What Insurance Plans Cover Invisalign in NY and NJ?
Invisalign clear aligners offer many potential perks that could appeal to patients over traditional metal braces or ceramic braces. Unlike other orthodontic appliances, Invisalign clear aligners can be:
- Removed at your discretion (for 2 hours a day, during eating, drinking, and dental cleaning)
- Appear nearly invisible when worn
- Worn with no diet restrictions
- Less irritating than traditional braces
- Less prone to breakage as compared to braces
It’s easy to see why those things could be advantageous for patients. Unfortunately, those advantages of Invisalign clear aligners will typically come at a bit of a higher cost; if you opt for Invisalign clear aligners over traditional braces, expect to pay at least a few hundred dollars more on average.
Still, there are ways to make bearing the brunt of that cost a little easier. FSA and HSA savings accounts can help cover a portion of the costs, or here in NJ and NY, so can certain insurance plans.
But how exactly do you find out how much your insurance plan will cover Invisalign clear aligners, or whether your plan will cover any costs at all? Hopefully, this coverage guide will help you gain more insight into whether you can afford Invisalign under your state-sponsored or private network insurance plan.
Cost of Invisalign Without Insurance
It’s a totally valid option to pay for Invisalign treatment without insurance coverage, entirely out of pocket. That said, it’s probably not the option most patients will prefer. On average, Invisalign treatment costs between $2,400 to $8,000 without coverage. Your provider may offer flexible, monthly payment plans to make that burden a little more manageable, but that will still not be most patient’s desired option.
Given that many Americans struggle to pay an unexpected $400+ expense (per the Federal Reserve), we recognize that is likely not the ideal price range. But while Invisalign will never be covered in full, some of the following plans may be able to cover a fraction of the cost in NY and NJ. Here is an overview of some popular providers, and whether they cover Invisalign.
Humana’s Invisalign Benefits
Most Humana dental plans will offer a portion of orthodontic care for adults and children, and that often includes discounts on Invisalign clear aligners. However, unlike some other companies, Humana will not offer coverage for treatments that have already started — unless you’ve already signed up for their dental plan directly.
Before you even arrange the first consultation, consult Humana to make sure you’re already covered to receive discounts.
Does Aflac Cover Invisalign?
Orthodontics are a listed benefit under Aflac Dental’s coverage, as the “Orthodontic Benefit Rider” option. To reap this benefit, the individual must have completed a 24-month waiting period. Then, the patient will pay $500 for initial orthodontic treatment. Following the initial appointment, Aflac will then pay $50 for each continued treatment.
As “limited treatment” is listed under Aflac’s official benefit form, and Invisalign treats limited sets of teeth at a time, you should be able to receive at least some coverage for Invisalign clear aligners. However, these benefits are not payable to patients who began treatment before the waiting period ended. Coverage may also vary depending on locale, age, or the location where you seek treatment. Be sure to review your case with an Aflac provider before making any big commitments.
Making Invisalign Cheaper with MetLife
MetLife’s dental coverage may be able to cover Invisalign clear aligners, provided that a licensed dental professional is administering the care. They have a wide assortment of dental plans, including those exclusive to veterans and federal government employees. By far though, their PPO plans offer the widest range of coverage options and dental providers to choose from.
They also offer an HMO plan (available in NY and NJ) that allows you to preselect a dental provider when you enroll. However, such plans usually do not cover Invisalign, so do not choose an HMO as your first option affordable clear aligners. For the best results, we recommend looking into their PPO options and consulting a provider directly.
UnitedHealthOne Dental Primary Plans
If your family is enrolled in UnitedHealthOne, your children might be eligible to receive orthodontic coverage under certain primary plans. However, orthodontic care is only covered for eligible patients under the age of 19.
Furthermore, that “cosmetic dentistry” is listed as an unpayable service under any circumstance, pursuing receiving Invisalign coverage through UnitedHealthOne may not be the best idea for you and your family. For more information, review their Dental Primary Plan or speak with a UnitedHealthOne representative directly.
Cigna’s Invisalign Coverage
Cigna offers three dental plans, but as of now, only the Cigna Dental 1500 plan will offer orthodontic benefits. These benefits include Invisalign — and you may be eligible to cover up to 50% of your orthodontic provider’s treatment cost through that coverage.
You will have to wait at least a year to begin treatment after enrolling in the 1500 plan. This plan can also include some fairly pricey lifetime maximums ($1000 per person), something to keep in mind before moving forward.
Aetna’s Orthodontic Care Options
Certain Aetna plans may offer coverage for orthodontic appliances and Invisalign clear aligners. However, given that plan parameters can vary, it’s important to consult your provider about plan parameters directly. You can also refer to Aetna’s official Orthodontic Care FAQ.
You do not need a referral if your plan includes orthodontic benefits, though patients under an Aetna DMO (Dental Maintenance Organization) will only have their coverage limited to using in-network orthodontists. Certain plans may also be subject to age limits, so if you are an older patient seeking Invisalign clear aligner coverage, be mindful of that.
Blue Cross/Blue Shield’s Dental Benefits
Unfortunately, it is highly unlikely that patients with Blue Cross/Blue Shield plans will be eligible to receive coverage under their respective plans. Orthodontic discounts are not mentioned under any of their dental plans, but they do mention that “cosmetic” treatments are not covered.
If you’re a patient over the age of 18, it’s almost certain that your Invisalign treatment will be considered a cosmetic procedure by Blue Cross/Blue Shield, even if you’re seeking it out for more serious conditions. So, if you’re seeking orthodontic coverage, Blue Cross/Blue Shield dental plans are not the ideal source for that.
Delta Dental Insurance on Invisalign
As one of the nation’s largest dental insurance providers, it would be odd if Delta Dental didn’t offer insurance coverage for orthodontics and Invisalign clear aligners. Fortunately, they do; their comprehensive allowance options include all steps of treatment and post treatment, but only covers comparative standard treatment cost.
The patient will be responsible for covering any additional fees outside of that average cost, and unfortunately, Invisalign will not be a covered expense for enrollees under their DentalCare USA plan. With all of that in mind, carefully review the fine print from both your Delta Dental provider and dental care provider before committing to anything.
USAA Dental: Invisalign For Veterans?
If you are an active-duty service member, veteran, or related to one, you may be eligible for reduced cost Invisalign treatment in NY or NJ. USAA has an option for orthodontic coverage, though given that they partner with Cigna, waiting periods to take advantage of those discounts will apply.
In New York, that means a 12-month waiting period, but New Jersey patients will only be subject to a 6-month waiting period. Much like Blue Cross, USAA does strictly scrutinize “cosmetic” procedures — meaning younger patients may have better luck receiving better Invisalign discounts under a USAA dental plan than older ones. For more information, review their official Dental Disclosures page or consult them with any questions directly.
Does Medicaid Cover Invisalign?
Unfortunately, patients covered under the Medicaid program in New York, New Jersey, or elsewhere will not be able to receive coverage for Invisalign clear aligners. They have the strictest anti “cosmetic procedures” policy of any provider on this list. If you qualify to receive orthodontic coverage under the State Medicaid program, you are not eligible for any options except metal braces. Traditional braces are a good option as well, as long as your orthodontist is an experienced provider.
With insurance or without insurance, there are plenty of options to reduce the cost of your Invisalign treatment in NY or NJ.