Orthodontic Insurance Is Different from Dental Insurance
Many patients assume their dental insurance covers orthodontic treatment the same way it covers fillings or cleanings. It typically does not. Orthodontic benefits are usually a separate component of your plan — with different rules, different maximums, and different waiting periods.
Here is how to navigate your benefits so you can get the most out of your coverage.
How Orthodontic Benefits Work
Most orthodontic plans offer a **lifetime maximum** — a fixed dollar amount the plan will pay toward orthodontic treatment, regardless of the actual cost. Common lifetime maximums range from $1,000 to $2,500 for adults and $1,500 to $3,000 for children.
Once that maximum is paid out, the benefit is exhausted — even if you later need a second round of treatment.
Key Questions to Ask Your Insurance Company
Before your consultation, call the member services number on your insurance card and ask:
1. Does my plan include orthodontic benefits? 2. What is my lifetime maximum for orthodontics? 3. Has any of my lifetime maximum been used? 4. Is there an age limit for coverage? (Many plans only cover patients under 18 or 19) 5. Is there a waiting period before orthodontic benefits kick in? 6. Does the plan cover Invisalign, or only traditional braces?
We Handle the Insurance Coordination for You
At Platinum Orthodontics, our team contacts your insurance company on your behalf, confirms your benefits, and applies them directly to your treatment cost. You do not have to figure it out yourself.
We also accept Denti-Cal (California Medicaid) for eligible patients, which covers orthodontic treatment for children who meet medical necessity criteria.
What If You Do Not Have Orthodontic Insurance?
Our all-inclusive pricing and flexible payment plans are designed to make treatment accessible without insurance. We offer low down payments and monthly payment options. Many of our uninsured patients pay less per month than they expected.
Book a free consultation and our team will walk you through exactly what coverage you have — and how to structure payment for whatever is left.