Key takeaways
- Orthodontic coverage from Delta Dental of Arizona typically includes your pre-treatment visit, braces or clear aligners and post-treatment retainers.
- The orthodontic lifetime maximum applies per person, so each family member has their own benefit.
- Orthodontic coverage isn’t limited to employer-provided plans. Delta Dental of Arizona’s Palo Verde plan is a great option for those who are paying for dental benefits on their own and are looking for coverage for braces, clear aligners, retainers and more.
Braces can be an exciting step toward a healthier, more confident smile, but they can also raise questions about cost. Before starting orthodontic treatment, it helps to understand what your dental plan covers. If you’re wondering whether Delta Dental of Arizona helps pay for braces, knowing how orthodontic benefits work can make it easier to plan ahead and avoid unexpected expenses.
What Orthodontic Treatment for Braces May Include
Braces get most of the attention, but they’re just one part of what orthodontic treatment involves. Coverage varies by plan, but most Delta Dental of Arizona plans with orthodontic benefits include:
- Pre-orthodontic treatment visit
- Exam and start-up records (e.g., X-rays, photos and impressions of your teeth)
- Comprehensive orthodontic treatment (including braces or clear aligners)
- Post-treatment retainers
- Post-treatment records
After any coinsurance is paid, coverage applies up to your lifetime maximum, which means any costs beyond that limit are paid by you. Additional appliances like expanders, space maintainers and replacement retainers are not part of standard orthodontic coverage. When your orthodontist presents your treatment, ask which services are covered under your specific benefits so you know exactly what to expect before treatment begins.
If Your Child Needs Braces, Here’s What to Know
Your dentist just said “braces” and now you’re wondering how to make it happen without breaking the bank. The good news is most plans with orthodontic coverage offered by employers help cover braces for children.
It’s important to know that there’s a time window. Orthodontic treatment for dependent children must begin on or after age 8, and braces need to be in place before age 17. Between school schedules and everything else on a parent’s plate, it’s easy to put orthodontic treatment on the back burner. But putting it off too long could mean missing out on benefits you’re already paying for.
It’s also helpful to understand how payments work. Delta Dental of Arizona doesn’t pay the full cost of orthodontic treatment upfront. Instead, an initial payment is made when braces are put on, and a second payment follows 8 to 12 months later if the member receiving the treatment is still enrolled in a qualifying plan. You pay your coinsurance share directly to the orthodontist and can work with them on a payment plan.
Getting Braces as an Adult
If you’re like many adults, the idea of getting braces has probably crossed your mind more than once. It just never felt like the right time—or maybe it’s never been a priority in your budget.
Adult orthodontic treatment is more common than you might realize, and the options have come a long way. Beyond traditional metal braces, there are a few directions you can go depending on your lifestyle and how visible you want your treatment to be:
- Ceramic braces use tooth-colored brackets that blend in with your teeth. Same function as metal, just less noticeable.
- Lingual braces are placed on the back of your teeth, making them virtually invisible from the front.
- Clear aligners are removable trays that straighten your teeth without any brackets or wires at all.
Not every dental plan includes orthodontic coverage for adults. If you receive dental benefits from your employer, coverage for orthodontic treatment will depend on your specific plan. If you’re paying for dental benefits on your own, you’ll want Delta Dental of Arizona’s Palo Verde plan which covers orthodontic treatment for adults. This coverage kicks in during the second year of enrollment.
Already mid-treatment when you switched to a Delta Dental plan? You may still have options. Delta Dental of Arizona’s standard orthodontic takeover policy might be able to cover part of your remaining costs. Under this policy, your new Delta Dental plan pays the difference between its maximum and what your old plan paid before switching. Your member portal will have more information on how this applies to your specific benefits, or you can contact us to find out if you have takeover on your plan.
What You Can Expect to Pay for Braces
The cost of braces varies depending on the type of treatment, how long it takes and where you live. A plan with orthodontic coverage can lower what you pay out of pocket.
Most Delta Dental of Arizona plans with orthodontic coverage split the cost with you up to a lifetime orthodontic maximum. That coverage is separate from your annual dental maximum, so your other dental benefits aren’t affected. On Delta Dental of Arizona’s Palo Verde plan, there’s no deductible on orthodontic treatment, meaning you won’t be required to pay a set amount out of pocket before your benefits kick in. However, employer-provided plans may require a deductible for orthodontic treatment.
