Does Dental Insurance Cover Invisalign and Braces in Canada?
If you're an adult in Canada considering straightening your teeth, you're probably wondering: Does dental insurance cover Invisalign? Or maybe you're looking for dental insurance that covers Invisalign for adults, or trying to find out if braces are covered by dental insurance at all.
Navigating dental insurance plans and understanding what’s actually covered, especially when it comes to orthodontic dental care services like Invisalign, braces, or retainers, can be overwhelming. Here’s a helpful guide tailored to answer all your key questions.
Are Braces Covered by Dental Insurance?
Yes, dental insurance can cover braces, but the level of coverage depends on your specific plan. Most group insurance plans through employers may include orthodontic coverage for children, and occasionally for adults too. However, individual dental insurance with orthodontic coverage is less common and may involve waiting periods or partial reimbursements.
Key Tips:
- Check for maximum lifetime coverage for orthodontics (e.g., $1,500–$3,000)
- Coverage often applies to traditional metal braces but may exclude cosmetic alternatives like Invisalign.
- Pre-authorization from the insurance company is often required.
Read More: Top 5 Types of Teeth Orthodontic Braces
The Hidden Hurdle: Orthodontic Waiting Periods
When searching for "dental insurance that covers Invisalign for adults", one of the biggest surprises is the waiting period. Insurance companies institute these policies to prevent customers from buying a plan simply to cover one expensive procedure and then cancelling it immediately after.
How Long is the Wait? For major dental services like orthodontics, the standard waiting period in Canada is 2 to 3 years from the date your policy begins. This means you must be a continuous, paying plan member for this duration before any orthodontic benefits (including the lifetime maximum) become active.
The Impact: If you enroll in an individual plan today with the intention of starting braces or Invisalign next month, your claim will be denied because the benefits are not yet active.
The Solution: The only way to bypass this is to enroll in a plan well in advance of your anticipated treatment start date. Always confirm the waiting period with your insurer before signing up.
Read More: 5 Proven Ways to Fix Misaligned Teeth
Orthodontics and the Medical Necessity Question
For both private insurance and the limited coverage under the CDCP, the difference between getting 50% coverage and getting zero coverage often hinges on one question: Is the treatment medically necessary?
Cosmetic vs. Functional: If you seek Invisalign primarily for aesthetic reasons (like closing small gaps or minor crowding), most private insurers, and definitely the CDCP, will classify this as cosmetic and deny coverage.
What Qualifies as Medically Necessary? Coverage is typically reserved for cases where the misalignment affects a major functional aspect of health, such as:
Severe bite problems (overjet, crossbite) impacting the ability to chew.
Conditions leading to severe gum disease or bone loss.
Jaw discrepancies that cause speech impediments.
- The HLD Index: The Canadian Dental Care Plan (CDCP) is particularly strict, limiting coverage to children under 18 who meet the criteria of a severe and functionally handicapping malocclusion as assessed by the Modified Handicapping Labio-Lingual Deviation (HLD) Index. This is a clinical measure that demonstrates the functional severity of the issue, not just the aesthetic look
Does Dental Insurance Cover Invisalign?
In many cases, dental insurance does not fully cover Invisalign, especially for adults. Invisalign is often considered a “cosmetic” treatment, which may limit your benefits. However, this is slowly changing as more insurance providers begin to recognize Invisalign as a viable orthodontic treatment.
Still, does dental insurance cover Invisalign for everyone? Not always. But if your plan includes orthodontic services, there's a chance you could get partial coverage.
Read More: How do you fix an overbite?
Dental Insurance That Covers Invisalign for Adults
Adults often have a harder time finding coverage for Invisalign. If you're searching for dental insurance that covers Invisalign for adults, focus on plans that:
- Include orthodontic care regardless of age.
- Mention Invisalign or “clear aligners” specifically.
- Offer at least partial reimbursement (usually 50%).
Plans from providers like Sun Life, Manulife, or Blue Cross may offer options, but be sure to read the fine print. If you're buying individual dental insurance with orthodontic coverage, confirm whether adult orthodontics (and Invisalign) are included before signing up.
