What is an Invisalign treatment?
Invisalign is a great way to straighten your teeth without using metal braces. You wear clear aligners that are custom-made for your teeth. They gently move your teeth into the right position over time. They’re practically invisible, so most people won’t even notice you’re wearing them. You can take them out when you eat or brush your teeth, which makes life so much easier. Plus, you’ll get a new set of aligners about every 7 days to keep your teeth moving in the right direction.
How much does Invisalign cost?
The cost of Invisalign depends on your needs. At Freelove Orthodontics, a full Invisalign case costs $5,000 to $7,000, and limited cases start at $2,500. The fee is the same whether a patient uses in-network insurance, out-of-network insurance, or no insurance. Freelove Orthodontics provides flexible payment arrangements. These options are designed to meet your family’s needs.
How much will the Invisalign treatment cost with insurance?
A full Invisalign case at Freelove Orthodontics costs $5,000 to $7,000, based on the patient’s needs. With the average $1,500 orthodontic benefit, a $5,000 case leaves about $3,500 out of pocket. Costs also depend on the following:
- Deductible: The amount you pay before insurance starts covering costs.
- Coverage Percentage: Most PPO plans pay 50% of the treatment fee, up to the lifetime maximum.
- Out-of-Pocket Payments: Any balance left after insurance pays its share.
Freelove Orthodontics provides detailed cost estimates. They also offer in-house monthly financing to make aligner treatment more affordable.
Types of Insurance Plans That May Cover Invisalign
The type of insurance plan you have will affect your coverage for Invisalign. Here are the common types:
- PPO (Preferred Provider Organization): PPO plans are flexible. Freelove Orthodontics accepts all major PPO orthodontic plans and files the claim even when the practice is out of network on that plan.
- HMO (Health Maintenance Organization): These insurance plans might need a referral from a doctor. Freelove Orthodontics does not accept HMO plans, except DeltaCare.
- Indemnity Plans: These are flexible but vary greatly in coverage. Check with your insurer if Invisalign is included.
- DHMO (Dental Health Maintenance Organization): These plans often have stricter limits. Invisalign may not be fully covered, and specific dentists might need to be used.
Freelove Orthodontics also accepts Apple Health (Washington Medicaid) orthodontic benefits for qualifying cases; Apple Health decides whether treatment is covered. It’s best to confirm your eligibility before starting orthodontic treatment.
Insurance Coverage Limits for Invisalign
According to Dr. Andy Glassick, a top-rated orthodontist in Charlottesville, VA, patients should be aware of several important insurance limitations that can affect their Invisalign coverage:
- Lifetime Maximums: Many plans have a cap between $1,000 and $3,000 for orthodontic care.
- Age Limits: Some policies only cover braces or Invisalign aligners for people under 18 or 19 years old.
- Pre-Existing Conditions: Insurance may not cover aligner treatment if it started before you got the policy.
- Waiting Periods: Some plans require a waiting time of 6 months to 1 year before covering orthodontics.
Insurance Providers in Kent and Sammamish
Some Delta plans cover Invisalign treatment. Coverage depends on the specific terms of your plan.
- Delta Dental: Freelove Orthodontics accepts Delta Dental PPO plans and DeltaCare.
- UnitedHealthcare: Freelove Orthodontics files the claim in or out of network, so coverage depends on the plan’s orthodontic benefit.
- Cigna: Some Cigna plans include orthodontic benefits that partially cover Invisalign.
- Humana: Offers plans covering both braces and Invisalign under specific orthodontic packages.
If your insurance is through work, check if it covers orthodontic care. Some plans may have extra benefits.
Local Insurance and Invisalign in Kent & Sammamish
Invisalign coverage in Kent and Sammamish depends on these factors:
- Washington State Rules: Each insurance plan, not the orthodontic office, sets what orthodontic treatment it covers.
- Provider Networks: Freelove Orthodontics accepts all major PPO orthodontic plans in or out of network, and the fee is the same either way.
- Regional Pricing: A full Invisalign case at Freelove Orthodontics starts at $5,000.