What you’re required to pay out of pocket is billed directly by your orthodontist, not to Delta Dental of Arizona. Ask their office about setting up a payment plan so the full cost of braces can be paid off over time.
Before treatment starts, you will receive a pre-treatment estimate. This will tell you what is covered, how much your plan will pay toward treatment and how much you’ll need to pay out of pocket. It’s not a guarantee of payment, but it gives you a realistic number to work with before you commit.
When it comes to choosing an orthodontist, you can see any licensed provider, but you’ll save more by staying in network. Delta Dental has a large network of orthodontists in Arizona and across the country, and you can search for one near you using our search tool.
What an Orthodontic Lifetime Maximum Means for You
An orthodontic lifetime maximum is the total amount your plan will pay for braces over your lifetime. Any additional amount becomes your responsibility.
This is different from your annual dental maximum, which resets every year. Your orthodontic lifetime maximum is a one-time benefit and is separate from your annual maximum. So, using it doesn’t affect what your plan pays toward cleanings, fillings or other dental care.
For families, the orthodontic lifetime maximum applies per person. If you have more than one family member who needs braces, each one will have their own limit.
How Soon Can You Use Your Orthodontia Coverage?
For most Delta Dental of Arizona employer-provided plans, there is no waiting period for orthodontia coverage. It’s available from day one, which is one less thing to factor into your treatment timeline.
If you’re paying for dental benefits on your own, Delta Dental of Arizona’s Palo Verde plan requires one full year of enrollment before coverage for braces kicks in.
Delta Dental makes two payments over the course of treatment—one when braces go on and a second 8 to 12 months later. Staying enrolled in a plan with orthodontia coverage for the full course of treatment ensures both payments are made. If you lose or change your coverage before that second payment, you may be responsible for the remaining costs.
Finding a Plan that Covers Braces
Where you go from here depends on where you’re starting from.
If you’re already a Delta Dental of Arizona member, sign in to your member portal to review your plan details and confirm whether braces coverage is included. Your coverage summary will show your orthodontic lifetime maximum and any waiting periods that apply.
If you’re shopping for a new dental plan, orthodontic coverage isn’t always included. Here are a few things to look for when comparing options:
- Who’s covered: Some plans limit orthodontic benefits to dependent children. Look for a plan that covers everyone who needs, or wants, braces.
- Clear aligners: Most plans with orthodontic benefits cover both braces and clear aligners, but not all. Confirm before you enroll.
- Waiting periods: Individual plans might have a waiting period before orthodontic benefits kick in. If you’re planning to start treatment soon, factor that timeline into your decision.
- Lifetime maximum: This is the total your plan will pay toward braces per person. The higher the maximum, the more your plan contributes toward the total cost of treatment.
Delta Dental of Arizona’s Palo Verde plan is a great option for those who are paying for dental benefits on their own and are looking for coverage for braces, clear aligners, retainers and more!
Frequently Asked Questions
The services covered under orthodontic treatment depend on your plan. Most Delta Dental of Arizona plans with orthodontic benefits include a pre-orthodontic treatment visit, exam and start-up records, comprehensive orthodontic treatment (including braces and clear aligners), post-treatment retainers (does not include replacement retainers) and post-treatment records.
An orthodontic lifetime maximum is the maximum amount Delta Dental will pay toward your orthodontic treatment throughout your entire lifetime. Any additional expenses beyond this limit are paid by you.
There is no waiting period for orthodontia on most Delta Dental of Arizona employer-provided plans. Delta Dental of Arizona’s Palo Verde plan requires one full year of enrollment before coverage for braces kicks in.
Delta Dental of Arizona makes an initial payment at banding equal to 50% of the total covered cost or 50% of your plan’s orthodontia lifetime maximum, whichever is less. A second payment is made 8-12 months after banding as long as the member receiving treatment is still enrolled in an eligible plan. You will be responsible for paying the dentist directly for your portion of the total cost.
Yes! Delta Dental of Arizona’s Palo Verde plan is great option for those who are paying for dental benefits on their own and are looking for coverage for braces, clear aligners, retainers and more!