Read More: Does Dental Insurance Cover Braces Cost?
Does Insurance Cover Retainers?
Retainers are often required after completing treatment with braces or Invisalign. So, does insurance cover retainers?
In most cases, yes, retainers are covered under orthodontic benefits, but usually only if they’re part of your initial treatment plan. Replacements may not be covered. It’s important to clarify this with your insurance provider ahead of time.
Read More: Orthodontics Specialty in Ontario
Maximizing Affordability: Tax Credits and HSAs
Even with a lifetime maximum from your dental insurance plan being reached, you have two major financial tools to make treatment more affordable:
Health Care Spending Accounts (HCSAs): If your employer offers an HCSA, you can use these funds (which are tax-free) to pay for any eligible medical or dental expense not covered by your primary insurance. This is essentially spending pre-tax money on your treatment.
Medical Expense Tax Credit (METC): The Canada Revenue Agency (CRA) allows you to claim eligible medical expenses, including out-of-pocket orthodontic costs for yourself, your spouse, and dependents. While this is a non-refundable tax credit, it can reduce your overall tax burden, especially in a year where you have significant expenses.
The Threshold: You can claim the portion of expenses that exceed the lesser of 3% of your net income or a set dollar limit (which is updated annually by the CRA). This credit can make a big difference in softening the final cost blow.
Rule: You can only claim the costs that were not reimbursed by insurance.
What About the Canadian Dental Care Plan (CDCP)?
Yes, as of 2025, the Canadian Dental Care Plan (CDCP) does cover limited orthodontic services, including braces and Invisalign, but only under specific conditions.
Read More: Orthodontic Insurance
CDCP Orthodontic Coverage Details
- Eligibility: Coverage is available to children under 18who meet strict medical criteria. The condition must be deemed a severe and functionally handicapping malocclusion, as assessed by the Modified Handicapping Labio-Lingual Deviation (HLD) Index. This index evaluates the severity of dental misalignment and its impact on oral function.
- Preauthorization Required: Orthodontic treatments must be preauthorized by the CDCP. This process involves submitting documentation to demonstrate the medical necessity of the treatment.
- Coverage Limitations: There are maximum spending limits for orthodontic services under the CDCP. The plan may cover a portion of the treatment costs, but patients might need to pay any additional charges directly to the provider.
- Cosmetic Treatments Not Covered: Orthodontic treatments pursued solely for cosmetic reasons, such as elective Invisalign for adults, are not covered under the CDCP.
Read More: How Long Do You Have to Wear Braces?
2026 CDCP Orthodontic Coverage Details
Income Eligibility | Mandatory: The patient's Adjusted Family Net Income (AFNI) must be under $90,000. Patients with AFNI between $70,000 and $90,000 may also have a 40% to 60% co-payment. |
Age Eligibility | Coverage is only available to children under 18. |
Medical Necessity | The condition must be deemed a severe and functionally handicapping malocclusion, as assessed by the Modified Handicapping Labio-Lingual Deviation (HLD) Index. |
Exclusions | Cosmetic treatments, such as elective Invisalign for adults, are not covered. |
Nest Step:
If you believe your child qualifies for orthodontic coverage under the CDCP:
- Consult with an Orthodontist: Schedule an appointment to assess whether your child's condition meets the medical criteria for coverage.
- Submit a Preauthorization Request: Work with your orthodontist to submit the necessary documentation to the CDCP for approval.
- Understand Potential Costs: Be prepared for possible out-of-pocket expenses, as the CDCP may not cover the full cost of treatment.
For more detailed information, refer to our page: CDCP coverage.
Read More: Kid Dental Clinic
How to Maximize Your Dental Insurance for Invisalign or Braces
Finding out if Invisalign is covered by insurance in Canada or are braces covered by dental insurance involves strategic steps. Don't rely solely on what your employer or policy booklet says. Being proactive will ensure you use every dollar of your orthodontic insurance coverage before your plan's lifetime maximum is reached.
Here are the key actions you must take to maximize your benefits:
Read More: Retainer After Invisalign
1. Get a Predetermination (Pre-Authorization)
This is the single most important step. Before starting any expensive treatment, ask your orthodontist to submit a detailed treatment plan to your insurance provider.
