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Many people prefer clear aligners over traditional metal braces. Clear aligners gradually straighten crooked teeth and fix bite issues.
Unlike traditional braces, clear aligners are nearly invisible and removable. This makes them a preferred orthodontic solution.
The process of submitting insurance claims for aligners is similar to that of other types of orthodontic treatment.
There are many ways to help maximize coverage. Obtaining some coverage for those with no orthodontic benefits is possible.
Before filing any claims, find out more information about your eligibility and coverage. Get a pre-estimate or pre-determination of what your out–of–pocket costs would be. Benefits vary significantly from policy to policy.
Once you’re familiar with the plan, it’s easier to determine how the case should be filed. You usually need to submit the correct paperwork to your insurer. Then, the aligner company helps with the rest.
However, the process differs depending on the insurance company and the aligner brand.
Some insurance companies ask for monthly or quarterly claim submissions to continue treatment. In those cases, there will be more than five claims submitted. Other insurance companies only pay for a maximum amount of 24 months of treatment.
Separating the claims allows the insurance company to pay some of the fees from the person’s annual maximum. This is opposed to their lifetime maximum.
This method also allows some patients to receive benefits from their insurance toward treatment. These are the people who may not otherwise have orthodontic coverage.
Filing the claims separately can also help quicken the payment process. It can give you an idea of how the insurance company may handle future claims and payments.
Clear aligners can save you thousands of dollars compared to braces. Learn about clear aligners.
Some dental insurance plans may cover clear aligners. However, coverage depends on the following:
Here are some ways to find out whether your insurance covers clear aligners:
In severe cases deemed medically necessary, medical insurance can cover orthodontic treatment. This usually occurs for facial deformities, tooth impactions, and severe bite problems.
In general, dental insurance will cover some of the costs of the following:
Different dental insurance companies will have different policies when they cover orthodontic treatment. Every insurance question comes down to your specific dental insurance plan.
Insurers typically provide partial dental coverage plans for orthodontics, including braces or clear aligners.
We recommend at-home clear aligners if you have mild teeth misalignment. View our top recommendations.
Not all aligners are covered equally. Here’s how coverage varies by brand:
Many dental insurance plans cover Invisalign treatment the same way they cover braces.
Invisalign insurance coverage depends on your insurance. For instance, your insurance may cover a certain percentage of your Invisalign treatment. Or, it may pay for a specific amount of the Invisalign cost.1
Typically, there is a lifetime cap on the amount insurance will pay for orthodontic treatment like Invisalign.
If your dental insurance provider includes orthodontic benefits, they’ll likely cover some of your ClearCorrect treatment.
Like with most brands, insurance coverage varies on a case-by-case basis. Sometimes, an insurer will consider ClearCorrect cosmetic and refuse to cover it.
You shouldn’t assume that ClearCorrect will be covered just because your dentist recommends it. Always check with your insurance provider first.
Candid is in-network with the following insurers:
If Candid is in-network with your insurance provider and you have orthodontic coverage, you can be covered for an average of $1,000 at checkout. You don’t have to wait for a reimbursement.2
If you don’t see your insurance provider on Candid’s in-network list, you can send your information to them. Then, they’ll submit the claim on your behalf.
However, Candid can’t guarantee whether or not you’ll be reimbursed. Candid strongly recommends that you check your insurance coverage ahead of time.
Ask your insurer if you have orthodontic benefits and if it covers remote treatments billed with the code D8090.
With Byte, it’s possible to receive 50 percent coverage, depending on your insurance plan.3
Consider that costs vary depending on various factors, including:
Most dental insurance plans cover customers for a portion of the cost of NewSmile aligners.
NewSmile costs 75 percent less than many other clear aligner brands, which already provides impressive savings.4
Contact NewSmile to see if you’re qualified for coverage. However, know that NewSmile impression kits are typically not covered by insurance.
With AlignerCo, a qualified dentist or orthodontist in your state will approve and assess your care remotely instead of in person.
Some insurers consider AlignerCo like other orthodontic treatments and offer coverage accordingly.
However, AlignerCo does not include regular, in-person checkups. As such, some insurers consider Aligner a do-it-yourself treatment and decline to provide coverage.
AlignerCo doesn't have any partnerships with insurers that make them in-network to streamline the process. They may still be covered by dental insurance, but you’ll need to see if they provide reimbursement first.
Some dental and health insurance plans may cover some of 6 Month Smiles treatment.
Like most brands, contacting your insurance provider to check if your policy covers it is best.5
An HSA or FSA may help pay for clear aligners. But there are limits on what types of medical care are covered.
The basic guidelines are: if treatment is essential medical care, it’s covered. If it’s cosmetic, it isn’t.
Regarding dental treatment, anything that treats or prevents disease or related health concerns qualifies for reimbursement. If treatment addresses aesthetic concerns, it won’t be covered.
Interested in straightening your teeth at home? Here are the best clear aligner companies.
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