Delta Dental coverage for Invisalign? How to get Delta Dental Insurance to pay for your Invisalign Procedure?

Delta Dental is one of the largest dental insurers in the country, so it is no surprise that we hear “Does Delta Dental cover Invisalign?” every week. The answer depends less on Delta Dental itself and more on the specific plan you have: when a Delta Dental PPO plan includes orthodontics, clear aligners like Invisalign are normally covered under that benefit.

Here is how Delta Dental orthodontic coverage usually works, what to look for in your plan, and how to make sure you actually get the money. Coit Dental in Frisco is an in-network Delta Dental PPO provider and files the claims for you.

Quick answer: Many Delta Dental PPO plans with orthodontic coverage pay a share of Invisalign (commonly around 50 percent) up to a lifetime orthodontic maximum, in installments during treatment. Some plans cover children only. A pre-treatment estimate tells you what your plan will pay before you start.

Does Delta Dental cover Invisalign?

Dental insurers group Invisalign with braces under comprehensive orthodontic treatment. So the real question is whether your Delta Dental plan includes an orthodontic benefit, and for whom. When it does, the coverage usually works like this:

• A percentage, not a flat amount. Plans commonly pay around 50 percent of the orthodontic fee after any orthodontic deductible.
• A lifetime orthodontic maximum. This is separate from your yearly dental maximum and is often in the range of $1,000 to $2,500 per person. Once it is used up, it does not reset.
• Age limits. Many plans cover orthodontics for dependent children only, often up to age 26. Some include adults.
• Waiting periods. Some plans, especially individual ones, require you to be enrolled for a period (often 12 months) before orthodontic benefits start.

Your own plan may differ, which is why the next step matters.

How do you check your Delta Dental orthodontic benefit?

Delta Dental is not one company but a network of member companies that operate in different states, and each employer group picks its own plan design. That is why the orthodontic benefit, the age limit (often up to 26 for children’s orthodontics), and the lifetime maximum can vary so much from one Delta Dental card to the next.

Log in to the Delta Dental member portal and open your plan’s benefit summary to see whether orthodontics is included, at what percentage, and with what lifetime maximum. You can also confirm that a dentist participates in your network with Delta Dental’s Find a Dentist tool.

Prefer not to dig through plan documents? Call us at 214-387-8400 with your member ID, or send us a message. We can see your Delta Dental benefits directly and tell you what applies.

How do you get Delta Dental to pay for Invisalign, step by step?

1. Book an orthodontic consultation. Dr. Thasma checks your bite, takes records and confirms whether Invisalign is right for you, or whether traditional braces would work better.
2. Ask for a pre-treatment estimate. We send your treatment plan to Delta Dental. Orthodontic treatment is billed with standard dental procedure codes (D8080 for adolescents, D8090 for adults), and Delta Dental replies with what it expects to pay under your plan.
3. Review the numbers before you commit. The estimate shows the covered percentage, how much of your lifetime maximum applies, and what is left for you to pay.
4. Start treatment; we file the claim. Because we are in-network, we submit the claim to Delta Dental for you.
5. Expect installments. Orthodontic benefits are usually paid as an initial amount when treatment starts and then in installments while treatment continues, as long as you stay covered.

How does Delta Dental pay you back?

How the money reaches you depends on whether your dentist is in Delta Dental’s network.

• In-network (like Coit Dental): we file the claim and Delta Dental pays us directly. You pay only your share, and the network’s agreed fees usually make that share smaller.
• Out-of-network: you usually pay the office, then submit a claim form with the itemized bill. Delta Dental pays you based on its allowed amount, which can be lower than the office’s fee.

Either way, Delta Dental sends an Explanation of Benefits (EOB) for each payment. Keep these: they show what was paid and how much of your lifetime maximum is left. Our step-by-step guide to getting reimbursed by dental insurance covers claims in more detail.

Invisalign or braces: does insurance treat them differently?

Usually not. Delta Dental, like most dental insurers, pays orthodontic benefits for the treatment rather than the appliance, so clear aligners and metal braces generally fall under the same benefit, percentage and lifetime maximum. What can differ is the total fee, and therefore how much is left for you once Delta Dental has paid its share. Some plans do have their own rules for adult cases or for particular appliances, so the pre-treatment estimate is the place to confirm it. Dr. Thasma will recommend whichever option suits your teeth best; if both would work, we can price both so you can compare.

Have two dental plans? How coordination of benefits works

If you are covered by two plans, for example your own Delta Dental plan and a spouse’s plan, the insurers coordinate benefits. One plan is primary and pays first; the other is secondary and may pay some of what remains, up to its own limits. For children, the primary plan is often decided by the “birthday rule”: the plan of the parent whose birthday comes first in the calendar year. Two orthodontic benefits can make a real difference to the final cost, so tell us about both plans when you book.

How can you get more from your Delta Dental orthodontic benefit?

• Check the age limit early. If a dependent’s orthodontic coverage ends at a certain age, starting treatment before that birthday can matter.
• Look at open enrollment. If your employer offers a plan option with orthodontic coverage, switching for the next plan year may be worth it, keeping any waiting period in mind.
• Keep your coverage active during treatment. Installments usually stop if coverage ends, so plan job or plan changes carefully.
• Use pre-tax money for the rest. An HSA or FSA can cover your share.
• Stay in-network. Network fees are usually lower, and we handle the claims.

How do you pay the part Delta Dental does not cover?

After insurance there is usually a balance. Two things help: health savings accounts (HSA) and flexible spending accounts (FSA) can generally be used for orthodontic treatment, because the IRS treats it as a qualifying dental expense (IRS Publication 502), and we can talk through payment options at your consultation. Our guide to using an HSA or FSA for Invisalign explains the details. For a sense of typical fees, see Invisalign’s own cost guide.

Frequently asked questions

Does Delta Dental cover Invisalign for adults?

Some Delta Dental PPO plans include adult orthodontics; many limit it to dependent children. Your benefit summary in the Delta Dental member portal shows which applies to you.

How much does Delta Dental pay toward Invisalign?

Plans with orthodontic coverage commonly pay a percentage of the fee (often about half) up to a lifetime orthodontic maximum. The exact figures are in your plan, and a pre-treatment estimate applies them to your treatment plan.

Is there a waiting period for orthodontics with Delta Dental?

Some plans, especially individual plans, have a waiting period before orthodontic benefits start. Employer plans often have none. Your plan documents list it.

Does Delta Dental pay all at once?

Usually not. Orthodontic benefits are typically paid as an initial amount when treatment starts and then in installments while treatment continues and you remain covered.

Can Coit Dental check my Delta Dental benefits?

Yes. Coit Dental is in-network with Delta Dental PPO. Call 214-387-8400 with your member ID and we will check your orthodontic benefit and request a pre-treatment estimate.

Coverage varies by plan and employer. This guide is general information, not a statement of your benefits; your Delta Dental plan documents and pre-treatment estimate are what count.