dental insurance plans that offer coverage for orthodontic treatments also cover Invisalign. However, some dental plans are not likely to cover your Invisalign treatment as it is considered an elective procedure but many other plans cover Invisalign cost but at varying levels ranging from minimal coverage 25% to 50% or medium coverage say 50%.
We must not fail to inform you that you don’t always get express coverage. Most times you are required to pay a deductible or co-pay.
We are sure you understand by now that the chances of getting coverage for your Invisalign treatment are solely dependent on the specific plan you have at hand. Without an insurance plan at all, Invisalign treatments will cost you a whooping $4000-$7000.
So we’d advise you to confirm from your dental insurance provider whether or not they’re willing to cover Invisalign. If they do, insist on knowing what your specific benefits are. Talking to your dentist or orthodontist is another smart move you can make. Your dentist could suggest affordable payment or financing plans if your plans offer so little or no coverage for Invisalign treatment.
Now that you understand that there is coverage for Invisalign. There is other information you should have up your sleeves to help you secure the best coverage levels for teeth aligners.
You may love to see this: Does Dental Insurance Cover Orthodontics?
8 Factors That Govern Your Dental Insurance Coverage For Invisalign
Below are some of the factors that affect the level of coverage you receive from any of the dental plans:
- Plan Type
- Age:
- Medical Necessity vs. Cosmetic Reasons:
- Lifetime orthodontic maximum:
- Provider Network You choose:
- Location:
- Pre-approval and Waiting Periods:
- Cost Sharing:
#1. Plan Type:
Some plans do not cover orthodontic treatments at all and that includes Invisalign and those that offer you coverage for orthodontic treatments do so at different levels depending on whether your plan is a basic, mid-tier, or premium plan.
Your plan may cover a percentage for orthodontic benefits say 50% or a designated amount of dollars for instance $2500 per year for braces and aligners such as Invisalign.
#2 Age:
Some Plans that offer coverage for orthodontic treatments may decide only to cover the cost of Invisalign for children and young adults leaving adults to foot their bills.
Ensure you don’t fall victim to ignorance by contacting your insurance provider to make sure you understand whether or not there are age limitations for Invisalign treatment.
#3. Medical Necessity vs. Cosmetic Reasons:
If your need for Invisalign is deemed medically necessary by your insurance provider for instance if you need it to fix bite problems or functional issues then your insurance company may cover the cost partially.
However, if you simply just want to get pretty teeth without having any prior issues warranting Invisalign, then be prepared because some plans may not be ready to fund your luxury hence no coverage.
#4. Lifetime orthodontic maximum:
Some plans come with a policy of maximum coverage that can be offered to you. For some plans there is an annual limit to how much coverage you get for orthodontics for some other plans there is there is a lifetime limit.
If you have reached this limit getting coverage for other orthodontic treatments then you may get little or no coverage. Sometimes even the limits are insufficient for Invisalign cost.
#5. Provider Network You choose:
If you choose an in-network orthodontist you’re sure to typically maximize your coverage for Invisalign. But out-of-network providers may offer you minimal coverage with high out-of-pocket costs especially if your plan is a fee-for-service plan or there may even be no coverage at all.
#6. Location:
The level of coverage you get for Invisalign can differ based on your geographical area. Some areas term Invisalign a cosmetic luxury while other areas see it as medically necessary depending on your case and the type of policy insurance providers run in that area.
#7. Pre-approval and Waiting Periods:
For many plans, we require you to get a pre-approval statement from your orthodontist to prove that your case is medically necessary. Some plans also have waiting periods which you must observe before coverage begins.
#8. Cost Sharing:
Since coverage for Invisalign is less likely, there are specific amounts you should be prepared for even if your plan covers Invisalign to an extent. Some of them include
- Deductibles; which are fixed amounts you have to pay from your own pocket before insurance intervenes.
- Some plans demand Co-pays which is a statutory amount you have to pay at the time of service regardless of the actual cost of treatment.
- Percentage Covered differs. Percentage coverage can vary from plan to plan depending on their specific policies. This percentage coverage is what you get after you have settled your deductibles.
See this: Does Dental Insurance Cover Second Opinions?
How To Be Sure Your Plan Covers Invisalign
1. Study your Plan documents:
Go straight to your plan booklet and read it. Look out for orthodontic benefits in your booklet and see if your plan includes any specific coverage for Invisalign. If there is coverage scrutinize the conditions for which you get coverage for Invisalign.
Check if there are age limits and pre-approval demands also check for the percentage coverage you should expect. Look out for the potential out-of-pocket costs you should be prepared for.
2. Give your Insurance Provider a Call:
Your insurance providers are the experts in charge of your plan. They know what your plan can and cannot cover. Besides you have the right to ask them all the questions in your mind to get authentic information on what benefits your plan captures especially for Invisalign.
They’ll look up your plan and inform you of how much coverage you have for Invisalign.
3. Talk to your dentist or orthodontist:
Seeking the advice of your dentist is very important because they may have very useful information about your plan details and how to use it to get coverage for Invisalign.
They also counsel you on whether Invisalign is the best option for you. If you don’t have a plan at all they can proffer other possible alternatives for you.
Read Also: Does Dental Insurance Cover Deep Cleaning?
Why Do Most People Prefer Invisalign?
