Model of a mouth next to dental equiptment

Health Insurance for Orthodontic Treatment

Looking for health insurance to cover orthodontics? Find out what you will and won't be covered for.

Being blessed with perfect teeth is something we all want, but unfortunately only few of us can smile when speaking about their own. If you fall into this category, you’re likely to end up visiting an orthodontist. This is a specialist who can prep you for that perfect picture by straightening your teeth and jaw.

Orthodontic treatment generally involves the design and use of corrective appliances like braces and retainers, but can be rather expensive unless you have the right combination of private health cover.

Compare your extras options online or over the phone

Rates last updated December 7th, 2016
Details Features
Active Life Extras
Active Life Extras
Straightforward extras that covers you for vital out of hospital services while keeping premiums low. Treatments include general dental and optical, as well as healthy lifestyle benefits.
  • $500 general and major dental combined limit
  • $400 chiro and osteo annual limit
  • $400 physio annual limit
  • $400 alternate therapies annual limit
Get Quote More info
Extras 50
Extras 50
With the Extras 50 policy health.com.au will pay 50% of the provider's fee.
  • From $10.58 weekly
  • 50% back on extras
  • Unlimited emergency ambulance transport cover
  • $500 general dental limit
Enquire Now More info
Super
Super
Super Extras is the highest level of extras cover available from AHM and provides cover for services ranging from major dental to diet and nutrition to health improvement benefits.
  • No family limits
  • Orthodontics
  • Outpatient care
  • Pre and postnatal
Enquire Now More info
Premium Options
Premium Options
Premium extras cover for all everyday healthcare services. Save 4% when you pay for 12 months of your cover upfront.
  • Dental and chiropractic cover
  • Osteopathy and optical
  • Occupational therapy
  • Orthoptic
Get Quote More info
Platinum 80%
Platinum 80%
Platinum 80% provides you with 80% back on all included extras.
  • Claim up to $8500 on extras
  • General, complex and major dental and orthodontics
  • Pharmacy
  • Travel vaccinations
Enquire Now More info
Top Extras
Top Extras
Comprehensive extras cover that includes a wide range of non-hospital related treatments and services. Restricted fund: Only current and former employees of the Commonwealth Bank of Australia Group and their eligible families can join.
  • Generous overall limits on services
  • Major dental including orthodontics
  • Unlimited preventative dental
  • Hearing aids
Enquire Now More info
Gold Extras Set Benefits
Gold Extras Set Benefits
Top level extras cover including cover for a wide range of popular services including orthodontics, physiotherapy and optical.
  • Podiatry
  • Nursing
  • Pressure garments
  • Weight loss program
Enquire Now More info
Platinum Extras Cover
Platinum Extras Cover
Top level extras cover with highes range of cover for therapies and serivces.
  • 100% back on up to 2 dental visits per year
  • 100% back on initial chiro, physio, osteo
  • General therapies cover
  • Vaccinations and immunisations cover
Enquire Now More info
Top Extras
Top Extras
NIB's premier extras cover with up to $1,000 in General dental covered annually and cover for a range of therapies including Chiro & Osteo.
  • $1,000 general dental cover annual limit
  • $600 physiotherapy annual limit
  • Unlimited ambulance cover
  • $350 optical annual limit
Enquire Now More info
Top Extras
Top Extras
Top level extras cover with highest percentage back.
  • 60 - 100% back
  • $800 dental annual limit per person
  • $850 physiotherapy annual limit per person
  • $300 optical annual limit per person
Enquire Now More info

What type of health insurance do I need to claim for orthodontic treatment?

Orthodontics isn’t normally covered under your health care insurance, so to be fully protected and avoid any unwanted costs in the future, it’s vital you understand what extra policy options you’ll need to take out.

Orthodontic insurance can sometimes be included in your dental insurance, but it’s normally an add-on cost. This means you must double check how your existing policy covers you.

