Invisalign and Insurance: Is Your Smile Covered?
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Invisalign is covered by Medi-Cal, Medicare or a stand-alone dental policy. If your insurance covers Invisalign, it will pay anywhere between 20% - 50% of the costs. Companies that offer orthodontic coverage include Humana, Aetna, Cigna, Delta Dental, USAA Dental, Spirit Dental and Vision, UnitedHealthcare, Medi-Cal and Medicare Advantage. If your insurance doesn’t cover Invisalign, you can use an HSA, FSA, CareCredit or a LendingPoint Virtual Card to pay for services in installments.
If you’re looking into Invisalign for yourself or a family member, keep reading to get a better understanding of how you can get the treatment you want.
How Much Does Invisalign Cost With Insurance?
With insurance, the average cost of Invisalign in 2023 can range from $1,000 to $1,500. Since dental insurance providers cover between 20% - 50% of your Invisalign costs, consumers may enjoy considerable savings by having coverage. Most insurance plans will also have a lifetime limit. This means that once your provider has paid that amount (lifetime limit), the remaining cost will be up to you to pay.
There are several insurance agencies that provide coverage for Invisalign. They include:
- Delta Dental
- USAA Dental
- Spirit Dental and Vision
- Medicare Advantage
What Is the Average Cost of Invisalign Without Insurance?
On average, Invisalign costs $6,000 to $7,000 without insurance in 2023. The actual cost for Invisalign without insurance will heavily depend on the type of treatment you will receive:
- Invisalign Full: $3,500–$8,500
- Express 10: $2,500–$5,000
- Express 5: $1,500–$3,000
- Teen: $3,000–$6,500
While these are the average costs, it is possible your treatment can be as high as $10,000 depending on the severity of your need and the type of treatment you require.
Will My Health Insurance Cover Invisalign?
Many dental insurance plans cover Invisalign treatment the same way they cover braces. However, a typical health insurance plan will not usually cover dental services, including Invisalign.The only way a health plan could help cover treatment is if it were medically necessary to get Invisalign.
There are other types of insurance that may be available to help with these costs, too, such as Medi-Cal and Medicare.
For California residents enrolled in Medi-Cal, orthodontics coverage for Invisalign is covered. If you’re enrolled in a Medicare Advantage plan (Part C) you will most likely have dental coverage, but make sure your plan has orthodontic coverage as well. If your Medicare plan doesn’t, you may need to enroll in a new dental plan to cover dental services.
What Insurance Plans Cover Invisalign?
There are several insurance providers that offer coverage for Invisalign.
Humana offers a broad range of dental plans that offer orthodontic coverage. Some of Humana’s dental insurance plans will provide discounts on adult and child orthodontic care. The process and cost of getting Invisalign is broken down by Humana as follows:
- At-home length of treatment: 6 months with no appointments
- Typical at-home cost: Generally, $2,000
- In-office length of treatment: 12–20 months with appointments every 8–12 weeks
- Typical in-office cost: $3,500–$8,500
Some of their plans also feature no waiting periods, which means your coverage could start immediately.
Aetna offers plans that provide orthodontic coverage for Invisalign. Most dental insurance plans will:
- Cover one round of orthodontic treatment per lifetime. A second series of orthodontic treatments may not be fully covered if you have a child who requires Phase I and Phase II orthodontics.
- Have a maximum limit for orthodontic coverage. This means your provider only pays for braces up to a certain dollar amount, usually between $1000 - $1,500.
- Have possible age restrictions as to when they will pay for Invisalign.
- Base your benefits on the total cost of treatment. For example, if you choose Invisalign, you will still be using the benefits for conventional metal braces which will require you to pay the difference because Invisalign is more expensive than traditional braces.
- Include diagnostic X-rays needed during your orthodontic therapy if they do not coincide with duplicates taken by your family dentist.
Cigna offers Cigna Dental 1500 which is the only plan that offers orthodontic coverage and has a coverage limit of $1,000. There will be a 12-month waiting period and you will have to pay 50% of the provider's contracted fee after a separate lifetime deductible.
Most Delta Dental plans include:
- Pre-orthodontic treatment visit
- Exam and start-up records
- Orthodontist-recommended tooth extractions
- Comprehensive orthodontic treatment
- Post-treatment records
Plans usually won’t cover:
- Two-phase orthodontic treatment
- Appliances to correct harmful habits like thumb-sucking
- Jaw surgery to facilitate orthodontic treatment
- Treatment to prepare for any non-covered surgical procedures
Spirit Dental and Vision
Spirit Dental and Vision offers a $1,200 children’s orthodontia benefit on any of their network plans. Additional features include:
- A one-time $100 deductible.
- Coverage is 10% for year one, 25% for year two, and 50% for year three.
- A $1,200 lifetime maximum per child.
- An annual limit of $600.
