dentist talks to a male teenage patient about metal braces while he looks at mirror

Understanding orthodontic coverage: Braces, clear aligners, and beyond

A straighter smile isn’t just about appearance, it plays an important role in how you chew, speak, and maintain long-term oral health. Orthodontic treatment, whether traditional braces or clear aligners like Invisalign, can help improve both function and confidence.

If you’re considering treatment, understanding how your dental plan pays for orthodontics can help you plan ahead. While dental plans can vary on how they cover this, below is how Delta Dental of Tennessee pays for orthodontic services.

What counts as orthodontic treatment?

Orthodontic services, often referred to as “ortho,” are treatments used to correct misaligned teeth or bite issues. These services can include:

  • Braces

  • Retainers

  • Other orthodontic appliances

  • Clear aligners, like Invisalign

While the type of treatment may vary, coverage and payment structure generally work the same way.

Do You Need a Referral?

With Delta Dental of Tennessee plans, no referral is required to visit an orthodontist. Both general dentists and orthodontists can provide orthodontic treatment, so you can choose the provider that’s right for you.

You can locate a participating Delta Dental orthodontist by utilizing our Find a Dentist tool.


How orthodontic treatment is paid

Orthodontic care is typically paid differently than routine dental services. Instead of a one-time payment, coverage is spread out over the course of treatment.

Here’s how it works:

  • Your provider submits an orthodontic treatment plan before treatment begins

  • Once treatment starts, an initial payment is made

  • Monthly payments continue throughout treatment

Payments continue until either:

  • Treatment is complete, or

  • The plan’s lifetime orthodontic maximum is reached

If treatment has already started

If you started orthodontic treatment before enrolling in your current plan, coverage may still apply, but only moving forward.

In these cases:

  • Payments are made only for the months you’re covered under the plan

  • The original treatment cost is recalculated to determine remaining payments

  • Any fees incurred before coverage (like initial banding fees) are not included in payment calculations

Understanding coverage limits

Orthodontic benefits are not included in every dental plan and often come with specific limitations.

In many cases:

  • Orthodontics are considered a Class IV benefit

  • Coverage may be limited by age (commonly up to age 19)

  • A lifetime maximum applies per member

Because coverage varies, it’s important to review your specific plan details before beginning treatment.

 

 How to check what your plan covers

The best way to understand your orthodontic benefits is to review your plan information. You can:

  • Check your Summary of Dental Plan Benefits

  • Log in to your Member Portal

  • Contact customer service for help reviewing your coverage

A quick note before you start

Orthodontic coverage applies to select plans and may include limitations or exclusions. We strongly recommend requesting a pre-treatment estimate so you know what to expect before treatment begins.

Plan ahead for a healthier smile

Orthodontic treatment is a long-term investment in your health. By understanding how your plan pays for care, and confirming your coverage ahead of time, you can move forward with confidence and avoid surprises along the way.

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