Here are the two types of dental insurance cover.

  • General Dental. This includes cleaning, plaque removal, x-rays and small fillings.
  • Major Dental. This covers orthodontic treatment and procedures, wisdom teeth extraction, crowns, bridges and dentures.

What is covered by the funds in the finder.com.au panel?

Health fundWhich policies include cover for orthodontics and what are the benefit limits*?Find out more
HIF LogoThe orthodontic benefit limit in HIF policies is a lifetime limit that form part of the overall annual limit. The limit also increases annually and caps after five years.

  • Premium Options. Annual limit starts at $1,500 and caps at $3,000.
  • Super Options. Annual limit starts at $1,300 and caps at $2,500.
  • Special Options. Annual limit starts at $1,000 and caps at $2,000.
More info
health.com.aulogo
  • High Extras. Annual sub-limit of $350. Overall limit for dental services is $750.
  • Middle Extras. Annual sub-limit of $350. Overall limit for dental services is $700.
  • Basic Extras. Annual sub-limit of $300. Overall limit for dental services is $600.
  • Simple Extras. Shared annual limit of $500 for all dental services.
  • Extras 50. Annual limit of $500.
More info
ahm
  • Super Extras. Annual limit of $900 with a lifetime limit of $2,900.
  • Family Extras. Annual limit of $700 with a lifetime limit of $2,200.
  • Lifestyle Extras. Annual limit of $600 for singles with no lifetime limit. No annual limit is applied to families, instead they have a lifetime limit of $1,800.
More info
Australian Unity
  • Gold Extras. Annual limit of $600 with a lifetime limit of $2,400.
More info
GMHBAThe orthodontic benefit limit in GMHBA policies start increasing after three years of holding cover with the amount capping after year ten.

  • Gold Extras. Annual limit starts at $450 and caps at $850. Lifetime limit is $2,900.
  • Silver Extras. Annual limit starts at $320 and caps at $570. Lifetime limit is $1,900.
More info
HCFAnnual and lifetime limits are increased if you visit an HCF More for Teeth provider.

  • Platinum Extras. Annual limit of $800 and lifetime limit of $2,400 for HCF providers. Limits for other dentists are $400 and $1,200 respectively.
  • Gold Extras. Annual limit of $700 and lifetime limit of $2,100 for HCF providers. Limits for other dentists are $350 and $1050 respectively.
More info
nib
  • Top Extras. Annual limit of $800 with a lifetime limit of $2,600.
  • Core Family Extras. Annual limit of $350 with a lifetime limit of $1,500.
More info
Transport Health Logo
  • Top Extras. Annual limit of $500 which increases to a maximum of $1,000 after five years. Lifetime limit is $2,500.
More info

*Unless otherwise stated all benefit limits are per person.

Benefit limit terms explained

  • Sub-limit. A sub-limit is the largest possible amount you can claim for a specific service, which is then deducted from a larger overall benefit limit. For example, your dental cover might include an overall benefit limit of $900 with sub-limits of $300 being applied to bridgework, endodontics and dentures. In this case, the maximum you could claim for any one of those services is $300.
  • Shared or combined benefit limit. This means that the benefit limit is shared amongst multiple services, rather than applying a limit to each one individually. While you are not restricted to claiming a capped amount like you are with sub-limits, your total overall benefit amount is spread over a wider range of treatments, so be sure not to claim excessively on one service and leave yourself without cover for others.
  • Lifetime benefit limit. This is the maximum amount you can claim for a service throughout your lifetime. Be aware that if you've reached your lifetime benefit limit with one insurer and switch to a new one, they may deduct that amount from your new policy. It is recommended that you check with your new provider to find out if these penalties apply.

Does private health insurance cover braces?

How much do braces cost in Australia?

The fee you will have to pay for braces varies greatly depending on the types of braces you require and the scope of the dental issues they are used to correct. However, as a general rule you can expect to pay anywhere from $2,000 up to around $9,000 for braces in Australia.

