Does Delta Dental Cover Invisalign?

When it comes to straightening your teeth, one of the most common questions is: does Delta Dental cover Invisalign? The short answer is: it depends on your plan. Coverage for Invisalign isn’t automatic. Instead, it depends on whether your Delta Dental plan includes orthodontic benefits and, if so, what limitations apply.

(For an overview of what Delta Dental plans cover, use the Table of Contents below to skip down to the section, “What Else do Delta Dental Plans Cover?”)

The Straightforward Answer: It Depends on Your Delta Dental Plan

Delta Dental offers different types of plans, including PPO and DeltaCare® USA (HMO-type) plans. Invisalign is considered an orthodontic treatment, so coverage will depend on the orthodontic benefits built into your plan. Some plans cover it partially, others don’t cover orthodontics at all.

A Nuanced Yes, with Caveats

Even if Invisalign is covered, there are important caveats. You’ll need to consider factors like waiting periods, age restrictions, coinsurance, lifetime maximums, and whether your orthodontist is in-network. These details can make a big difference in what you’ll actually pay.

Understanding Orthodontic Coverage: Invisalign as an Orthodontic Treatment

Delta Dental places Invisalign under orthodontic treatment, just like braces. This means Invisalign is covered only if orthodontics are included in your plan, and the way coverage works will vary depending on whether you have a PPO or a DeltaCare® USA plan.

Delta Dental PPO: Unpacking Your Invisalign Benefits

How PPO Plans Typically Cover Orthodontic Care

The Basic PPO plan does not cover orthodontics. The Premium PPO plan does, but with specific conditions: orthodontics are covered at 50% coinsurance after a 6-month waiting period.

Percentage of Coverage and Coinsurance for Invisalign

With the Premium PPO plan, Delta Dental typically pays half the cost of Invisalign after you’ve met the orthodontic deductible.

The Role of Your Lifetime Orthodontic Maximum

Coverage is capped at a $1,500 lifetime maximum per person. Once Delta Dental has paid that amount, you’ll pay any remaining costs yourself.

Deductibles and Annual Maximums: How They Apply to Orthodontics

Orthodontics under the PPO Premium plan come with a $50 orthodontic deductible per person. Unlike regular dental care, orthodontics aren’t subject to the annual maximum. Instead, the lifetime maximum applies.

In-Network vs. Out-of-Network: Maximizing Your Savings

You’ll save the most by choosing an in-network orthodontist. If you go out-of-network, Delta Dental may reimburse you at a lower rate, leaving you with higher out-of-pocket costs.

DeltaCare® USA (HMO/Prepaid Plans): Invisalign Coverage Specifics

Fixed Copays and Structured Benefits

DeltaCare® USA plans provide coverage through set copays. For adult orthodontic treatment, which may include Invisalign, the copay is $2,800 in California. This gives you predictability about costs. Copay amounts can vary by state, so it’s important to review the plan available in your area.

Restricted Provider Networks: Choosing a DeltaCare® USA Orthodontist

Coverage is only available through DeltaCare® USA network orthodontists. If you go outside the network, you won’t receive benefits.

Potential Limitations on Orthodontic Treatment Types

Some DeltaCare® USA plans limit orthodontic coverage to certain types of treatment or specific age groups. Always check your plan’s “Description of Benefits and Copayments” to confirm if Invisalign is included.

PPO vs. DeltaCare® USA: At-a-Glance Comparison (California Example)

Feature	PPO Premium Plan	DeltaCare® USA Plan
Orthodontics Coverage	50% after 6-month waiting period	Fixed copay of $2,800 (CA rate)
Lifetime Maximum	$1,500 per person	No lifetime max (copay instead)
Deductible	$50 orthodontic deductible	None
Network Requirement	Can see any dentist, best savings in-network	Must use assigned network orthodontist

Note: These figures come from Delta Dental’s California Individual & Family 2025 plans. Rates and benefits may differ in other states.

Key Factors Influencing Your Invisalign Coverage

• Age restrictions: Some plans cover orthodontics only for children and teens.
• Medical necessity vs. cosmetic treatment: If Invisalign is considered cosmetic, coverage may be denied.
• Comprehensive treatment plan: Your orthodontist will need to provide a complete treatment plan for Delta Dental to approve coverage.
• Waiting periods: PPO Premium plans have a 6-month waiting period for orthodontics.
• Effective dates: Coverage starts only after your plan is active.

Common Misconceptions About Invisalign Coverage

• “Invisalign is never covered.” In fact, some Delta Dental plans do cover it, but with limits.
• “Only kids get orthodontic benefits.” Certain plans cover adult orthodontics as well.
• “Out-of-network orthodontists are fine.” They may cost more, so staying in-network usually saves you money.

