Does Insurance Cover Invisalign in Ontario?
If you’re thinking about Invisalign, there may be some good news hiding in your dental insurance plan.
You may have orthodontic coverage specifically available for Invisalign — and it may be separate from the insurance you normally use for cleanings, fillings, crowns and other dental treatment.
Many patients don’t realize this benefit exists until they start looking into Invisalign.
Does Insurance Cover Invisalign?
In many cases, yes.
Invisalign is considered orthodontic treatment, so dental plans that include orthodontic benefits will often provide coverage for Invisalign in much the same way they provide coverage for traditional braces.
The important words are “orthodontic coverage.”
Not every dental insurance plan includes it. Some plans provide orthodontic benefits only for dependent children or younger patients, while other plans also provide coverage for adults.
So don’t assume you’re covered — but don’t assume you’re not covered either.
Your Orthodontic Coverage Is Usually Separate
Most of us think of dental insurance as having an annual maximum. You use that amount for things such as examinations, cleanings, fillings, crowns and other dental treatment.
Orthodontic insurance is often structured differently.
A plan may have its own orthodontic maximum, separate from the annual maximum for your other dental treatment. Canadian insurance plans exist, for example, with a regular annual dental maximum and a completely separate lifetime orthodontic maximum.
That means you may have an insurance benefit specifically intended for orthodontics that you have never used.
Orthodontic Coverage Is Often a Lifetime Benefit
There’s another important difference. Regular dental insurance often renews every year.
Orthodontic insurance commonly does not renew every year. Instead, many plans provide a lifetime orthodontic maximum.
For example, imagine your insurance provides:
50% orthodontic coverage, to a $2,500 lifetime maximum.
Your insurer may pay a portion of eligible Invisalign treatment costs until it reaches the maximum allowed by your plan. Once that lifetime maximum has been used, it generally doesn’t simply refill the following January like an annual dental maximum. This also means that if you’ve never had braces or other orthodontic treatment, you may still have that benefit available.
How Much Will Insurance Pay for Invisalign?
That depends entirely on your insurance plan.
Your plan may pay a percentage of eligible orthodontic treatment, up to a specific lifetime maximum. Invisalign Canada notes that insurance may pay either a percentage of treatment or a specified dollar amount.
The two most important questions are:
- What percentage of orthodontics does my plan cover?
- What is my lifetime orthodontic maximum?
You should also check whether there are age restrictions and whether any of your orthodontic maximum has previously been used.
Thinking About Invisalign? We Can Check Your Insurance First
If you’re considering Invisalign, don’t just look at your regular dental maximum and assume that’s all the insurance you have available.
Your Dentist should be able to help you look specifically for orthodontic coverage.
It may represent a separate benefit that you have never used — and it could reduce what you need to pay personally for Invisalign treatment.
At Art of Smile Invisalign Center at Yonge & Eglinton, our team can help you review your orthodontic insurance information and understand the coverage available to you before starting treatment.
Every insurance plan is different, and your insurance provider ultimately determines your coverage and reimbursement.
But it’s certainly worth checking.