Invisalign is one of the most popular orthodontic treatments. It makes use of clear detachable aligners to gradually straighten your teeth.
Over 12 million people prefer Invisalign over traditional metal braces because it is relatively invisible which is aesthetically a more satisfying option compared to braces which leave you somewhat too embarrassed to smile sometimes, because of the conspicuous metals that seem glued to your teeth.
Here are a few stages you will have to undergo to get Invisalign:
- Consult your Dentist and get a 3D Scan:
The first thing your dentist or orthodontist does once you schedule an appointment is to first examine your teeth to determine if Invisalign will be the best for you. If it is, with an iTero scanner, your dentist will take a 3D scan of your teeth.
- Get your own Custom-Made Aligners:
After getting the scan, the results obtained are used to create aligners that perfectly fit only your own teeth because it is custom-made. Each of these aligners is unique in such a way that they fit and also shift your teeth toward their ideal position.
- Your Wearing Schedule:
Though the total time frame you are required to wear your aligners differs depending on the complexity of your case, it is often a faster approach in aligning your teeth over traditional braces.
Sometimes, you will typically be instructed to wear each of your aligners for two weeks before moving to the next aligner in the series.
- Go For Regular Checkups:
You have to monitor your progress to make sure the Invisalign you’ve been religiously wearing is actually doing its job. Visit your dentist regularly to access your teeth and ensure your aligners are always properly fitted.
Check this out: Does Dental Insurance Cover Bonding?
Other Affordable Options To Get Invisalign Procedure Incase You Don’t Have a Dental Insurance Plan
If the plan you have at hand does not cover Invisalign or orthodontic treatments or you don’t have a plan at all, you don’t have to worry here are very affordable alternatives to consider:
- Flexible Spending Accounts
- Healthcare Savings Accounts
- Direct-to-Consumer Aligner Brands
#1. Flexible Spending Accounts (FSAs):
Some employers offer you an opportunity to contribute pre-tax dollars to cover eligible medical expenses including Invisalign treatments. These are called FSAs Find out if your employer is one of those that offer FSAs and confirm if there are contribution limits or eligible expenses.
#2. Healthcare Savings Accounts (HSAs):
HSAs just like FSAs also allow you to save pre-tax dollars for healthcare expenses including Invisalign but HSAs give you the advantage of rolling over unused funds year after year unlike FSAs thereby offering you greater flexibility.
#3. Direct-to-Consumer Aligner Brands:
Consider brands that offer clear aligners directly to consumers at lower costs. These brands make Invisalign more affordable if insurance is just out of your reach. Some alternatives to traditional Invisalign include SmileDirectClub or AlignerCo.
Advantages of Invisalign To Dental Care
Now, here’s why Invisalign beats traditional braces:
- Invisalign Is Discreet
- It is Comfortable
- Faster treatment
1. Invisalign Is Discreet:
These aligners are clear and invisible, now who doesn’t want to wear a natural beautiful smile without making it obvious that there’s some artificial intervention? This is why Invisalign remains popular amongst people who are especially very self-conscious when they smile.
2. It is Comfortable:
Invisalign provides you with better comfort than traditional braces. I mean check it out! There are no hard metal wires or brackets to puncture or irritate your soft gums. Another amazing feature that makes it a more comfortable option is that you can remove your aligners when you want to eat, drink, or brush your teeth making it easier for you to maintain oral hygiene.
3. Faster treatment:
Invisalign has been proven to straighten teeth much faster than traditional braces in some cases it also reduces your risk of tooth damage because those wires and brackets which are likely to trap food and bacteria are not available. Therefore Invisalign helps you rid yourself of the risk of cavities and gum diseases.
Frequently Asked Questions
Yes, some dental insurance plans cover Invisalign treatments partially. While others who do not have orthodontic benefits do not cover Invisalign. Most times Invisalign is considered an optional treatment, so you are less likely to get coverage for it than basic dental procedures.
You should expect a percentage coverage of about 25% to 50% or a set dollar amount per year for instance $2500 but this depends on your plan. Limitations like lifetime orthodontic maximums can also determine the level of coverage you should expect. Check your plan documents or call your insurance provider to be clear about what to expect.
Factors that affect your coverage for Invisalign are your specific plan and your age. This is because some plans only offer children orthodontic benefits and hence coverage for Invisalign but do not cover adults, your reason for getting Invisalign is medically necessary or just for cosmetic purposes, and your provider type.
If your insurance does not cover Invisalign, there are other alternative options for you to explore such as flexible payment options like financing plans or discounts for upfront payment, at-home aligner options are also available for your consideration. Does any dental insurance cover Invisalign?
How much coverage can I expect?
What factors affect dental coverage for Invisalign?
What if my insurance doesn't cover Invisalign?
Important Recommendation
- Does Dental Insurance Cover Sedation?
- Does Dental Insurance Cover Gum Grafts?
- Does Dental Insurance Cover Anesthesia?
- Does Dental Insurance Cover Oral Cancer Screening?
Conclusion
By now we are hoping you’re clear about how your dental insurance can cover Invisalign treatments. It is very possible to get that firm smile without having to break the bank. Just ensure you understand your plan.
Contact your insurance provider to know how much coverage to expect for Invisalign. Always confide in your orthodontist for the best path to take as they’re familiar with your plan. With all these in place, you’re good to go get that Invisalign and achieve your dream smile.
Cheers!