Navigating orthodontic insurance in Canada can be complex, but we are here to help you understand how your benefits apply to adult treatment. Generally, coverage for adults depends on the specific type of plan you have:

• Employer-Sponsored Group Plans: These are the most common source of benefits for adults. While many plans focus on dependents, some do include adult orthodontic coverage. These plans typically cover about 50% of treatment costs after a deductible is met, up to a lifetime maximum that often ranges from $1,500 to $3,500.
• Individual or Private Plans: These may offer an optional orthodontic rider for an additional premium. However, be aware that these often have strict age limits (frequently only covering those under 19) and waiting periods of up to 12 months.
• Health Spending Accounts (HSAs): If your employer provides an HSA, this is an excellent option for adults. Orthodontic treatment is a tax-free eligible expense under CRA guidelines when prescribed by a dentist. You can use these funds to cover Invisalign or braces, as well as any deductibles or co-pays not covered by traditional insurance.
• Canadian Dental Care Plan (CDCP): Currently, the CDCP does not cover adult orthodontics unless there is an exceptional, medically necessary circumstance. It primarily focuses on essential dental services and excludes purely cosmetic treatments.

At our practice, we provide personalized dental solutions and complete dental care all under one roof. We can submit a pre-treatment estimate (predetermination) to your insurer to confirm exactly what they will pay before you begin. To bridge any remaining gaps, we offer flexible Invisalign payment plans and direct insurance billing to make your treatment as stress-free as possible.

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