The Benefit: The insurer will send back a letter confirming exactly how much of the cost they will cover, how much you owe (co-payment), and whether your orthodontic insurance is currently active (i.e., if your waiting period is complete).
The Keyword Check: This letter confirms if your specific treatment (e.g., clear aligners vs. metal braces) qualifies under your dental insurance that covers braces plan.
2. Coordinate Benefits (If Applicable)
If you and your spouse or partner both have dental insurance that covers Invisalign for adults or children's braces insurance, you may be able to use both policies.
How it Works: The primary policy pays its portion (e.g., 50% up to the lifetime maximum). The secondary policy may then cover some or all of the remaining balance. This is the best way to significantly reduce your out-of-pocket costs.
3. Maximize Across Calendar Years
If your treatment spans multiple years (which most orthodontic cases do), ask your orthodontist to strategically schedule major payments.
The Strategy: Since the lifetime maximum is the total benefit paid over the life of your plan, spreading payments ensures you maximize any other ancillary benefits (like annual maximums for related procedures) that might reset on January 1st.
4. Ask About Financing and Discounts
Even the most comprehensive dental insurance for Invisalign will only cover a portion of the cost. You need a backup plan for the remainder.
In-Office Plans: Many clinics, including York Orthodontics, offer interest-free in-house payment plans that break the total cost into manageable monthly installments over the treatment period.
Courtesy Discounts: Ask about discounts for paying in full upfront, or for multiple family members starting treatment at the same time.
By taking these steps, you move beyond simply asking "does insurance cover braces in Canada?" and start taking control of your investment toward a confident smile.
Read More: Braces with Ceramic Brackets
Final Thoughts: Your Next Step Toward a Confident Smile
Finding the right dental insurance plan that covers Invisalign or braces, especially as an adult, requires research, but it's not impossible. While CDCP coverage does not currently support orthodontic services, many individual dental insurance plans with orthodontic coverage can help offset costs, at least partially.
Whether you’re comparing dental insurance plans, wondering does insurance cover retainers? or looking for Invisalign for adults in Canada, it’s crucial to talk to an experienced provider who can guide you.
At York Orthodontics, we specialize in Invisalign treatment, braces, and comprehensive orthodontic dental care services for patients of all ages. Our team can help you understand your insurance coverage and work with you to create a flexible, affordable treatment plan tailored to your needs.
FAQs
As of now, CDCP does not cover orthodontic services, including braces, Invisalign, or retainers. The plan currently focuses on preventive and basic dental care such as cleanings, fillings, and extractions. If you need orthodontic treatment, you’ll need to explore private dental insurance or pay out of pocket.
There is no official confirmation yet, but the government has indicated that CDCP may expand in future phases. However, at this time, Invisalign and other orthodontic dental care services are not included. Keep an eye on government updates or speak with your dental provider about coverage options.
Some private dental insurance plans do cover Invisalign for adults, but coverage is typically limited and depends on your specific policy. Many plans treat Invisalign as a cosmetic procedure, so only a portion (or none) may be reimbursed. Look for plans with orthodontic benefits that specifically include adult treatment and clear aligners.
Yes—retainers are usually covered if they are part of an approved orthodontic treatment plan (braces or Invisalign). However, if you lose or break your retainer and need a replacement, many insurance policies will not cover it. Always check your policy details or consult your orthodontist’s office to confirm.
Dental insurance typically covers routine care like cleanings, exams, and fillings. Orthodontic coverage is a separate benefit that pays for treatments like braces or Invisalign. Not all dental insurance plans include orthodontic services, especially for adults—so it's important to find a plan that specifically includes orthodontic benefits if you’re considering Invisalign or braces.
Yes, many dental insurance plans do cover braces, especially for children.
For adults, coverage is less common and often limited or partial.
Check your plan for orthodontic benefits and age restrictions.
Sometimes.
Insurance may partially cover Invisalign if your plan includes orthodontic benefits.
However, many plans treat it as cosmetic, especially for adults.
Always check if clear aligners are specifically included.