Here in San Diego, many of our patients turn to Invisalign as a discreet, effective, and convenient alternative to traditional braces to achieve that picture-perfect smile. However, it’s no secret that it can come with a hefty price tag. In fact, I’m often asked “Does insurance cover Invisalign?”
You may also be wondering the same thing. After all, not everyone has thousands of dollars lying around for such costly treatment.
Understanding if we accept your insurance plan and what portion of treatment is covered can make a big difference in the cost.
As your local dentist, I want to make sure that you understand what your insurance covers so that you can make your dream smile a reality.
Average Cost of Invisalign in San Diego Before Insurance
Invisalign treatment costs, on average, from $3,500 to $7,000 in San Diego, with an average cost of $5,250. Of course, the exact cost depends on a number of factors, including the complexity of your case, the length of treatment, and your specific Invisalign dentist. Therefore, the cost may be more or less than that range depending on your unique situation.
Blyss Dental Tip: Before starting Invisalign, make sure to inquire with your dentist about the complete set of pre- and post-procedure treatments you may need. This way, you can easily determine which services are covered in your insurance plan.
Does Insurance Cover Invisalign?
The answer to that question is, “It depends.”
Generally, a dental insurance policy that covers orthodontics will cover treatment with Invisalign as well. Orthodontic work falls under a separate dental plan than general dentistry does, and there are different levels of coverage within that plan.
According to a survey conducted by the National Association of Dental Plans (NADP), more than three-quarters of all private dental insurance plans include some form of orthodontic coverage.
For individuals considering Invisalign in San Diego, it’s important to understand that the amount of coverage may vary and might not fully cover the cost. However, this doesn’t mean you should avoid considering Invisalign as an option.
It’s important to read through the fine print of your plan so you know exactly what’s covered. I recommend speaking directly with your insurance provider for clarification if you’re still unsure about the specifics. They should be able to provide better insight into what’s included in your specific policy.
At Blyss Dental, we work with most insurance companies and are happy to help you figure out if your plan will cover any portion of Invisalign treatment. We can also work with you to find ways to make your Invisalign costs more manageable.
So, does insurance cover Invisalign? It’s very possible, and I’m here to help make sure that you get the maximum coverage available through your plan.
How Much Does Invisalign Cost With Insurance?
Unfortunately, there’s no one-size-fits-all answer when it comes to insurance coverage. The amount you pay out-of-pocket will depend on your plan and your individual situation.
While I don’t typically have all the details on every individual’s insurance coverage, I can tell you that there are several factors that may impact how much Invisalign will cost with insurance.
One of the factors you should consider are other fees that may come with the treatment, such as:
- your dentist’s consultation fee,
- CBCT scans, and
- pre- and post-procedures.
The good news is that your insurance might cover some of these auxiliary costs, which are often not included in the price of your Invisalign treatment.
According to the American Dental Association’s Introduction to Dental Benefits, a typical plan design for an indemnity dental plan includes 50% coverage for orthodontics. This means that if you have a $3,500 Invisalign treatment plan, your insurance may cover up to $1,750.
But before you get too excited about the potential savings, keep in mind that most insurance providers have a lifetime maximum that they will cover for orthodontic services. That means you could be covered up to a certain amount only each year or over your lifetime.
In-Network vs Out-Of-Network Dentists
If you go with an in-network provider, then you are likely to see more coverage for your treatment than if you choose out-of-network care. Your insurance company has negotiated rates with in-network dentists so they can offer lower costs compared to out-of-network providers who do not have those negotiated rates in place.
Shopping for Dental Insurance
Getting dental insurance coverage for Invisalign treatment can be a complicated process as each dental plan is different. However, I suggest looking for plans that offer orthodontic coverage. This will help cover a portion of your costs.
There are also certain factors you need to take into consideration when looking into getting insurance coverage for Invisalign. These include the following:
1. Age Limit
Most dental plans, including those that cover Invisalign, have an age limit. Generally speaking, you must be over 18 years old, and some plans may even require you to be at least 21 years old.
2. Maximum Amount Covered Over Lifetime
Insurance companies usually limit the amount of money they will contribute towards orthodontic treatment, such as Invisalign, over the course of a person’s lifetime.
3. Yearly Maximum
Similar to the lifetime maximum clause mentioned above, there may also be an annual maximum imposed by your insurance company on how much money they will pay towards orthodontic treatment like Invisalign each year.
