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Insurance Plans We Accept
We work with all major PPO dental plans and bill claims on your behalf as a courtesy. Carriers we regularly coordinate with include:
- Delta Dental
- Cigna
- MetLife
- Aetna
- Anthem Blue Cross
- Blue Shield of California
- United Healthcare
- Guardian
- Humana
- Principal Financial
- Ameritas
- Premier Access
Do not see your plan listed? Call 510-796-1793 with your member ID. We will verify your benefits at no cost and usually get answers back within 24 to 48 hours.
A quick note on plan types:
- PPO plans: We bill your insurance directly and you typically receive your full out-of-network benefit. Most patients pay roughly the same as they would at an in-network office.
- DHMO plans: These usually require treatment with an in-network provider and may not extend benefits to BirchTree. If your plan is DHMO, we will tell you upfront so you can decide.
- Denti-Cal: We do not accept Denti-Cal at this time. We can refer you to a participating provider if needed.
How Orthodontic Insurance Typically Works
Orthodontic coverage works differently from regular dental coverage. Here is what you should know before treatment starts.
Lifetime maximum benefit. Most dental plans cap orthodontic benefits between $1,000 and $3,000 per person. This amount applies once over your lifetime, not annually.
Coverage percentage. Plans typically pay 50 percent of orthodontic charges up to the lifetime maximum.
Dependent age limits. Many plans only cover orthodontics for dependents under age 19. Adult orthodontic coverage is becoming more common but is still less standard. We confirm your specific plan rules during verification.
Waiting periods. Some plans require 6 to 12 months of enrollment before orthodontic benefits begin.
Dual coverage. If your child is covered under two parents’ plans, we can coordinate benefits so both plans contribute. This often reduces out-of-pocket cost meaningfully.
Free Insurance Verification
Before you commit to treatment, we will:
- Contact your carrier to confirm your specific orthodontic benefits
- Calculate exactly what your plan will pay
- Give you a written estimate of your remaining out-of-pocket cost
- Walk you through your payment options
No charge, no obligation, no high pressure follow-up.
Payment Options Without or Beyond Insurance for Braces / Invisalign
Whether your insurance covers part of treatment or none of it, we offer several ways to make orthodontic care affordable.
- 0% interest in-house financing. Pay a portion at the start, then spread the balance across your treatment timeline with no interest. No third-party lender, no credit check.
- Cash discount. Pay the full treatment fee upfront and receive a discount.
- ACH auto-debit discount. Set up automatic monthly payments from your bank account and receive a discount.
- FSA and HSA. Orthodontic treatment is an eligible expense under both Flexible Spending Accounts and Health Savings Accounts. Pay with your FSA or HSA card directly, or set up auto-debit from those accounts.
- Credit card or check. Accepted for full payment or monthly installments.
- Family discount. Multiple family members in active treatment receive a discount on the second and subsequent cases.
Our Pricing Promise
Three commitments we make to every patient:
- No upsells. We only recommend treatment that is clinically necessary. If observation or no treatment is the right answer, we will tell you.
- No surprises. Your written estimate at the first visit is the price. The only exception is a mid-course change in scope, which we will discuss with you in advance.
- No pressure. Take the estimate home, compare, ask questions. We are happy to be your second opinion.
Dr. Sharma treats your hard-earned money the way she treats her own.
Frequently Asked Questions
Do you accept my PPO insurance?
We accept all major PPO dental plans. Call 510-796-1793 with your member ID and we will verify benefits at no cost.
What if my plan does not cover orthodontics?
Many of our patients have no orthodontic coverage. We offer 0% in-house financing so you can spread payments across your full treatment timeline, with no credit check and no interest.
How much does insurance typically cover?
Most plans pay 50 percent of orthodontic fees up to a lifetime maximum of $1,000 to $3,000. The exact amount depends on your plan. We verify this for you before you start treatment.
Can I use my FSA or HSA for braces or Invisalign?
Yes. Orthodontic treatment is a qualified medical expense under both FSA and HSA rules. You can pay your full treatment fee or your monthly installments using FSA or HSA funds.
Can I combine two insurance plans?
Yes, if you or your child are covered under two dental plans, we coordinate benefits so both plans contribute toward your treatment.
For children covered under both parents’ plans: Most carriers follow the Birthday Rule. The parent whose birthday (month and day, not year) falls earlier in the calendar year provides the primary plan. The other parent’s plan is secondary. Court orders for divorced or separated parents can override this rule.
For adults covered by their own plan and a spouse’s plan: Your own employer’s plan is primary for you. Your spouse’s plan is secondary.
Once primary pays, the secondary plan covers a portion of the remaining balance based on its own coordination rules. Combined benefits will not exceed the total cost of treatment, and each plan’s lifetime orthodontic maximum still applies on its own.
Coordination of benefits is one of the trickier parts of orthodontic billing. Please call our office at 510-796-1793 with both insurance cards on hand, and we will walk you through exactly what each plan will cover and what you will owe.
Does insurance cover Invisalign the same as braces?
Most plans treat Invisalign and traditional braces identically for coverage. A small number of older plans still exclude clear aligners specifically. We confirm this for your plan during verification.
How are payments structured?
A typical structure is a portion of the total fee at the start of treatment, followed by monthly installments across your active treatment time, usually 18 to 24 months.
Ready to find out what you owe?
Call 510-796-1793 or book a free consultation. Bring your insurance card. You will leave knowing exactly what your treatment will cost.