Extras policies for braces have a 12-month waiting period, so you may want cover sooner rather than later.
*Prices are based on a single person living in Sydney earning less than $90,000 a year.
Compare health insurance with orthodontics cover
This table lists some extras policies from Finder partners that cover orthodontics and braces. All have a 12-month waiting period before you can claim. All prices are based on a single individual with less than $90,000 income and living in Sydney.
Compare prices from 30+ Aussie funds in under 30 seconds.
What is orthodontics insurance?
Orthodontics insurance helps towards the cost of orthodontics treatments, such as braces, aligners and retainers. Cover for orthodontics is found in some extras health insurance policies. This is the type of health insurance you should be looking for if you want cover for orthodontics, as well as for services like optical and physiotherapy.
Just be aware, not every health insurance policy with dental covers orthodontics. Always pay close attention to the benefits and features included, and use Finder to compare policies side by side.
How does orthodontics insurance work?
Orthodontics is covered by extras health insurance. You pay a regular fee, known as a premium, and in exchange you can claim some money back whenever you spend cash on certain healthcare treatments.
You won't get 100% of the cost of your orthodontics treatments back. Health insurance will cover a percentage of the cost or a set amount, which will almost always be less than the total cost. The amount varies between funds, policies and treatments, but it will be listed in your product disclosure statement (PDS). For example, your fund might pay 80% of your bill up to a maximum of $800, or they might offer an flat $800 benefit.
Annual and lifetime limits
There are also annual limits and lifetime limits to be aware of when taking out health insurance for orthodontics. Annual limits are the amount you can claim back for orthodontics treatments in a year. Usually this is several hundred dollars, but it may increase the longer you hold your policy. Lifetime limits are how much you'll ever be able to claim for orthodontics treatments. Almost all funds have a lifetime limit on orthodontics that apply across funds. That means you won't be able to switch funds and access more orthodontics treatment, unless you buy a more comprehensive policy.
Every extras policy applies a 12-month waiting period before you can make a claim for orthodontics or braces. This prevents people from taking out health insurance, making a big claim, then cancelling right away. That said, some extras policies have no waiting period on general dental if you need basic dental care soon.
How much do braces cost without insurance?
Braces can cost anywhere from $4,500 to $15,000+ for a 12-24 month treatment, including the cost of regular consultations. The cost of braces varies significantly based on the type of treatment required, the time it takes to correct your teeth and the clinic or specialist you use. This table summarises a few of the quotes we were able to find online.
Type of Braces
Traditional metal braces
$4,500 – $9,000
$5,000 – $9,500
$7,500 – $15,000
$4,500 – $9,500
How to maximise your health insurance orthodontics benefits
With health insurance that covers orthodontics, you may be able to make a big dent in the cost of braces. As the treatment is spread over an extended period, you'll be able to claim your annual limit multiple times, once per year. For most health funds, benefit limits renew in January or July (check your PDS to be sure). Time it right and you may be able to max out 3 separate annual limits (up to your lifetime limit)
What limits are applied to orthodontics?
With extras insurance, each specific benefit has an annual limit. That means you won't be able to claim more than a certain amount every year. If your annual limit for orthodontics is $800, that's the most you'll be able to claim until your benefit limit resets. Limits usually reset in January, but some funds reset in June. Sometimes, your annual benefit may increase every year, for a certain number of years. For example, you may have $500 annual benefit which increases to $700 the following year and $900 the year after that. This isn't always the case, but it's something to keep an eye out for.
Most funds apply lifetime limits to orthodontics. That means, no matter how long you hold your policy for, you'll never be able to claim over a certain amount on orthodontics treatments. Importantly, this lifetime limit applies across funds. That means you won't be able to switch funds and access more orthodontic benefits. The only way to access more money back would be to take out a more comprehensive policy and increase your limit amount.
Are braces covered by Medicare?
Braces and orthodontics are not generally covered by Medicare - most dental treatment isn't covered by Medicare. While the Child Dental Benefits schedule does offer some dental coverage for kids, orthodontics and braces are specifically not eligible.
