Search for “average braces price” or “average Invisalign price” and you’ll quickly realize why so many people have questions about insurance coverage. In short, these treatments aren’t cheap. The good news is that your Humana dental plan might include orthodontic discounts, which can save you some money. But not every insurance plan will cover braces and clear aligners.
As you compare treatments, you should study the details of your plan and understand how orthodontic benefits work. This guide is your starter on Humana’s general policies and how to take advantage.
Table of Contents
Humana Invisalign Coverage
Humana insurance plans don’t technically cover Invisalign or other orthodontics. However, they will often provide discounts if you go to an in-network dentist or orthodontist, and this includes Invisalign. The discounts will vary depending on the specific plan you choose but can be up to 20%. You’ll often find these discounts in the pricier, more comprehensive plans. Humana’s basic plans rarely provide coverage or discounts.
Even though it’s not traditional coverage, sometimes these discounts can be even better, since they might not incorporate age limits or lifetime spending maximums.
Other in-office clear aligner treatments like ClearCorrect may also be discounted because they’re very similar. Six Month Smiles might be classified differently because it usually treats mild, cosmetic cases, but you still might get a discount!
Humana Braces Coverage
Braces fall in the same boat as Invisalign. They’re not usually covered by Humana’s dental plans, but you could receive discounts at in-network orthodontists. These discounts might be minor, but they also might be better than the coverage provided by plans from other providers. It all depends on which plan you choose.
If you’re eligible for discounts, they’ll likely apply to any type of braces you choose — lingual, ceramic, self-ligating, etc. However, you’ll still want to check with your orthodontist and Humana to make sure.
Humana At-Home Clear Aligners Coverage
Humana has formed a partnership with Byte — our top rated at-home clear aligner provider — so they consider Byte in-network. However, having a qualifying plan doesn’t necessarily mean you’ll get the full 20% discount — or any savings for that matter.
Thankfully, Byte will handle all of your insurance communication and paperwork for you, so you can be sure you’re getting the most out of your benefits.
If you’re considering other home aligner providers, it’s still worth seeing if your treatment could be discounted. SmileDirectClub will do a coverage check on your behalf, but you’ll have to handle further paperwork on your own. For other remote providers, you’ll need to check your coverage yourself.
Average Costs Before Insurance
How much, exactly, will you pay for orthodontic treatment? Your final price is influenced by various factors, including your condition severity, your dentist’s or orthodontist’s fees, your location, and the type of treatment you choose. It’s tough to pin down your specific bill, but here are the average prices for different treatments.
Invisalign
Most adults seeking orthodontic treatment want discreet options. Invisalign is the brand that took clear aligners mainstream, offering less visible teeth straightening when compared to traditional braces. There are a lot of upsides to Invisalign but many patients rule it out due to its price — $3,000–$8,000 on average. Your exact cost depends on many factors, from the number of aligners you need to how many Invisalign cases your doctor has treated. Read through our true cost of Invisalign guide for a closer look.
Other In-Office Aligners
If you want clear aligner therapy, Invisalign isn’t your only option. Three excellent competitors to consider are ClearCorrect, SureSmile, and 3M Clarity. ClearCorrect has a typical price range of $3,000–$5,000, so it can save you a decent amount when compared to Invisalign. SureSmile also has a lower price range, at $2,000–$6,000, and offers more customization options than other companies. 3M Clarity won’t save you money but it has the widest scope of treatment, which might matter if your case is complex.
At-Home Clear Aligners
Some in-office aligners are more affordable than others, but all of them are pricey. If your goal is to find affordable clear aligner treatment, you might want to go remote. At-home clear aligner companies cut out the office visits and the associated fees, bringing their average cost down to $1,500–$2,500. Each company sets their own prices and most use flat-rate pricing, meaning everyone pays the same amount no matter how many aligners they need.
For example, SmileDirectClub is always $2,250, while AlignerCo is $995. Our top choice for at-home aligners is Byte, with a price tag of $1,999 for standard treatment and $2,399 for Byte At-Night. That isn’t the lowest price, but it delivers a lot of value, with multiple items included in their treatment bundle, a lifetime smile guarantee, and an average treatment plan length of just 4–5 months. Byte also takes over the entire insurance claims process for you, from paperwork to appeals. Check out our guide on insurance coverage with Byte for more info.
Braces
You might expect older methods of orthodontic treatment to be the most affordable. Sometimes, braces are cheaper than aligners, averaging $4,000–$6,000 for traditional options. However, when you go for newer styles, like lingual and self-ligating braces, you can end up with a $10k+ bill for treatment. See our guide on the true cost of braces.