Demystifying the Cost of Invisalign with Delta Dental

The Overall Cost of Invisalign Treatment

Invisalign treatment typically costs between $3,000 and $7,000 depending on complexity. Delta Dental can help reduce, but not eliminate, that cost.

Estimating Your Out-of-Pocket Costs

• With PPO Premium (California): Delta Dental covers 50% of the cost, up to the $1,500 lifetime max.
• With DeltaCare® USA (California): You’ll pay a fixed $2,800 copay for adult orthodontics.

The Power of a Pre-Treatment Estimate

Always request a pre-treatment estimate. This provides a written statement showing exactly what Delta Dental will cover and what you’ll owe.

Understanding Your Orthodontic Benefits Statement

After approval, you’ll get a detailed orthodontic benefits statement outlining deductibles, maximums, and payment schedules.

Leveraging the Delta Dental Cost Estimator Tool

Use Delta Dental’s online Cost Estimator tool to get an approximate idea of what Invisalign will cost under your plan.

Practical Steps to Confirm Your Individual Invisalign Coverage

1. Review your plan documents carefully, focusing on orthodontic coverage.
2. Check your benefits in the Delta Dental member portal.
3. Call Delta Dental directly to confirm Invisalign coverage, copays, and provider requirements.

Step-by-Step Guide to Getting Started with Invisalign and Delta Dental

1. Confirm your eligibility and orthodontic coverage.
2. Schedule a consultation with an in-network orthodontist.
3. Request a pre-treatment estimate to know your costs upfront.
4. Begin treatment once you’re clear on your financial responsibility.

What Else Do Delta Dental Plans Cover?

Delta Dental offers individual plans that are designed to meet the needs of patients of all ages, from children needing preventive services to adults considering orthodontic services or implants. In addition to Invisalign, Delta Dental benefits include a wide range of dental coverage with clear coverage amounts that help you anticipate your out-of-pocket expenses. Each benefit plan outlines specific provisions so members understand exactly what treatment type and treatment options are available under their plan.

Delta Dental benefits extend far beyond Invisalign and orthodontics. As part of the national network of Delta Dental companies, members gain access to one of the largest provider networks in the country. Delta Dental PPO plans in particular are designed to balance affordability with flexibility, giving you coverage whether you see an in-network dentist or go out-of-network.

Your benefit plan typically includes dental coverage for many treatment options, not just orthodontics. Specific provisions vary by state and plan type, but here’s what is generally included:

• Preventive care: Routine cleanings, exams, and x-rays are often covered at 100%.
• Basic services: Fillings and simple extractions are included, typically with coinsurance.
• Major services: Depending on your plan, crowns, root canals, implants, and dentures may be covered. This answers common questions like does Delta Dental cover dental implants?
• Specialty services: Some plans include teeth whitening, mouthguards, and treatment for gum disease.

These additional benefits make Delta Dental plans valuable beyond Invisalign or braces. They help ensure your overall dental health is protected.

Frequently Asked Questions

Does Delta Dental insurance cover Invisalign?

Yes, but it depends on your plan. PPO Premium and some DeltaCare® USA plans cover Invisalign as part of orthodontic benefits.

Does Delta Dental cover adult braces?

Some plans do cover orthodontics for adults. For example, California’s PPO Premium plan covers 50% of adult orthodontic treatment, which may include braces or Invisalign.

How much does Delta Dental cover for braces?

Coverage varies by plan. The PPO Premium plan in California covers 50% up to a $1,500 lifetime maximum. DeltaCare® USA charges a fixed copay (e.g., $2,800 for adults in California).

Does Delta Dental cover braces in general?

Yes, many plans cover braces as orthodontic treatment, but details differ depending on your specific plan.

Does Delta Dental cover dental implants?

In some plans, yes. For example, California’s PPO Premium plan includes implants as a major service covered at 50% after the waiting period.

Why Choose Delta Dental?

Delta Dental offers one of the largest provider networks, predictable costs with both PPO and HMO-style options, and comprehensive coverage that includes orthodontics for kids and adults. For families or individuals considering Invisalign or braces, Delta Dental provides the flexibility and cost savings that make treatment more accessible. Plus, with benefits that go beyond orthodontics, you’re protecting your whole smile.

How Abrams Insurance Solutions Can Help

Insurance details can be confusing, especially when it comes to orthodontics like Invisalign. At Abrams Insurance Solutions, we’ll help you cut through the fine print and understand your exact coverage. We’ll review your plan with you, explain waiting periods, maximums, and copays, and help you figure out the most affordable way to get the smile you want. With expert guidance, you can approach your Invisalign or braces treatment with confidence.

Now is the time to take control of your dental benefits. Click below to explore Delta Dental plans that cover Invisalign and start your journey toward a healthier, straighter smile.