How to find the best health insurance for orthodontics
The best health insurance for orthodontics may be different depending on how much treatment you need done, what your budget is, and any other benefits you're likely to claim.
Follow these steps and they should help you find the best policy for you:
Compare online. Don't just go with a brand you recognise, or the one your best friend recommends. Compare online to find out which policy is right for you - you could save hundreds of dollars just by researching for a few minutes.
Look at annual limits. This is the most you'll ever be able to claim in a year for orthodontics. The higher the limit, the more you can claim. However, you'll also pay a higher premium.
Check lifetime limits. Insurers also apply lifetime limits to orthodontics. If you know you're going to have a lot of work done, be sure to check the lifetime limit as it's the most you'll ever be able to claim - no matter how long you hold a policy.
Percentage back. Just because you have an annual limit of $500, doesn't mean you'll be able to claim $500 back. That's because you can only claim back a percentage of your bill. Keep an eye out for higher percentages as it means you have to pay less on every bill.
Price. We all know price is important. Don't just go for the cheapest policy without comparing your options, as you might be able to find a better deal elsewhere. On the flipside, don't push yourself beyond your budget.
Other benefits. Extras policies come with heaps of benefits on top of orthodontics. You can get money off massages, physio appointments and even gym memberships. Take a look at what else is on offer to really make the policy work for you.
Which policies include cover for orthodontics and what are the benefit limits*?
*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.
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Frequently asked questions
Some health insurance policies include cover for braces, but not all of them. If you're looking for help with braces, you need to look for an extras health insurance policy which includes orthodontics cover. With orthodontics cover, you'll be able to claim back some of the costs related to braces. However, it's unlikely the full cost of your braces will be covered. Health funds will either pay a percentage of your bill or a set amount up to certain limits, which are generally lower than the total cost. Orthodontics generally hs a 12-month waiting period before you can claim.
Major dental policies typically cover orthodontics. GMHBA Mid Extras is our expert's pick for major dental because it is was the cheapest eligible policy in the market that covers major dental treatments. Keep in mind that if your main concern is how much of the costs it will cover, there are more comprehensive but expensive plans.
No. Unfortunately major dental, which includes orthodontics and braces, always has a 12-month waiting period. You can skip waiting periods on general dental though. This can include x-rays, examinations, tooth extractions and minor restorative services such as fillings.
Braces are expensive, and can cost between $4,500 and $15,000 for a 12- to 24-month treatment. Medicare will not cover the cost, so you'll need to pay out of pocket or take out health insurance for braces and orthodontics.
Orthodontics is usually defined as specialist dentistry treatment which aligns teeth and jaws. Treatments include braces, plates and retainers. You may need orthodontic treatment for crooked teeth, a bad bite, gaps between your teeth, teeth that stick out, or even if you have issues speaking, breathing or chewing. In addition to more traditional braces, Invisalign should also be covered by health insurance with orthodontic benefits. Just be aware, Invisalign can be more expensive than traditional methods for similar treatments, so you could be left with greater out-of-pocket expenses.
All orthodontic health insurance policies have a 12-month waiting period. Waiting periods are applied to orthodontics because orthodontics treatments can be a major expense. If there was no waiting period, there is a risk people would sign up to a health fund just to make a claim worth several hundred dollars and then leave after a week. If that happened, health funds would quickly start losing money and would have to put the price of their policies up for everybody else, making them unaffordable.
Nicola Middlemiss is a contributing writer at Finder, with a special interest in personal finance and insurance. Formerly a business and finance journalist, Nicola has written thousands of articles helping Australians better understand insurance and grow their personal wealth. She has contributed to a wide range of publications, including Domain, the Educator, Financy, Fundraising and Philanthropy, Insurance Business, MoneyMag, Mortgage Professional, Yahoo Finance, Your Investment Property, and Wealth Professional. Nicola has a Tier 1 General Insurance (General Advice) certification and a Bachelor's degree from the University of Leeds.
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