Yes, Delta Dental covers Invisalign, but it depends on your specific plan.
Invisalign sounds like the dream option for straightening your teeth—clear, discreet, and no metal in sight. But once the cost comes up, many patients understandably wonder: Will my insurance help cover it?
If you’re insured through Delta Dental, this post is for you. We’re diving into what Delta Dental typically covers when it comes to Invisalign, what limitations to expect, and how to navigate costs like a pro.
Key Takeaways
✔ Delta Dental PPO plans may cover Invisalign up to a lifetime ortho maximum (typically $1,000–$2,000)
✔ DeltaCare USA plans rarely cover Invisalign, but may offer discounts
✔ Coverage is often limited to patients under 19, especially for orthodontics
✔ Invisalign may be viewed as cosmetic, so medical documentation helps
✔ Use FSA/HSA funds, flexible financing, or consider alternative treatments if needed
What Is Invisalign and How Does It Work?
Invisalign is a clear aligner system that uses a series of custom-made plastic trays to gradually shift teeth into their ideal position. It’s become a popular alternative to braces for both teens and adults who want a more subtle, flexible option.
Unlike metal braces, Invisalign trays are removable and nearly invisible, making them ideal for anyone looking for comfort, discretion, and convenience.
But here’s the catch: Invisalign is often more expensive than traditional braces, and not all insurance plans treat it the same way.
Does Delta Dental Cover Invisalign? The Short Answer
The answer is yes, but it depends on your specific Delta Dental plan.
Invisalign is considered an orthodontic treatment, and Delta Dental does offer orthodontic coverage in many of its PPO and group plans. However, that doesn’t mean all plans will cover Invisalign specifically.
Some key points:
- Coverage varies by plan and often by employer
- Invisalign may be treated as an upgraded or elective treatment
- You’ll need to confirm if your plan includes orthodontic benefits
- Age matters, many plans only cover orthodontics for patients under 19
Delta Dental PPO Plans and Invisalign
If you’re enrolled in a Delta Dental PPO plan, here’s how Invisalign coverage generally works:
- Invisalign may be covered at the same rate as traditional braces
- Most PPO plans pay 50% of orthodontic treatment costs
- There’s usually a lifetime maximum—often between $1,000 and $2,000
- A pre-treatment estimate is highly recommended
- Age limits often apply (usually under 19, but some plans extend to adults)
Example:
Let’s say Invisalign costs $5,000 total. If your plan covers 50% of ortho treatment up to $1,500:
- Plan pays: $1,500 (maximum benefit)
- You pay: $3,500 out-of-pocket
DeltaCare USA (HMO) Plans and Invisalign
DeltaCare USA is Delta Dental’s HMO-style plan, and its Invisalign coverage is much more limited.
- Most DeltaCare USA plans do not cover Invisalign
- Coverage is generally limited to traditional braces only
- Invisalign may be available at a discounted fee through certain in-network providers, but it’s not reimbursed
In short: If you’re on DeltaCare USA, don’t expect full coverage for Invisalign, but ask about discounted rates.
Does Age Affect Invisalign Coverage?
Yes, it often does. Many Delta Dental plans restrict orthodontic benefits to patients under 19. That means adults may not receive any reimbursement, even if their plan includes ortho coverage.
However, some enhanced or employer-sponsored PPO plans include adult orthodontic benefits, so it’s worth checking with your provider or HR department.
Is Invisalign Considered Cosmetic?
Insurance plans, including Delta Dental, may label Invisalign as elective or cosmetic in some cases, especially if you’re correcting minor spacing or alignment issues.
To improve your chances of approval, your dentist or orthodontist should document any:
- Bite alignment issues
- Crowding that affects oral health
- Jaw discomfort or TMJ symptoms
The more functional the reason, the better your odds of receiving coverage.
How Much Does Invisalign Cost With and Without Insurance?
Without Insurance:
- National average: $3,500–$7,000
With Delta Dental PPO (If Covered):
- Lifetime ortho max: usually $1,000–$2,000
- Typical coverage: 50% of treatment cost
- Patient pays the balance out of pocket: usually $2,000–$5,000
With DeltaCare USA:
- Full coverage unlikely
- Discounted provider pricing may be available but varies
Tips for Maximizing Invisalign Coverage
Want to get the most from your benefits? Try this:
- Confirm that your plan includes orthodontic coverage
- Ask for a pre-treatment estimate before committing
- Submit supporting documentation if your case is medically necessary
- Use your FSA or HSA to reduce out-of-pocket cost
- Take advantage of in-house payment plans offered by your dental office
What If Invisalign Isn’t Covered?
Don’t lose hope—there are still ways to move forward.
1. Consider Traditional Braces
They’re more likely to be covered and may be more affordable under your current plan.
2. Use Payment Plans
At Humble Memorial Dental, we offer flexible financing options to help make Invisalign more affordable.
3. Appeal the Decision
Sometimes claims can be re-submitted with additional medical justification or a letter of necessity. Ask your provider to assist with this.
Looking for Invisalign in Humble, TX?
At Humble Memorial Dental, we provide Invisalign treatment for both teens and adults, and we make insurance simple.
- We work with Delta Dental PPO and DeltaCare USA
- We verify your benefits and submit pre-approvals when needed
- We offer flexible payment plans and transparent pricing
Ready to straighten your smile? Book an Invisalign consultation today.
Final Thoughts
Delta Dental can cover Invisalign, but it’s not guaranteed. Your plan type, age, and treatment justification all play a role.
Understanding your insurance coverage ahead of time makes the process smoother—and can save you money. The best move? Talk to your dental provider, get pre-approved, and plan smart.
Because Invisalign is an investment in your smile, and you deserve to make it confidently.