UnitedHealthcare has a Premier Plus dental plan that offers orthodontic care for dependents plus coverage for dental implants, which includes Invisalign, under “Major Services,” making it their most comprehensive plan. It will pay 50% of your child’s orthodontics after 12 months. There is also the UnitedHealthcare Dental 160 plan which includes a value-priced orthodontic program. You pay a negotiated fee, plus startup and final records fees. Your plan’s primary care office will then submit a referral form. Your plan will then send you an “Explanation of Benefits” that will include the name and location of an orthodontist who can provide you with treatment.
USAA has partnered with Cigna and IHC to offer dental insurance which can include orthodontic coverage. You can choose plans with benefits for braces, implants and other specialty services. There are also no waiting periods so you can get routine cleanings, oral exams, x-rays and other preventative care services as soon as your coverage begins. Customers can access thousands of providers across the country through the Cigna DPPO Advantage or IHC networks. Remember, USAA is only available for active military, their family members and veterans.
Those enrolled in Medi-Cal have access to dental care which includes orthodontics for children who qualify. Medi-Cal is California's no-cost or low-cost health insurance program designed to help cover medical expenses for low-income individuals, families, pregnant women, seniors, people with foster care children and people with disabilities. According to the DHCS (Department of Healthcare Services), additional dental coverage through Medi-Cal includes:
- Complete and partial dentures
- Crowns (prefabricated/laboratory)
- Diagnostic and preventive dental hygiene (examinations, x-rays and teeth cleanings)
- Emergency services for pain control
- Periodontal maintenance
- Root canal treatments (anterior/posterior)
- Scaling and root planning
- Tooth extractions
Medicare Advantage (Part C)
Many Medicare Advantage Plans offer dental coverage and some offer additional orthodontics coverage. Medicare Advantage is a health insurance program that combines Medicare Part A (hospital insurance), Part B (medical insurance), and usually Part D (prescription drug coverage) parts of Medicare. The average premium for Medicare Advantage in 2022 is $19 per month.
Invisalign Cost vs. Traditional Metal Braces
Invisalign is typically more expensive than traditional metal braces. The reason is the clear aligners that are used during treatment are custom-made in a laboratory. Invisalign will also charge the orthodontic practices it works with a permission fee between $1,000 - $2,000 in order to offer their treatment. Keep in mind these costs may not reflect any additional treatment you might need, which could include tooth extractions, x-rays, and your retainers after treatment.
- Invisalign Full: $3,500–$8,500
- Express 10: $2,500–$5,000
- Express 5: $1,500–$3,000
- Teen: $3,000–$6,500
Alternative Ways to Pay for Invisalign
There are many ways to pay for Invisalign treatment if your insurance doesn’t provide the necessary coverage.
You can get a monthly payment plan arranged between you and your dentist or orthodontist. The first payment will most likely be needed before you begin treatment to help pay for your treatment with Invisalign. Payment plans are designed to make a large expense manageable by breaking it up into smaller amounts. Depending on the amount you pay per month a monthly payment plan can last as long as your treatment or more. Many dental practices offer plans that don’t have extra fees or interest rates. If there is an interest rate, make sure you understand what you’re required to pay and whether or not you can cover these costs.
FSA stands for flexible savings account that you pay money into throughout the year. You may get it from your employer though not all employers offer an FSA. Money from your paycheck is automatically deducted and placed into the account and can be used to pay for medical, dental and orthodontic costs. This can include Invisalign. You can set aside up to $2,750 to cover your medical expenses per year.
HSA stands for health savings account. You can contribute funds to this account if you have a health plan with a high deductible. This means you have to pay a large amount of money out-of-pocket before your insurance will cover your dental costs. The money can either be deducted from your paycheck or you can personally deposit the money. You can then use these funds to pay for medical, dental, and orthodontic treatment. Individuals can set aside $3,650 per year to cover healthcare costs. Those with a family can set aside $7,300 per year.
You can also use CareCredit if you find yourself facing high out-of-pocket costs for your Invisalign treatment. CareCredit can help cover upfront costs for dental work, which you would then pay back in installments. You can also pay monthly for ongoing treatment. You may need to find a provider that is within the CareCredit network that offers the treatment you need.
The LendingPoint Virtual Card is a fixed-rate installment loan offered from LendingPoint Patient Financing through the My Invisalign mobile app. It’s a fully digital financing and payment solution that can be used at any dental practice that accepts Mastercard. You can get prequalified and get fully financed before your first consultation or appointment. The credit can be put towards any treatment bundled with Invisalign treatment. Only the approved loan amount is loaded to the virtual card, and you’ll only pay for what you use.
Even though health insurance won’t pay for invisalign, you still need protection. SmartFinancial can help get the health coverage you need at a price you can affordably pay. Enter your zip code below or call 855.214.2291 to receive your free quotes.