How does health insurance cover braces?

If you want health insurance cover for the cost of braces, you’ll typically need a high-level extras policy that includes cover for orthodontic treatment. The exact level of cover provided varies depending on the health fund and policy you choose, as annual limits and also lifetime limits apply to the cover available.

How much does Invisalign cost in Australia?

Invisalign is a hygienic and almost invisible way to straighten teeth. However, it tends to be more expensive than conventional braces. While costs vary depending on the complexity of your dental problems and your orthodontist’s consultation fees, costs generally range from $6,000 up to $9,000.

How does health insurance cover Invisalign?

If you have an extras cover private health insurance policy that includes orthodontics, your Invisalign treatment may be covered to the same level as traditional braces. However, it’s best to confirm the extent of cover available with your insurer and check any annual or lifetime limits that may apply.


What should I do if I need to claim orthodontic treatment?

Before you can start reaping the benefits from your orthodontic insurance, you’ll need to make a claim. To do this you’ll need to ask your specialist for a “treatment plan”. This will determine how long the procedure could take and how you intend to pay for the cost of the treatment.

Once you have this information you can send it to your insurer to see what benefits, if any, you’re eligible for. There are two options to start claiming benefits through your health fund. You can either pay by instalments or up-front.

  • Paying by instalments. Here your dentist or orthodontist can process your claim on the spot by swiping your HICAPS (Australia's leading health claims and payments service) card.
  • Paying up-front. If you choose to do this, you’ll need provide your fund with a tax invoice to claim benefits for the procedure.

What types of treatments are performed by orthodontists?

An orthodontist offers a range of procedures inside the mouth to help straighten your teeth or jaw. Problems are often found in young patients under the age of ten but issues can also be found much later in life.

These procedures can include the following.

  • Treatment assessment. Here your orthodontist or specialist will talk about what treatment is needed before making arrangements to begin.
  • Extractions and teeth removal. This is a preliminary procedure where your orthodontist will remove teeth to gain sufficient space to align remaining teeth.
  • Braces. This is the most efficient and accurate way of moving teeth and includes bands, brackets and wires, which are usually made of stainless steel.
  • Rubber bands and headgear. This accompanies your braces and gives important extra forces for the correction of the bite.
  • Length of treatment.  Usually takes 18 - 24 months. Some cases may be finished earlier and others may take longer.
  • Check-ups. This is an ongoing cost and will see your specialist regularly inspecting how the treatment has gone and if it has worked.
  • Retainers. This is when your braces are removed and retainers are fitted to hold your teeth steady in their new position. These appliances may be removable plates or wires fitted behind the teeth.

 

Why is orthodontic treatment expensive?

Orthodontic treatment can impose a major financial burden, because problems and procedures can be extremely complex. They also require expensive equipment to get the job done, like the cost of having an X-ray and imaging equipment, along with regular check-ups and orthodontic adjustments.

What information do I need to ask my dentist or orthodontist for?

You should ask your dentist or orthodontist the following questions before you begin treatment to straighten your teeth or align your jaw. Here are some questions to think about.

  • What is the total cost of your treatment? You must be aware of the full cost and how you will pay for it.
  • Is there a timeframe for your active treatment procedure? This is when your teeth are still being moved as opposed to them being retained (kept in place).
  • What item numbers will apply? This will give some insight into the cost and what procedures will take place. It will also include your dentist or orthodontist’s provider number.

How do limits and waiting periods apply to my policy?

Benefits differ between private health funds. Before they start you will in most cases have to serve a 12-month waiting period before you see any financial benefits returned. There are a number of private funds that will maximize your benefits the longer you are with them. This gives you an incentive to stay with that policy provider.

Here’s an example of an accrued benefit based on a policy with a starting limit of $500, which then increases by $200 every year after you have served the initial 12 month waiting period.

