Does Delta Cover Invisalign? (Dental PPO Explained)
Does Delta cover Invisalign? What is covered? How much can I save?
- A major dental insurance provider in the United States is Delta Dental.
- Depending on the plan and treatment, you may be able to receive orthodontic coverage if you use Delta Dental.
- Invisalign treatment is covered by some Delta plans. There are others who do not.
- At-home clear aligners are not covered by Delta Dental plans.
- There are many plans that cover braces in some way.
- There are many factors that affect the cost of orthodontic treatment, including type, brand, and location.
- There are several ways to pay for orthodontic treatment, including HSAs, FSAs, and financing plans.
Depending on your plan and the treatment you choose, Delta Dental may cover your clear aligner or braces treatment. You can learn more about Delta’s coverage and how you can use it in this guide before starting treatment.
Does Delta Dental Cover Invisalign?
If the insurance plan includes orthodontic benefits, Delta Dental will cover Invisalign. Ensure that orthodontics and Invisalign are covered by your insurance contract by reading the fine print. If Invisalign is listed as a provided benefit, then Delta Dental will cover it.
Observe the following:
You should keep an eye out for a couple of clauses in the insurance contract that could prevent you from getting Invisalign coverage.
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Served outside of coverage. You will not be covered for Invisalign if your insurance policy states orthodontics are not covered services or expenses.
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Exclusions and limitations. If you are under 19, you may be able to get orthodontic coverage through Delta Dental. Those over 19 are not eligible for the orthodontic benefit due to this limitation.
Does Delta Dental Cover At-Home Aligners?
At-home clear aligners are not covered by Delta Dental plans. If you have a Delta plan, you will not be able to receive assistance for your at-home aligner treatment.
Despite the fact that this isn’t entirely accurate, Delta claims home aligners are a DIY treatment.
State-licensed dentists or orthodontists assess every case developed by some aligner providers. Byte and SmileDirectClub, for example.
Conversely, DIY orthodontics involves straightening teeth with household items such as rubber bands. DIY treatments can cause severe damage since they do not involve a dentist.
In this matter, Delta Dental remains steadfast. Currently, none of their plans cover home aligners. Among them are:
Read more about home kits here.
Delta Dental Orthodontic Plans: Choosing the Right One
Patients can find the best Delta Dental orthodontic coverage plan by visiting their insurance products page on the Delta Dental website. You can see on this page a chart that summarizes the general types of Delta Dental insurance plans and other basic facts about each one. Also, patients can use the search function to find out more specific information about Delta Dental insurance plans in their state and if they are covered or not.
Source: https://www.deltadental.com/us/en/product/individual-and-family.html
What Does Dental Insurance Usually Cover?
A dental insurance policy typically covers some of the costs associated with preventive care, fillings, crowns, root canals, and oral surgery. Additionally, they may cover orthodontics, periodontics (the structures that surround and support the tooth), and prosthodontics. Preventive visits are usually covered twice a year.
The most common coverage structure is 100-80-50. Preventive care is covered at 100%, basic procedures at 80%, and major procedures at 50%, or a larger co-payment. Some dental plans, however, may not cover certain procedures, such as sealants.
Read more here:Â https://www.reddit.com/r/Invisalign/comments/lc7ds9/how_much_have_you_paid_out_of_pocket_with/
Dental Insurance Plans Have Limitations
Many plans have a low cap on what they will pay during a plan year. The maximum is set each year. Over that amount, you are responsible for all expenses. There is an annual maximum of less than $1,500 for about half of dental PPOs. All expenses over $1,500 would be your responsibility under that plan. You can reach the maximum quickly if you need a crown, root canal, or oral surgery.
Orthodontics costs are generally subject to a separate lifetime maximum.
Certain services or treatments may be excluded from some plans in order to reduce costs. Make sure you understand what is covered and what is not covered by the plan.
Claim Filing Instructions
Your dentist or orthodontist will file an insurance claim for in-office treatments like Invisalign and braces. There is no paperwork to worry about.
Out-of-network benefits may or may not be available if you choose a dental office that does not participate with Delta Dental. Out-of-network benefits can sometimes be filed for you by offices. In some cases, they will request upfront payment and you will have to file paperwork on your own.
The HR department of your employer may be able to guide you through the process if they provide your insurance.
You can also file a claim online using Delta’s step-by-step instructions.
Your dentist will need to provide a statement of treatment, according to the website.
Alternative Payment Options
If your current insurance plan does not cover the orthodontic treatment you want, there are alternative payment options available to you. These include:
- Flexible Spending Account (FSA) or Health Savings Account (HSA): These accounts allow you to set aside money from your income before taxes to be used for certain medical and dental expenses, including orthodontic treatment. They are often offered by employers.
- Financing plans: Many dentists and orthodontists offer payment plans to help with the cost of orthodontic treatment. Some at-home aligner brands also offer financing options. A credit check may be required to qualify for these plans.
- Third-party financing options: There are also third-party financing options available, such as CareCredit, which provide financing for medical and dental expenses. These options typically require a credit check.
By considering these alternative payment options, you can find a solution that works for you and helps you get the orthodontic treatment you need.
Books
Here are a few books about Invisalign that you may be interested in:
- “Invisalign: The Insider’s Guide” by Dr. Sari Koshetz
- “Invisalign: Straight Talk” by Dr. William G. Kincer
- “Invisalign: A Practical Guide” by Dr. Massimo L. Bianchi
- “The Invisalign Teen System: A Comprehensive Guide” by Dr. John F. Grady
- “Invisalign for Orthodontists” by Dr. Carlos Flores-Mir
These books cover a variety of topics related to Invisalign, including how the treatment works, how to care for Invisalign aligners, and how to achieve the best possible results with Invisalign. They may be helpful for anyone considering Invisalign treatment or for orthodontists who are looking to learn more about using Invisalign in their practice.
Conclusion
The most important takeaway is that adult orthodontic treatment is covered by insurance. As compared to other insurance companies, Delta Dental generally covers braces and Invisalign if you have an orthodontic plan. As with most other providers, you can get up to 50% covered. However, you might need to explore other options if you intend to use at-home aligners.
When it comes to orthodontics, insurance can be a bit of an enigma. When you know the ins and outs of your plan, you’ll be able to determine which treatments are covered and how to make use of them. Getting advice about insurance coverage from your dentist, orthodontist, or in-home aligner provider is always a good idea.
Does Delta Cover Invisalign?Â
Disclaimer – This article is intended to promote understanding of and knowledge about orthodontics and general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your orthodontist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.
Perry heads up a dynamic marketing team that has help the leading orthodontic practices in the USA 10X their business for over a decade. He’s a tea connoisseur, avid reader, traveling and grower of exotic fruits in his permaculture food forest.
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