- Local Orthodontists: Clinics like Freelove Orthodontics help patients understand their insurance. They can also help you save money on orthodontic treatment.
Talk to a trusted Invisalign aligners provider in Kent or Sammamish for cost-saving options.
How to Check Your Invisalign Insurance
Understanding your insurance is important to getting the most out of it. Start with these steps:
- Look for key terms like “orthodontic benefits” or “lifetime maximum” in your policy.
- Call your insurance provider and ask these questions:
- Does my plan coverage include Invisalign?
- What is the lifetime maximum for orthodontics?
- Are there age limits or waiting periods?
- Ask whether your plan pays a different orthodontic benefit in network than out of network.
Filing an Invisalign Insurance Claim
Freelove Orthodontics files every Invisalign claim directly with the insurer, so the family does not submit paperwork. The steps look like this:
- Get the Plan Details: Ask your orthodontist for a detailed aligner treatment plan, including costs and treatment codes.
- Submit the Claim: The practice sends the claim to the insurance company after the assignment of benefits form is signed.
- Follow Up: The insurance coordinator follows up with the carrier.
- Appeal a Denial: If denied, review the reason and ask your orthodontist to help appeal.
The insurer then pays the practice directly over the course of treatment.
Invisalign Payment Options
If insurance doesn’t cover all the costs, try these financing options:
- Payment Plans: Freelove Orthodontics offers monthly payment options. In-house financing starts with $300 down, with monthly payments from $199 and 0% financing options available.
- CareCredit: A special credit card for medical and dental costs.
- HSA/FSA Accounts: Pay for aligner treatment with pre-tax dollars from your health savings account or spending account.
- Tax Deductions: Some orthodontic costs qualify for tax deductions. Consult with your tax advisor.
Maximizing Your Insurance Benefits
Here are a few tips:
- Know the Payout: Most orthodontic benefits are a lifetime maximum paid in installments during treatment, not an annual limit that resets.
- Track Deadlines: Ensure coverage doesn’t lapse during your treatment.
- Combine Plans: Dual coverage may help reduce out-of-pocket costs.
- Ask for Discounts: Freelove Orthodontics takes 5% off when you pay in full, and offers a 5% family discount when more than one family member is in treatment.
Trusted Orthodontics Near Sammamish
Ready to take the next step in your investment toward a healthier smile? Schedule your consultation at Freelove Orthodontics. You can visit either the Kent or Sammamish office.
Bring your insurance details, questions about coverage, and any budget concerns with you. The team verifies the insurance benefit, files the claims, and explains the payment options. Contact either office to schedule a free consultation.
About the Authors
Dr. Cameron Freelove – Orthodontist in Kent and Sammamish, WA
Dr. Andy Glassick – Orthodontist in Charlottesville, VA
Invisalign Treatment FAQs
How to find out if your dental insurance covers Invisalign?
Start by calling your insurance company or visiting their website. Look for a list of treatments they cover. You can also send your insurance card to Freelove Orthodontics, and the team verifies the orthodontic benefit with the carrier before the visit.
Make sure to ask about waiting periods or yearly maximums. If you use online tools, log into your insurance portal. It often has detailed information about your benefits. If your current plan doesn’t cover Invisalign, you might be able to use funds from your FSA or HSA, or even look into switching to a plan that does offer coverage.
Why won’t insurance pay for Invisalign?
Most plans with an orthodontic benefit pay toward Invisalign at the same percentage as braces, up to the same lifetime maximum. When a plan pays nothing, the usual reasons are that it has no orthodontic benefit or that the patient is past the plan’s age limit.
Is it hard to get approved for Invisalign?
Getting approved for Invisalign isn’t usually too difficult, but it does depend on your individual case. Most people with mild to moderate orthodontic issues are good candidates for Invisalign. Your dentist or orthodontist will examine your teeth and discuss your goals to determine if it’s right for you. They’ll look at things like the alignment of your teeth, your bite, and any specific concerns you have. If you have more complex dental issues, traditional braces might be a better option.