  • 1st year - $500
  • 2nd year - $700
  • 3rd year - $900
  • 4th year - $1100

Under this arrangement, your annual benefit will continue to increase until you reach the maximum benefit, or what is known as a “Lifetime Limit”. It is important to note that not all health funds have accrued benefits. Instead, some pay a fixed benefit each year.


What if my orthodontic treatment is provided by a general dentist?

Normally your fund will give the same amount of benefit back whether you see an orthodontic specialist or a general dentist. However, in some cases your insurer may pay a lower benefit if you see a dentist, so it’s important you speak to your provider about this.

Can I claim orthodontic treatment on my tax?

You can claim orthodontic dental work on your tax reform, but you must determine it to be more than ‘solely’ cosmetic surgery.

For example, if you have your teeth extracted and braces put on to help with crowded teeth, or your jaw aligned to help you chew or swallow properly - you can claim this on your tax return. You won’t qualify if you have your teeth whitened because of smoking stains.

The Australian Tax Office lumps dental expenses together with other medical expenses, so you can’t claim back every dollar you spend, but there are certain rebates to be mindful of.

If you have more than $2060 in total medical expenses (your total medical expenses minus Medicare and private health rebates) within one tax year, you can claim 20% of the amount above the total, as a deductible expense.

Learn more about how private health insurance is taxed

What happens to loyalty limits when I change health funds?

If you change health funds, your accrued benefits may not be carried over unless your fund agrees, but this is rare. In most cases, your benefit is not transferable and it could be lost if you switch providers. This could see you forced to start at the base benefit with your newly chosen private health insurer.

Compare policies from leading health insurance funds and avoid hefty dental bills

Dental and Orthodontic insurance gives you satisfaction that you won’t be left in the lurch before your next visit to your specialist.

For tips on how to find the right dental and orthodontic cover and skip paying the expensive costs, read this article before your next visit, or decision to switch funds.

Compare private health insurance policies and quotes from multiple funds

Health fundWhich policies include cover for orthodontics and what are the benefit limits*?Find out more
ahm
  • Super Extras. Annual limit of $900 with a lifetime limit of $2,900.
  • Family Extras. Annual limit of $700 with a lifetime limit of $2,200.
  • Lifestyle Extras. Annual limit of $600 for singles with no lifetime limit. No annual limit is applied to families, instead they have a lifetime limit of $1,800.
More info
Australian Unity
  • Gold Extras. Annual limit of $600 with a lifetime limit of $2,400.
More info
Bupa
  • Platinum Extras. Annual limit of $900 with a lifetime limit of $2,800.
  • Gold Extras. Annual limit of $800 with a lifetime limit of $2,600.
  • Silver Extras. Annual limit of $700 with a lifetime limit of $2,000.
  • Your Choice Extras. Annual limit of $450 after one year of holding cover. Increases each year until it caps at $900 after year seven. Lifetime limit of $1,300.
More info
cdhlogo
  • Gold Extras. Annual limit of $600 per policy with a lifetime limit of $2,500.
  • Silver Extras. Annual limit of $400 per policy with a lifetime limit of $1,800.
More info
cua
  • Gold Extras. Annual sub-limit of $1,250 which is deducted from an overall dental benefit limit of $2,000. Lifetime limit is $2,500.
  • Silver Extras. Annual limit of $520 with a lifetime limit of $1,500.
More info
GMHBAThe orthodontic benefit limit in GMHBA policies start increasing after three years of holding cover with the amount capping after year ten.

  • Gold Extras. Annual limit starts at $450 and caps at $850. Lifetime limit is $2,900.
  • Silver Extras. Annual limit starts at $320 and caps at $570. Lifetime limit is $1,900.
More info
Frank
  • Lots Extras Cover. Annual sub-limit of $380 which is deducted from an overall dental benefit limit of $2,000 for singles and $4,000 for couples/families.
  • Some Extras Cover. Annual sub-limit of $300 which is deducted from an overall dental benefit limit of $500 for singles and $1,000 for couples/families.
More info
gmflogoGMF orthodontic benefit limits increase after five years and finally cap at ten years.

