Orthodontic Insurance and Financing
Reviewed by Dr. Brent E. Sexton
Almost every family we see wants two questions answered before anything else: what will insurance pay, and what happens to the rest? This page answers both. Delta Smiles accepts all dental insurance plans, and we offer no-interest in-house payment plans for whatever your plan doesn’t cover.
Does Insurance Cover Braces?
Yes, in most cases, if your plan includes orthodontic benefits. Plans with orthodontic coverage typically pay a percentage of comprehensive treatment up to a lifetime maximum for each covered person, instead of resetting each year like a regular dental allowance. Coverage for children is common on plans that offer orthodontics; adult orthodontic benefits are less universal but no longer unusual.
Three details decide what you’ll actually receive:
- Whether your specific plan includes orthodontics. Not every plan does. It’s a separate benefit from cleanings and fillings.
- Your lifetime maximum. This is a per-person cap on what the plan will ever pay toward orthodontics, and it applies whether treatment happens now or in ten years.
- Age limits. Some plans cover dependents only to a certain age. Others cover adults at a lower percentage.
We accept all dental insurance plans as an out-of-network provider. We’ll verify your exact benefits before you commit to anything, and if your plan covers less than you’d hoped, you’ll hear that figure straight.
A quick clarification: Delta Smiles is not Delta Dental
No. Delta Smiles is an independent orthodontic practice in Antioch and Brentwood, and our name comes from the Sacramento-San Joaquin Delta region we serve. We are not affiliated with Delta Dental, the insurance company, and we are not in network with any insurance plan.
We accept most insurance plans with orthodontic benefits and file claims on your behalf. Bring your card or your member ID and group number to the free exam, and our financial coordinator will run a benefits check before you leave.
Two structural notes that apply across carriers:
- PPO versus DHMO. PPO plans typically pay a percentage of the fee up to the lifetime maximum. DHMO or managed-care plans usually work off a fixed copay schedule instead, which can be a good deal on comprehensive treatment but tends to restrict which offices you can use.
- Coordination of benefits. If a child is covered under two parents’ plans, the two may combine, sometimes substantially. It’s worth telling us about both even if one seems minor.
Flexible Spending and Health Savings Accounts
Orthodontic treatment is a qualified medical expense under most FSA and HSA plans, so you can pay for treatment with pre-tax dollars. Two practical points:
FSA funds usually expire at the end of the plan year, so timing the start of treatment near an enrollment period can matter. HSA funds roll over, which makes them easier to plan around. Check specifics with your plan administrator; we’ll provide whatever documentation they ask for.
Paying for the Balance
Whatever insurance doesn’t cover is payable over the course of treatment, not up front.
- No-interest in-house payment plans. We carry the balance ourselves throughout treatment. No finance charge, no third party, no credit product.
- Flexible monthly payments. The monthly figure is built around what your household can actually carry, and it’s set before treatment begins, not renegotiated later.
- Automatic payments. Optional, and most families use them so nothing gets missed during a busy month.
- CareCredit. For families who want terms longer than our in-house plan runs, CareCredit is a healthcare lender with promotional financing periods. Application takes a few minutes and our team can walk you through it.
What Your Fee Covers
One quoted fee covers the whole course of treatment. That includes diagnostic records and imaging, your treatment plan, the braces or aligners themselves, every scheduled adjustment visit, emergency visits for a broken bracket or a poking wire, and your first set of retainers at the end.
Replacement retainers and appliances lost or damaged along the way are billed separately, and we’ll always quote those before doing the work. See what drives the cost of treatment.
Get a Benefits Check at Your Free Exam
Call (925) 754-3197 in Antioch or (925) 513-9320 in Brentwood, or request an appointment. Bring your insurance information and you’ll leave with your coverage verified, your balance clear and a payment plan you’ve had time to think about.
Frequently Asked Questions
Delta Smiles offers flexible payment options, transparent pricing, and personalized financing solutions to help families throughout Antioch and Brentwood get the care they need without unnecessary financial stress.
Can I pay for braces monthly instead of all at once?
Yes, and most of our patients do. Our in-house plan spreads the balance across treatment with no interest, frequently with nothing down. The monthly amount depends on your case and your insurance, and you’ll know it exactly before you agree to anything.
Does insurance cover Invisalign as well as braces?
Many plans with orthodontic benefits cover Invisalign the same way they cover braces, up to your lifetime maximum. We’ll check exactly what your plan covers at your free exam.
Does insurance cover orthodontics for adults?
Some plans include adult orthodontic coverage, often at a lower percentage than for children, while others cover dependents only. Our team will review your benefits before treatment begins.
What if I don't have orthodontic insurance at all?
Plenty of our patients don’t. Uninsured families use the in-house payment plan, CareCredit, or an HSA, and start treatment on the same terms as anyone else. Not having coverage isn’t a reason to skip the free exam.
Do I have to use my benefits before they expire?
Lifetime orthodontic maximums don’t expire, but annual plan changes, job changes, and dependent age limits all can affect them. If you know your coverage is changing, tell us, and we’ll factor the timing into the plan.