4. Waiting Period
Some insurance plans require a waiting period before they will cover dental procedures such as Invisalign. For example, a 3-month waiting period may apply once you sign up for an insurance plan before coverage begins.
Some dental plans will require pre-approval before coverage for Invisalign treatment can be provided. This means your dentist will need to submit a treatment plan proposal and wait for the insurance company to review it before they will grant coverage.
6. Pre-Existing Conditions
Insurance does not always cover pre-existing conditions. This means that if you have any dental issues, such as cavities or other dental work to be done before starting Invisalign, those treatments may need to be taken care of and paid for out-of-pocket before insurance coverage will begin for Invisalign.
7. Deductibles and Copays
Deductibles are upfront costs that you must pay before your dental insurance policy begins covering any expenses. Copays are fixed amounts that must be paid each time services are rendered under the policy’s coverage limits.
It’s worth taking the time to research various plans and compare them against each other for cost and coverage.
Databases such as DentalPlans make it simple to compare costs and discounts from over 40 different discount plans. Additionally, through the National Association of Dental Plans, you can search for any type of plan—whether it’s group, individual, or discounted—which makes it easy to find one that fits your needs.
My insurance does not cover Invisalign. What are the alternative ways to pay for my Invisalign?
For those considering Invisalign to straighten their crooked teeth, it can be disheartening to learn that insurance is not going to cover the cost of the treatment. Fortunately, there are alternative ways to pay for your Invisalign treatment if your insurance does not cover it.
1. In-House Financing
Payment plans can be set up with your dentist’s office so you can make payments over time as you complete each stage of your treatment. These plans allow you to spread the cost out over a period of months or years so that it is more manageable on your budget. Additionally, some clinics may offer special promotional offers or discounts, which can help reduce the total cost of Invisalign.
2. Financing Companies
These companies, such as CareCredit or LendingPoint, offer financing plans specifically designed for healthcare expenses, including Invisalign treatment. They provide flexible payment plans with zero to low monthly payments and competitive interest rates, making it easier to manage the cost of your treatment over time.
3. HSA or FSA
Another option is to utilize a Health Savings Account (HSA) or Flexible Spending Account (FSA) if you have one. An FSA or HSA is a type of savings account offered by certain employers. These accounts allow you to set aside pre-tax dollars to pay for eligible healthcare expenses. Invisalign treatment is an eligible expense that can be paid for using FSA or HSA funds.
4. Personal Loan
Another option is to use a personal loan from a bank or credit union. This does require a good credit score and does have to be paid back with interest, so it is important to consider the terms of any loan very carefully.
Blyss Dental Tip: Blyss Dental offers some of the best no-interest loans around, and you won’t have to worry about expensive penalties if you don’t pay off your loan in full. Our straightforward financing options give customers the ability to choose a 48- to 72-month repayment plan after an initial grace period.
Ready to Get Straighter Teeth with Invisalign?
I hope this article has been helpful in understanding how insurance can cover some or all of the cost of Invisalign treatment, as well as outlining alternative ways to finance your treatment if insurance does not cover it.
If you have questions regarding whether or not your insurance covers Invisalign in San Diego, California, reach out to us at Blyss Dental.
As a qualified and certified Invisalign dentist in San Diego, I can provide the answers you need and the best course of action for your individual case.
At Blyss Dental, we strive to make sure our patients achieve the smile they desire without having to worry about financial concerns. We offer payment plans and will work with you to figure out a path forward that works for you.
Sources Cited From
- Dental Insurance & Dental Savings Plans | DentalPlans.com. (2018, July 18). https://www.dentalplans.com/
- American Dental Association. (n.d.). Introduction to Dental Benefits. www.ada.org. Retrieved March 21, 2023, from https://ebusiness.ada.org/
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- National Association of Dental Plans – For all individuals to have equitable access to dental care. (n.d.). National Association of Dental Plans. https://www.nadp.org/
- Invisalign treatment | Invisalign clear aligners. (n.d.). https://www.invisalign.com/
- Health Care Options, Using a Flexible Spending Account FSA. (n.d.). HealthCare.gov. https://www.healthcare.gov/have-job-based-coverage/flexible-spending-accounts/
- Health Savings Account (HSA) – Glossary. (n.d.). HealthCare.gov. https://www.healthcare.gov/