  • Complete Extras. Annual shared limit starts at $850 and caps at $2,500.
  • Mid Extras. Annual shared limit starts at $850 and caps at $2,500.
More info
HBFPlease note that orthodontics and implants share a combined benefit limit.

  • Flexi Extras Plus. Annual limit starts at $1,700 and caps at $2,000 after four years.
  • Flexi Extras Mid. Annual limit starts at $1,400 and caps at $1,700 after four years.
  • Flexi Extras. Annual limit starts at $1,100 and caps at $1,400 after four years.
More info
HCFAnnual and lifetime limits are increased if you visit an HCF More for Teeth provider.

  • Platinum Extras. Annual limit of $800 and lifetime limit of $2,400 for HCF providers. Limits for other dentists are $400 and $1,200 respectively.
  • Gold Extras. Annual limit of $700 and lifetime limit of $2,100 for HCF providers. Limits for other dentists are $350 and $1050 respectively.
More info
health.com.aulogo
  • High Extras. Annual sub-limit of $350. Overall limit for dental services is $750.
  • Middle Extras. Annual sub-limit of $350. Overall limit for dental services is $700.
  • Basic Extras. Annual sub-limit of $300. Overall limit for dental services is $600.
  • Simple Extras. Shared annual limit of $500 for all dental services.
  • Extras 50. Annual limit of $500.
More info
hcilogo
  • Premier Extras. Annual limit of $900 with a lifetime limit of $2,700.
More info
logo health partners
  • Gold Extras. Lifetime limit of $500 after one year, $1,500 after two years and $2,500 after five years.
  • Silver Extras. Lifetime limit of $200 after one year and $1,000 after two years.
More info
HIF LogoThe orthodontic benefit limit in HIF policies is a lifetime limit that form part of the overall annual limit. The limit also increases annually and caps after five years.