What Does Dental Insurance Usually Cover?
Some things are generally true about dental insurance, but nothing ever applies across the board. Different insurance companies take different approaches, and coverage can vary between policies from the same provider. Always base your understanding of coverage on the terms laid out in your policy.
With that said, most likely, your policy will classify dental procedures into one of four categories — preventive, basic, major, and cosmetic — and establish rates of coverage for each.
Preventive treatments are nearly always covered, and many insurance companies will pay for 100% of their costs. Things like routine cleanings fall into this category, and paying for them can help you avoid more costly procedures down the road, which saves the insurer money. Basic procedures (fillings, root canals, gum disease treatment) are usually treated the same as preventative ones since covering them can help the insurance company turn a profit.
Major treatments are things like crowns and bridges. They tend to be covered, but not at a high rate — usually just 50% or less. Cosmetic treatments are almost never covered unless they are also restorative. Expect to pay the full cost for things like teeth whitening, tooth shaping, and veneers.
Which Category Does Orthodontics Fall Into?
At first, it seems like classifying treatments is easy: if it prevents or restores, it gets some level of coverage, and if it’s just cosmetic, it doesn’t. Even though orthodontics can fall into either category, it’s typically covered as medically necessary. However, there are some restrictions to know.
First off, having dental coverage does not mean having orthodontics coverage. If your policy doesn’t explicitly cover orthodontic care, you won’t get help from your insurance company, no matter how the treatment is classified. Also, orthodontic coverage is often limited to children and teens, and many plans have a lifetime limit.
Let’s assume your policy has adult orthodontic benefits and you haven’t hit your lifetime limit — will your company pay for treatment? Possibly. If your misalignment is causing or might cause problems, then it will likely be covered at 50% of the cost or less. But if you are making cosmetic changes, like closing a small gap, your insurance company might deny coverage.
Key Terminology to Know
Reading through your policy and deciphering the insurance jargon can be intimidating. However, if you understand a few key words and phrases, it should be easier to make sense of how much you’ll need to pay. Below are four terms to know.
- Premium: This is essentially the fee you pay to access a policy. Most people pay it once a year though semestral and quarterly payments are sometimes an option.
- Deductible: This is the dollar amount you must pay out-of-pocket towards covered expenses before insurance will step in to help with the bills. So if you have a $1,000 deductible and need a $500 procedure, and you haven’t paid towards your deductible yet, you will pay for the procedure in full.
- Copay: Short for copayment, this is a set dollar amount you will need to pay for office visits and procedures once you’ve met your deductible. The cost of your copay can vary based on the procedure.
- Coinsurance: While copays are a set dollar amount, coinsurance is a set percentage. Most companies will have you pay one or the other, but it is possible to have a policy with both.
- In-Network vs. Out-of-Network: Doctors who partner with your insurance company are in-network. If they don’t, they’re out-of-network. In-network providers are covered at a higher rate and they can file your insurance paperwork for you, while out-of-network providers are covered at lower percentages and leave you to file on your own.
How to Get Orthodontic Coverage with Humana
To get orthodontic coverage with Humana, you need a policy that includes it — and not all will. There are two ways to access a policy: through your employer or by purchasing one independently.
Most adults receive their coverage through an employer, either theirs or their spouse’s. Employer-sponsored plans come with two key financial advantages: your wages pay towards the premiums before being taxed, lowering what you owe come April, and your employer often will pay part of your premium as well. But there are drawbacks, too. You are limited to the plans your employer offers, if they offer any, and you have to wait for open enrollment to get a policy.
If your employer doesn’t offer a plan that suits your needs, you can purchase one individually on the insurance marketplace. This means paying for premiums in full and not saving on taxes, but it also means choosing from all the plans available and skipping the wait for open enrollment. Humana offers individual plans in most states, but we recommend shopping around, since other providers may offer more generous orthodontic benefits in your state.
Save on Orthodontics Without Traditional Insurance
For those without dental insurance or with a plan that doesn't cover orthodontic treatments, DentalPlans may offer an appealing alternative. This service helps connect individuals with dental savings plans, an option that can provide more flexibility than traditional insurance.
These plans, which offer potential savings of up to 20% on orthodontic treatments, are designed to meet the needs of those struggling with high out-of-pocket costs. DentalPlans takes into consideration your unique circumstances, to help identify the most suitable plan for your needs.
How to File a Claim
If your dentist is in-network with Humana, filing a claim is easy; you let them handle everything for you. If your provider is out-of-network, you will need to apply for your discount on your own or with the help of your HR department — and since Humana opts for the discount structure rather than outright covering treatment, expect a denial.
