Delta Dental coverage for orthodontics and clear aligners is an employer-specific policy rider that typically pays 50% of your treatment costs up to a designated lifetime maximum. At St. Matthews Family Dental, utilizing this benefit requires a healthy oral foundation established through mandatory six-month preventive cleanings before aligner therapy begins.
If you have ever had braces in the past, you likely remember the uncomfortable, gag-inducing trays of cold putty used to construct impressions of your teeth. At St. Matthews Family Dental, we have completely eliminated that outdated step. Instead of putty, Dr. Nikki Bevilacqua uses a high-speed digital intraoral scanner. This small, wand-like device captures thousands of images per second to create a sub-millimeter 3D map of your mouth. Medical literature supports that the use of intraoral scanners aids dental professionals in making informed decisions and improving dental restorations [1] (Alkadi et al., 2023). Not only does this make your visit incredibly comfortable, but it also provides a financial advantage. We send this high-resolution digital evidence directly to Delta Dental or MetLife. Providing insurance companies with flawless 3D data proves the medical necessity of your treatment, drastically reducing claim delays and getting your clear aligners approved faster.
The fear of the unknown is the biggest barrier to dental care. We believe in radical transparency, so you know exactly what to expect from day one. Here is the streamlined process for our Louisville patients:
Table that compares orthodontic and cosmetic options
Feature | Clear aligners | Traditional braces | Porcelain veneers |
Delta Dental coverage | Ortho rider | Ortho drider | Cosmetic |
Primary benefit | Invisible | Corrects severe bite issues | Instant cosmetic correction |
Cost | Up to $6000 | Up to $6000 | Premium investment |
Durability | Permanent (with retainer) | Permanent (with retainer) | 10-15 years |
Maintenance level | Daily aligner cleaning | High | Low |
The day you finish your clear aligner treatment is a huge milestone, but your orthodontic journey is not completely over. Teeth have a natural “memory” and will try to shift back to their original positions, a process known as orthodontic relapse. To protect your newly aligned smile, you must wear a custom retainer. In most cases, the cost of your very first set of retainers is bundled into your initial “Comprehensive Orthodontic Treatment” code. This means your Delta Dental lifetime maximum typically covers them. However, insurance rarely covers replacement retainers if you lose or break them. We highly recommend keeping your retainers in a brightly colored hard case to protect your hard-earned smile and your wallet.
If you are a professional, you likely do not have the time to deal with the metal brackets, broken wires, and dietary restrictions of traditional braces. Clear aligners are engineered to respect your schedule and your social life. Because the aligner trays are virtually invisible, you can confidently lead a boardroom presentation downtown without anyone noticing you are undergoing orthodontic treatment. More importantly, they are completely removable. There are absolutely zero dietary restrictions. You can eat your favorite foods, brush and floss your teeth as usual, and pop the aligners back in to keep your treatment on track.
Even with a premium Delta Dental orthodontic rider covering 50% of your treatment, you will still have an out-of-pocket balance. If your lifetime maximum covers $2,000, but your treatment costs $4,000, you have a gap to fill. This is where stacking your corporate benefits becomes a game-changer. Because clear aligners are a qualified medical expense, you can use pre-tax dollars from your Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for that remaining balance. By using pre-tax funds, you are effectively giving yourself a 20% to 30% discount on your out-of-pocket costs. Our administrative team excels at “Benefit Phasing.” If you start treatment late in the year, we can help you use your expiring FSA funds in December and tap into your renewed funds in January, allowing you to leverage two years of tax-free money for a single, flawless smile.
It depends entirely on your specific employer’s contract. While some Delta Dental plans restrict orthodontic benefits to dependents under the age of 19, many premium plans now offer “Adult Orthodontic Riders” with no age limit.
Yes. In fact, it is clinically required. Your clear aligners sit flush against your teeth, meaning they can trap bacteria if you do not maintain excellent hygiene. Your Delta Dental plan will continue to cover 100% of your preventive cleanings every 6 months while you are undergoing your aligner treatment.
[1] Alkadi L. A Comprehensive Review of Factors That Influence the Accuracy of Intraoral Scanners. Diagnostics (Basel). 2023;13(21):3291. Published 2023 Oct 24. doi:10.3390/diagnostics13213291
[2] Yazdi, M., Daryanavard, H., Ashtiani, A. H., Moradinejad, M., & Rakhshan, V. (2023). A systematic review of biocompatibility and safety of orthodontic clear aligners and transparent vacuum-formed thermoplastic retainers: Bisphenol-A release, adverse effects, cytotoxicity, and estrogenic effects. Dental research journal, 20, 41.