Does Medicare Cover Invisalign?

Once upon a time, the only options we had to straighten our teeth were braces.

Big, ugly, gaudy silver braces that were uncomfortable to wear and to look at. But things have changed. And we now have other options to help us get a winning smile with straight teeth.

One of the more popular options are clear aligners. These are molds that go over our teeth and slowly straighten them over time. And, unlike traditional braces, these aligners are removable. So you can take them out to eat, brush your teeth, etc.

The most well-known brand of invisible aligners is Invisalign. While there are other options on the market now, Invisalign is the one most orthodontists/dentists use.

This brings us to a common question many people have which is, “Does Medicare cover Invisalign?” In this article, we answer the question in clear, plain English. You will also find the average costs of Invisalign and other helpful info.

The short answer is no. Medicare will not cover the cost of Invisalign. That said, there may be some situations where you can get some coverage for orthodontic care. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay.

Original Medicare (Medicare Part A and Part B) does not provide coverage for Invisalign. If you want them, you will have to pay 100 percent for your Invisalign. Original Medicare typically does not provide coverage for orthodontic care. This includes aligners such as Invisalign.

However, Original Medicare may provide coverage for an orthodontic procedure if it is considered medically necessary. One of the ways an orthodontic procedure may be considered medically necessary is when a beneficiary experiences an accident or disease and needs a restorative orthodontic procedure.

In a case where the surgical orthodontic procedure requires a hospital stay; Medicare Part A may provide coverage for it.

Medicare Advantage plans (Medicare Part C) must offer the same coverage as Original Medicare. So the above applies to them as well. However, these plans also offer some coverage for things that Original Medicare does not.

For example, many Part C plans do offer dental coverage. However, this is usually for routine dental care. Coverage for braces and aligners are very rare in these plans.

That said, be sure to check the list of benefits or your Part C plan or those of Part C plans you’re considering closely. You may find some that have at least partial coverage for some orthodontic care.

How Much Does Invisalign Cost?

On average, Invisalign treatment cost in the $3,000 to $7,000 range. However, according to The Consumer Guide to Dentistry most of the time, people usually spend $5,000 or less for Invisalign treatment.

There are also other types of invisible aligners you can get. Many of these, which you can order from home, cost between $1,200 and $2,400.

Unlike braces, which can cost from $3,000 to $10,000, Invisalign treatment is less expensive. Plus, it has additional advantages over them. The main ones are they are not as noticeable as regular braces and are easily removable.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.