If you don’t go to an in-network dentist or orthodontist and you’re stuck filing your own claim, Humana has some resources that can help. You can find useful information about using your insurance benefits on their “Member Support” page and necessary dental claim forms on their “Documents and Forms” page.
Home aligner companies also might help you navigate getting your discount. Byte will handle the entire process, while SmileDirectClub will just run a check with Humana. Other remote aligner companies leave the process up to you.
Other Options if You’re Not Covered
What if you’re ready to get started with braces or aligners, but your current insurance plan doesn’t cover the treatment you want?
Start by turning to your Health Savings Account (HSA) or Flexible Spending Account (FSA) if you have one (or both). These accounts hold pre-tax income that you can apply toward qualifying expenses. Ask your account administrator about the limitations on using your funds for braces or aligners.
Keep in mind that you can apply funds even after using your Humana discount, and you can use funds from both accounts. Just don’t double-bill between policies and accounts.
But if you’re just going to take on the expenses on your own, you might look for ways to break it down, specifically financing plans. Most dentist and orthodontist offices have payment plans, as do all at-home aligner companies. Unless you go with Byte, SmiledirectClub, AlignerCo, or NewSmile, a credit check might be necessary to qualify.
There are also third-party companies that provide financing specifically for medical and dental expenses. Be sure to research these plans thoroughly before committing; since these options typically include interest, increasing the total cost — in some cases, significantly so.
Final Thoughts
If you’re still looking at your treatment estimate and stressing about numbers, remember that you might receive a discount through your Humana insurance. Even though they don’t cover orthodontics the same way other providers do, their discounts can still be helpful (and sometimes even better). And thanks to their partnership with Byte, you may even be able to access discounts for remote treatment.
If you haven’t enrolled in a dental insurance plan yet, make sure you do ample research on each option, especially if you’re considering orthodontic treatment. This way, you can be confident that you’ll receive assistance when it comes time for your braces or clear aligner treatment.
Frequently Asked Questions
Why are dental policies separate from health insurance?
The medical and dental fields have been separate from the start, with their own techniques, schools, and professional associations. Insurance simply followed their lead and treated them as separate as well.
Is it better to get a policy through an employer or on your own?
If your employer offers a policy that meets your needs and you can wait for open enrollment, then it will offer the best financial benefits. If your employer doesn’t offer dental plans or theirs aren’t a good fit, you have to weigh your options.
What is an open enrollment period?
It’s the time each year when you can begin, modify, or cancel an employer-sponsored insurance policy. Typically, it takes place in the fall, with policies and changes going into effect January 1st of the following year.
What is teledentistry?
This is a term that encompasses any dental or orthodontic services rendered remotely instead of in-person. This can be something short and simple, like a video chat check-in with your provider. It can also be as lengthy and complex as ongoing remote monitoring for aligner therapy.
What makes some insurance companies hesitant to cover at-home aligners?
It’s because of the lack of in-person visits, which leave a little more room for problems to go unchecked, especially invisible ones, like root resorption. Most complications are less likely with remote aligners because they only make small movements, but if they occur, it’s less likely they’ll be caught, too.
If I have orthodontics coverage, how much should I expect to pay out of pocket?
This depends on many variables, including:
- If you have met your deductible
- Your copay
- Your coinsurance
- If you have adult orthodontics coverage
- Whether or not you have and have met your lifetime limit
- The percentage of treatment covered
- The cost of your treatment
Even if Humana doesn’t cover every home aligner brand, could remote treatment be the better choice?
We suggest you see an in-network dentist to get a quote and have them find out what you can get discounted through Humana. Then compare that to the cost of at-home aligner companies, choosing the best fit for you. Be sure to have Byte and SmileDirectClub reach out to Humana on your behalf to see if your remote treatment could qualify for discounts. In some cases, remote options may still end up being more affordable even without coverage.
If my policy doesn’t include orthodontic coverage, can I add it on as a rider?
Your company can, depending on the insurance provider they work with. But as an individual, you cannot.
What are some of the reasons adults are denied orthodontic coverage?
The number-one reason is age: many plans exclude adults from coverage. Other common reasons are wanting to correct a cosmetic issue and having already reached their lifetime limit.
Kierstin A West says
What is your average coverage amount for invisilign aligners?
Smile Prep says
Hi Kierstin – our understanding is that Humana plans don’t ordinarily cover Invisalign treatment, but you may be able to get a discount on treatment with an in-network provider. With that said, we are a separate company and not affiliated with Humana, so you’ll be best off contacting Humana (or your employer’s HR representative if you are insured through your workplace) for details about your specific plan.