  • Premium Options. Annual limit starts at $1,500 and caps at $3,000.
  • Super Options. Annual limit starts at $1,300 and caps at $2,500.
  • Special Options. Annual limit starts at $1,000 and caps at $2,000.
More info
latrobehealthlogo
  • Premier Gold and Family Care Gold. Annual limit of $300 after two years which increases each following year until it caps at $1,000 after ten years.
  • Premier Silver. Annual limit of $300 after two years which increases each following year until it caps at $667 after six years.
  • Premier and Premier Plus. Annual limit of $300 after two years which increases each following year until it caps at $600 after six years.
More info
 medibank
  • Top Extras. Annual limit of $400 with a lifetime limit up to $1,200.
  • Growing Family Extras. Annual limit of $100 with a lifetime limit up to $1,200.
More info
mildurahealthfundlogo
  • Five Star Extras. Annual sub-limit of $720 which is deducted from an overall dental benefit limit of $2,000. Lifetime limit is $2,000.
More info
onemedifundlogo
  • Extras Plus. Lifetime limit of $2,100 which increases to $2,600 after five years.
More info
nib
  • Top Extras. Annual limit of $800 with a lifetime limit of $2,600.
  • Core Family Extras. Annual limit of $350 with a lifetime limit of $1,500.
More info
peoplecare provider page link
  • Premium Extras. Annual limit of $1,000 with a lifetime limit of $3,000.
  • High Extras. Annual limit of $800 with a lifetime limit of $2,400. 
More info
phoenix health fund provider link
  • Top Extras. Annual limit of $1,200 with a lifetime limit of $2,400.
  • Mid Extras. Annual sub-limit of $1,000 which is deducted from an overall dental benefit limit of $1,500. Lifetime limit is $1,000.
More info
queensland country health fund provider link
  • Premium Extras. Annual limit of $1,000 which increases each year until it caps at $3,000 after three years of holding cover. Lifetime limit is $3,000.
  • Essential Extras. Annual limit of $500 which increases each year until it caps at $1,500 after three years of holding cover. Lifetime limit is $1,500.
More info
St. Lukes Health Logo
  • Super Extras. Annual sub-limit of $1,000 which is deducted from an overall dental benefit limit of $1,500. Overall lifetime limit is $2,800.
More info
Transport Health Logo
  • Top Extras. Annual limit of $500 which increases to a maximum of $1,000 after five years. Lifetime limit is $2,500.
More info
westfund provider link
  • Platinum Extras. Annual limit of $650 with a lifetime limit of $3,250.
  • Gold Extras. Annual limit of $500 with a lifetime limit of $2,500.
More info
CBHS Health Fund LogoRestricted fund**
  • Top Extras. Lifetime limit of $2,800.
More info
defencehealthlogoRestricted fund**
  • Premier Extras. Annual limit of $1,000 with no lifetime limit.
  • Value Extras. Annual limit of $800 with no lifetime limit.
More info
navyhealthlogoRestricted fund**
  • Premium Extras. Annual limit of $2,500.
  • Healthy Living Extras. Annual limit of $2,000.
More info
doctorshealthfundlogoRestricted fund**
  • Total Extras. Annual limit of $600 with a lifetime limit of $3,000.
  • Essential Extras. Annual sub-limit of $250 which is deducted from an overall dental benefit limit of $800. Lifetime limit is $1,250. 
More info
policehealthlogoRestricted fund**
  • SureCover Extras. Annual limit of $800 after two years which increases to $1,500 after four years. Lifetime limit is $3,000.
More info
rthealthlogoRestricted fund**
  • Premium Extras Cover. Annual limit of $1,000 with a lifetime limit of $3,000.
More info
rbhslogoRestricted fund**
  • Extras Cover. Annual limit of $890 which increases every year until it caps at the lifetime limit of $4,450 after five years.
More info
teachersRestricted fund**
  • Top Extras. Annual limit of $1,500 after three years, $2,000 after four years and $2,500 after five years.
More info
tuhRestricted fund**
  • Comprehensive Extras. Annual limit of $1,000 with a lifetime limit of $2,800.
  • Healthy Options Extras. Annual limit of $700 with a lifetime limit of $2,100.
  • Mid Range Extras. Annual limit of $550 with a lifetime limit of $1,650. 
More info

*Unless otherwise stated all benefit limits are per person.
**Restricted funds only provide cover to members of specific industries, groups and organisations. In some cases family members may also be eligible to join.

Benefit limit terms explained

  • Sub-limit. A sub-limit is the largest possible amount you can claim for a specific service, which is then deducted from a larger overall benefit limit. For example, your dental cover might include an overall benefit limit of $900 with sub-limits of $300 being applied to bridgework, endodontics and dentures. In this case, the maximum you could claim for any one of those services is $300.
  • Shared or combined benefit limit. This means that the benefit limit is shared amongst multiple services, rather than applying a limit to each one individually. While you are not restricted to claiming a capped amount like you are with sub-limits, your total overall benefit amount is spread over a wider range of treatments, so be sure not to claim excessively on one service and leave yourself without cover for others.
  • Lifetime benefit limit. This is the maximum amount you can claim for a service throughout your lifetime. Be aware that if you've reached your lifetime benefit limit with one insurer and switch to a new one, they may deduct that amount from your new policy. It is recommended that you check with your new provider to find out if these penalties apply.

Compare private health insurance policies and quotes from multiple funds

Picture: Shutterstock

William Eve

Will is a personal finance writer for finder.com.au specialising in content on insurance. While he cannot give personal advice to clients, Will enjoys explaining the intricacies of different types of protective cover to help individuals and businesses find affordable cover that won't leave them underinsured.

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