How to Get Your Invisalign Treatment Covered by Insurance: Step-by-Step Guide
You want Invisalign treatment but wondering how to get insurance coverage?
This guide shows you exactly what to do, in what order, and who to negotiate with.
Follow these steps to maximize your chances of getting covered.
Step 1: Check Your Health Insurance Rights
If you're under 16 years old
Immediate action: Request prior approval from your health insurance fund.
How to do it:
- Get a detailed quote from your orthodontist
- Fill out the prior approval form
- Attach the quote and send to your health insurance
- Wait for response (usually 15 days)
Possible coverage: Partial reimbursement depending on your plan.
If you're over 16 years old
Reality: Almost no coverage from basic health insurance, except very specific cases (maxillofacial surgery).
Action: Focus on your supplemental insurance – that’s where it matters.
Step 2: Analyze Your Supplemental Insurance Contract (Key to Success)
Immediate action: Find your contract
Where to look:
- Your insurance company’s online portal
- Mobile app
- Paper contract, section “Orthodontics” or “Special Dental Care”
What to look for exactly
Annual amount: How much does your insurance reimburse per year?
- $0 to $500 = basic insurance
- $800 to $1,500 = decent insurance
- $2,000 to $4,000 = premium insurance
Age limit: Until what age are you covered?
- Some insurances cover until age 25
- Others stop at 18
Waiting period: How long to wait after subscribing?
- Usually 6 to 12 months
- Check if you’re already within the timeframe
Concrete action
Call your insurance with these 3 specific questions:
- “What is my annual orthodontic coverage limit?”
- “Until what age am I covered?”
- “Do I have a waiting period to respect?”
Step 3: Get the Right Quote (Crucial for Coverage)
What your quote must contain
Mandatory information:
- Specific treatment codes
- Estimated treatment duration
- Exact breakdown of fees
- Number of treatment phases
How to request this quote How to request this quote
Magic phrase to tell your orthodontist: “I need a detailed quote with treatment codes for my insurance. Can you specify the duration and number of phases?”
Why it’s important: Without this information, your insurance cannot accurately calculate your coverage.
Step 4: Make Insurance Companies Compete
If your insurance covers poorly
Concrete action: Compare before committing to treatment.
Useful comparison sites:
- Direct comparison on insurance company websites
- Insurance brokers specializing in dental care
- Online comparison platforms
Questions to ask new insurances
- “What is your adult orthodontic coverage limit?”
- “What is the waiting period?”
- “Do you reimburse Invisalign the same as traditional orthodontics?”
Profitability calculation
Example:
- New insurance: $120/month but covers $3,000 orthodontics
- Old insurance: $60/month but covers $500 orthodontics
- Net gain over 2 years: $2,500 – ($60×24) = +$1,060
Step 5: Negotiate with Your Orthodontist
Negotiation leverage
Payment facilities:
- “Do you offer payment plans without fees?”
- “Do you have family rates?”
- “Can I pay month by month?”
Possible discounts:
- Cash payment (often 5-10% discount)
- Large family
- Student or unemployed
Effective negotiation phrase
“Your treatment interests me, but I have a tight budget. What solutions can you offer me to spread out payments?”
Special Case: Expatriates and International Insurance
Action if you live abroad
Check specifically:
- “Dental care abroad” coverage
- Worldwide coverage including care in your home country
- Often higher reimbursement than local insurance
Tip: Some international insurances reimburse 100% depending on contracts.
Your 5-Step Action Plan
Week 1:
Call your insurance to know your exact coverage
Request a detailed quote from your orthodontist
Week 2:
Compare 2-3 insurances if yours covers poorly 4. Negotiate payment terms with your practitioner
Week 3:
Make your decision and start the process
What You Need to Remember
Invisalign insurance coverage is possible.
The key: Adapted insurance + good quote + negotiation.
Mistake to avoid: Starting without checking your coverage rights.
Your goal: Reduce your out-of-pocket costs by 50% minimum.
Ready to take the step? Request your free personalized quote now and check your coverage rights. Your future smile will thank you.