Is Adult Orthodontic Treatment Covered by Dental Insurance in Canada?

Yes, adult orthodontic treatment can be covered by dental insurance in Canada, though it is not guaranteed. While many provincial health plans rarely cover orthodontics for adults, many private dental plans offered through employers or individual policies do include these benefits.

Here are the key factors regarding adult coverage:

• Policy Specifics: Coverage is determined by each plan sponsor. Some group benefits include a specific orthodontic rider for adults, while others may restrict benefits to dependents under the age of 18 or 19.
• Treatment Types: Most Canadian plans treat Invisalign and traditional braces similarly, typically placing both under the same orthodontic benefit category.
• Lifetime Maximums: Unlike standard dental care, orthodontic benefits often have a lifetime maximum (typically between $1,500 and $3,000) rather than an annual limit. Once this cap is reached, no further benefits are available under that plan.
• Waiting Periods: It is common for insurers to require a 12-month waiting period before you can access orthodontic benefits.

We care about your smile and are here to help you navigate these complexities. In our judgement free space, we can assist you by reviewing your benefits booklet, submitting pre-treatment estimates, and exploring how to maximize your coverage by combining insurance with Health Spending Accounts (HSAs).

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