Clear aligners may be covered by dental insurance, but there are some important considerations:
- Most dental insurance plans cover some orthodontic treatment, whether braces or clear aligners. But the amount covered can vary greatly by the insurer and a specific plan.
- On average, dental insurance covers about 50% of orthodontic treatment costs, leaving the remainder owed by the patient.
- Many insurers classify clear aligners as an elective/cosmetic treatment and cover them at a lower percentage than traditional metal braces. Coverage can be as low as 20-30%.
- Certain group or employer-provided dental plans provide better orthodontic coverage in general, sometimes up to $3,000 total. Government healthcare usually offers limited or no orthodontic benefits.
- Even with insurance, the patient’s out-of-pocket responsibility for clear aligner treatment tends to be higher than with conventional braces.
- Some insurance plans only cover teens under age 19 and have lifetime orthodontic benefits maximums.
- It’s important to call your insurance provider and understand your individual orthodontic benefits before starting clear aligner treatment.
- Financing options like Invisalign’s payment plans can help cover the out-of-pocket portions after insurance.
Here are some factors that may affect whether or not your insurance will cover clear aligners:
- The type of clear aligner you choose: Some insurance companies may only cover certain brands of clear aligners.
- The severity of your dental needs: If you have a severe case of malocclusion, your insurance may be more likely to cover clear aligners.
- Your age: Some insurance companies may only cover clear aligners for adults.
- Your overall health: If you have a chronic health condition, your insurance may be more likely to cover clear aligners.
While insurance can offset some cost, patients should expect to have significant remaining expenses for clear aligner therapy based on limited coverage compared to traditional braces. Thoroughly checking benefits and payment options is advised.
