Yes, Delta Dental does cover orthodontics, but how much they cover and who qualifies depends entirely on your plan, age, and treatment type.
Whether you’re considering braces for your child or looking into Invisalign for yourself, understanding your Delta Dental benefits can make a huge difference in both your treatment plan and your budget. While orthodontic treatment can be life-changing, it’s also one of the more expensive dental procedures—so it pays to know your options.
This guide will walk you through exactly what Delta Dental may cover, what to expect in terms of cost, and what to do if your treatment isn’t fully insured.
Key Takeaways
✔ Delta Dental PPO plans often cover 50% of ortho care, up to a lifetime max
✔ DeltaCare USA plans offer fixed copays for braces but rarely cover Invisalign
✔ Most plans target patients under age 19, but adult benefits do exist
✔ Invisalign may be included in some PPOs with documentation
✔ Maximize benefits through pre-approvals, in-network care, and smart timing
What Is Orthodontics and Why Might You Need It?
Orthodontic treatment is about more than just straight teeth—it’s about improving bite function, facial balance, and long-term oral health. Braces and aligners correct issues like:
- Overbites, underbites, and crossbites
- Crowding or wide gaps between teeth
- Jaw misalignment
- TMJ problems and speech difficulties
For children and teens, orthodontic care is often recommended during growth years. For adults, it can resolve chronic discomfort, improve function, and offer a confidence boost.
Does Delta Dental Cover Orthodontics? The Short Answer
Yes, Delta Dental offers orthodontic coverage in many of its PPO and DeltaCare USA plans—but not all plans include it.
- Most orthodontic coverage applies to dependent children under 19
- Adult orthodontic benefits are more limited and found mainly in employer-sponsored PPO plans
- Invisalign and specialty braces may not be covered unless specified
- Coverage may require pre-authorization, waiting periods, and documentation of medical necessity
Delta Dental PPO Plans: What’s Covered?
Delta Dental PPO plans typically offer the most flexible orthodontic coverage. Here’s what you need to know:
- Coverage percentage: Usually 50% after deductible
- Lifetime orthodontic maximum: Between $1,000–$2,500
- Waiting periods: Commonly 6–12 months for new enrollees
- Treatments covered: Traditional metal braces, Ceramic braces (some plans), Invisalign (with documentation, depends on plan)
Coverage amounts and included treatments vary by plan tier, so always confirm with a pre-treatment estimate.
DeltaCare USA (HMO) Plans: What to Expect
DeltaCare USA plans work differently:
- Copay-based pricing instead of percentage-based reimbursement
- Must use assigned in-network provider
- Fixed copays for braces—usually between $1,500 and $2,500 for full treatment
- Invisalign typically not covered
- Referrals may be needed for orthodontic specialists
Great for cost predictability, but more limited in treatment options.
Is Orthodontic Coverage Available for Adults?
Orthodontic benefits are primarily targeted at children and teens, but some adults may qualify.
- PPO plans may include adult orthodontic coverage in employer-sponsored plans
- Adult Invisalign or cosmetic braces may be partially covered or excluded
- Medical necessity—like jaw pain, severe bite issues—may increase eligibility
If adult ortho benefits aren’t included in your current plan, consider adding supplemental coverage or timing enrollment around open enrollment periods.
Braces vs. Invisalign: What Delta Dental Might Cover
Braces
- Most PPO and DHMO plans cover traditional metal braces
- Some PPO plans include ceramic (tooth-colored) braces
Invisalign
- Covered by some PPO plans, often with medical documentation
- Rarely included in DeltaCare USA HMO plans
Other Types
- Lingual braces (behind the teeth): Seldom covered
- Coverage typically applies to the most cost-effective treatment unless stated otherwise
How Much Does Orthodontic Treatment Cost With and Without Delta Dental?
Without Insurance:
- Metal Braces: $3,000–$7,000
- Ceramic Braces: $4,000–$8,000
- Invisalign: $4,000–$8,000
With Delta Dental PPO (if covered):
- 50% coverage up to $1,500–$2,500 lifetime max
- Out-of-pocket cost: $2,000–$5,000 average
With DeltaCare USA:
- Fixed copay: ~$1,500–$2,500
- Lower upfront costs, but less flexibility in provider and treatment options
What Is a Lifetime Orthodontic Maximum?
A lifetime orthodontic maximum is the total amount Delta Dental will pay for ortho care per person over their lifetime.
- Separate from your annual dental max
- Doesn’t renew yearly
- Applies to all orthodontic work—even if you switch providers or plans
Plan your treatment carefully to get the most out of this benefit.
How to Maximize Orthodontic Coverage With Delta Dental
- Verify your benefits before starting treatment
- Ask your dentist or orthodontist to submit a pre-treatment estimate
- Stick to in-network providers
- Spread treatments across benefit years if possible
- Use an HSA or FSA for tax-free savings
What If Orthodontics Isn’t Covered by Your Plan?
You still have options:
1. Ask About Alternatives
Early interceptive treatment, aligner trays, or retainers may cost less
2. Use Payment Plans
Humble Memorial Dental offers financing and monthly payment options
3. Upgrade During Open Enrollment
Select a PPO plan with comprehensive orthodontic coverage
4. Appeal with Documentation
Medical necessity (e.g., bite misalignment, jaw pain) may boost approval chances
Looking for Orthodontic Care in Humble, TX?
At Humble Memorial Dental, we help patients of all ages get the smiles they deserve:
- Braces and Invisalign for kids, teens, and adults
- Friendly consultations and custom treatment planning
- We accept Delta Dental PPO and DeltaCare USA
- We’ll check your coverage and give you a transparent breakdown of costs
Book your orthodontic consultation today and let’s create your confident smile together.
Final Thoughts
Yes, Delta Dental can and often does cover orthodontics, especially for children. Adults may have fewer options, but the right plan and documentation can still open the door.
Understanding your plan type, lifetime max, and covered treatment types is key to getting the most value out of your benefits.
With a little planning, and the right dental team, you can straighten your smile without stressing your wallet.
