Yes, Delta Dental does cover braces, but not for everyone and not always in full. Whether you’re a parent considering braces for your teen or an adult wondering if Invisalign is covered, the answer lies in your specific plan.
Orthodontic treatment is a big investment. Thankfully, with the right Delta Dental coverage and the right dental office (like Nassau Bay Dental), you can get the care you need without drowning in confusion or unexpected costs.
Key Takeaways
✔ Delta Dental covers braces under both PPO and DHMO plans
✔ Most coverage is limited to patients under 19
✔ PPO plans offer 50 percent reimbursement up to a lifetime max
✔ DHMO plans use copays and require in-network providers
✔ Nassau Bay Dental offers personalized orthodontic care and insurance support
Why Are Braces Needed?
Braces are used to fix bite problems, straighten crooked teeth, and improve both oral health and appearance. They’re not just cosmetic. Proper alignment can prevent:
- Jaw pain
- Difficulty chewing or speaking
- Gum disease and cavities caused by hard-to-clean teeth
And let’s be real, a confident smile is a powerful thing.
Does Delta Dental Cover Braces? The Short Answer
Yes, but here’s what you need to know:
- Most Delta Dental plans cover braces for children under 19
- Adult orthodontic coverage is limited and mostly available through PPO or employer-sponsored plans
- Invisalign? Only covered under specific PPO plans, often for teens and with documentation
So yes, coverage exists, but it’s layered in fine print.
Delta Dental PPO Plans: Orthodontic Coverage Overview
If you have a Delta Dental PPO plan, here’s what you might get:
- Braces covered at 50 percent, typically up to a lifetime maximum of $1,000 to $2,500
- Coverage includes:
- Traditional metal braces
- Ceramic braces (some plans)
- Invisalign (only in select cases)
- You’ll need:
- A pre-treatment estimate
- To meet any waiting periods in your plan
PPO plans offer flexibility and better provider access, which matters when choosing the right orthodontist.
DeltaCare USA (DHMO Plans): Fixed Copays, Fewer Options
DHMO plans are more predictable, but they come with limits:
- You must use an assigned in-network orthodontist
- Coverage is provided via fixed copays, not percentage reimbursement
- Invisalign is almost always not included
Typical copays for full braces range from $1,500 to $2,500, depending on your region and plan level.
Does Delta Dental Cover Braces for Adults?
Short answer: not usually.
Most plans are designed to cover orthodontics for dependents under 19. However, there are exceptions:
- Some enhanced PPO plans or employer group policies include adult ortho coverage
- Coverage often requires a diagnosis of medical necessity, such as TMJ disorder or jaw misalignment
- Invisalign is rarely approved for adults unless it meets strict plan criteria
If you’re an adult exploring braces, prepare for out-of-pocket costs unless you’ve verified your plan includes coverage.
What Types of Braces Might Be Covered?
- Metal braces: Almost always included in eligible plans
- Ceramic braces: Sometimes covered under PPOs
- Lingual braces: Rarely covered
- Invisalign: Covered in select PPO plans for teens, not adults
The more traditional the treatment, the more likely it is to be covered.
Cost of Braces With and Without Delta Dental
Without Insurance:
- Metal braces: $3,000 to $7,000
- Invisalign: $4,000 to $8,000
- Ceramic or lingual braces: $5,000 to $10,000+
With Delta Dental PPO:
- Covers 50 percent up to your lifetime max
- Out-of-pocket: $2,000 to $4,000 depending on plan
With DeltaCare USA:
- Copays typically $1,500 to $2,500
- Less flexibility in choosing providers or treatment types
What Is a Lifetime Orthodontic Maximum?
This is the total amount your Delta Dental plan will pay for orthodontic treatment during your lifetime. It:
- Usually ranges from $1,000 to $2,500
- Applies per individual, not per plan or per year
- Doesn’t reset annually
Plan carefully to make the most of this benefit.
How to Confirm If Your Plan Covers Braces
Here’s how to check:
- Look through your Summary of Benefits
- Ask your dentist for a pre-treatment estimate
- Call Delta Dental’s member support or check your portal
- Let Nassau Bay Dental handle the verification—we do it every day
How to Maximize Your Orthodontic Benefits
- Start early if your child is under 19
- Use an in-network provider to reduce costs
- Time your treatment across calendar years if you’re close to your lifetime max
- Pay any remaining balance using your FSA or HSA
- Keep all documentation for pre-approval purposes
What If Braces Aren’t Covered?
1. Explore Supplemental Coverage
Some private insurance plans offer orthodontic add-ons.
2. Ask About In-House Financing
At Nassau Bay Dental, we offer flexible monthly plans to make treatment easier on your budget.
3. Consider Less Expensive Options
For minor corrections, partial aligners or shorter treatment periods may still work—and cost less.
Braces and Orthodontics at Nassau Bay Dental
At Nassau Bay Dental, we provide:
- Orthodontic evaluations for kids, teens, and adults
- Expert treatment plans that fit your insurance and your smile goals
- Delta Dental PPO and DHMO acceptance
- Transparent pricing, easy financing, and a welcoming team
Book your consultation today and let Dr. Zajac and our team guide you every step of the way.
Final Thoughts
Yes, Delta Dental covers braces, but the details matter. PPO plans offer more flexibility and coverage, while DHMO plans offer predictability with less choice. Adult coverage is rare but not impossible.
No matter where you stand, Nassau Bay Dental is here to help. We’ll decode your benefits, build a custom plan, and make your path to a better smile easier than you imagined.
