Health insurance for orthodontics and braces

Creating that perfect smile is a great investment, but wouldn't it be nice if you had a little help? Luckily, many health insurers will cover braces, aligners, retainers and other orthodontic treatments.

With the right policy, you can get up to $3,000 to help with the costs. A new policy will come with a 12-month waiting period, so you better get searching if orthodontics are on your horizon.

Compare health insurance for orthodontics and braces

Below you'll find a few options from Finder partners who offer orthodontic treatment as part of extras cover. All include a 12 month waiting period and all prices are based on a single living in Sydney.

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Name	Product	Teeth Alignment	Braces	Annual Limit	Price Per Month	Hide CompareBox
Medibank Growing Family Extras Only 60				$100	$48.90		Go to Site More Info	Compare	loading Fetching your data...
health.com.au Extras 50				$500	$50.68		Go to Site More Info	Compare	loading Fetching your data...
ahm lifestyle Extras				$600	$52.05		Go to Site More Info	Compare	loading Fetching your data...
Qantas Family Extras				$600	$54.29		Go to Site More Info	Compare	loading Fetching your data...
HCF Vital Extras				$700	$57.70		Go to Site More Info	Compare	loading Fetching your data...
AAMI Everyday Active Extras				$500	$62.64		Go to Site More Info	Compare	loading Fetching your data...
Suncorp Mid Extras				$500	$64.26		Go to Site More Info	Compare	loading Fetching your data...
Peoplecare High Extras				$800	$88.10		Go to Site More Info	Compare	loading Fetching your data...

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Just make sure to select comprehensive dental cover when asked 'what's most important to you?' below.

Guide to Orthodontics

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

Orthodontics isn’t usually covered under your health care insurance, so it's vital you understand what extra policy options you will need to take out.

Orthodontic insurance may be included in your dental insurance, but it’s usually an add-on cost.

There are 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.

• 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 fund and switch to a new one, they may deduct that amount from your new policy. It is recommended that you check with your new fund to find out if these penalties apply.

Does dental insurance cover braces?

How much do braces cost in Australia?

The fee you will have to pay for braces varies greatly depending on the type 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, the price generally ranges 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 fund 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 fund 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 to 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 10 but issues can also appear 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 is going and whether 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 maximise your benefits the longer you are with them. This gives you an incentive to stay with that fund.

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 – $1,100

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 fund may pay a lower benefit if you see a dentist, so it’s important you speak to your fund about this.

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 funds. This could see you forced to start at the base benefit with your newly chosen health fund.

Other health funds that cover orthodontics

Health fund	Which 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	Advanced 80% Extras. Annual limit of $800 with a lifetime limit of $2400 Classic Extras. Annual limit $600 with a lifetime maximum of $2400 Comprehensive Extras. Up to 100% back with a lifetime maximum of $2400	More info
Bupa	Top Extras 90. Annual limit of $900 with a lifetime limit of $2800. Top Extras 75. Annual limit of $800 with a lifetime limit of $2600. Top Extras 60. Annual limit of $700 with a lifetime limit of $2000. Your Choice Extras 60. Annual limit starts at $450 for first two years and increases each year after, capping at $900. Lifetime limit of $1300.	More info
CUA	Total Extras. Annual limit of $900 with a lifetime limit of $2500. 75% Extras. Annual limit of $800 with a lifetime limit of $2000. Classic Extras. Annual limit of $500 with a lifetime limit of $1500.	More info
GMHBA	Top Extras 75% & Top Extras Set Benefits. Annual limit starts at $700 and caps at $1,000. Lifetime limit is $3,200. Mid Extras 65% & MID EXTRAS Set Benefits. Annual limit starts at $400 and caps at $700. Lifetime limit is $2400.	More info
Frank Health Insurance	More Extras. Annual limit of 600 with a lifetime limit of $1800. Lots extras (80% & 50% back) Annual limit starts at $700 and caps at $900 after 5 years. A lifetime limit of $2,900 applies for orthodontic services if more than one course of treatment is needed.	More info
HBF	Top 70. Annual limit of $800 with a lifetime limit of $2400. Complete 60. Annual limit of $600 with a lifetime limit of $1800.	More info
HCF	HCF TOP EXTRAS. HCF Top Extras. Annual limit of $800 with a lifetime limit of $2400. HCF VITAL EXTRAS. Annual limit of $700 with a lifetime limit of $2100.	More info
Health.com.au	Active 60. Annual limit of $600 with a lifetime limit of $1800. Extras 50%. Annual limit of $500 with a lifetime limit of $1000.	More info
Healthcare	Premier Extras. Annual limit of $900 with a lifetime limit of $2,700. Healthy Extras. Annual limit of $600 with a lifetime limit of $1800.	More info
Health Partners	Freedom Max Extras. Annual limit starts at $900 and caps at $2000 after 4 years. Maximum yearly amount, less previous amounts claimed. Lifetime limit is $2,000.	More info
HIF	The orthodontic benefit limit in HIF policies is a lifetime limit that forms part of the overall annual limit. The limit also increases annually and caps after 5 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
Hunter	Elite Extras. Annual limit of $600 with a lifetime limit of $2500 Optimum Extras. Annual limit of $400 with a lifetime limit of $1800. Classic / Healthy Extras. Annual limit of $200 with $2400 lifetime limit.	More info
Latrobe	Premier Extras. Annual limit of $900 after 2 years which increases each rolling year until it caps at $3,000 after 10 years. Premier Singles and Couples. Annual limit of $750 with a lifetime limit of $2,400. Premier Families Extras. Annual limit of $750 with a lifetime limit of $2400. Core Extras. Annual limit of $900 after 2 years which increases each following year until it caps at $1800 after 10 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
Mildura Health Fund	Five Star Extras. Annual limit of $800 with a lifetime limit of $2400.	More info
onemedifund	Comprehensive Extras. Lifetime limit of $2100.	More info
nib	Top Extras. The annual limit starts at $800 and increases by $100 per person per calendar year. Lifetime limit of $2600.	More info
Peoplecare	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
Queensland Country Health Fund	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
stlukeshealth	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	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 health insurance	Ultimate Extras. Limit builds up to $650 per member per policy year, to use on orthodontics with a maximum accrued lifetime benefit of $3250. Advantage Pro Extras. Limit builds up to $500 per member per policy year, to use on orthodontics with a maximum accrued lifetime benefit of $2500.	More info
CBHS Health Fund Restricted fund**	Top Extras. Lifetime limit of $2,800. Intermediate Extras. Annual limit of $700 with a lifetime limit of $1400.	More info
Defence Health Restricted fund**	Premier Extras. Annual limit of $1,000 with no lifetime limit. Value Extras. Annual limit of $800 with no lifetime limit.	More info
Navy Health Restricted fund**	Premium Extras. Annual limit of $2,500. Healthy Living Extras. Annual limit of $2,000.	More info
Doctors Health Fund Restricted 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
Police Health Restricted fund**	Rolling Extras. Annual limit of $1500 with lifetime limit of $3,000.	More info
rt health Restricted fund**	Premium Extras Cover. Annual limit of $1,000 with a lifetime limit of $3,000.	More info
rbhs Restricted fund**	Extras Cover. Annual limit of $890 which increases every year until it caps at the lifetime limit of $4,450 after 5 years.	More info
TUH Restricted 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. Family Extras. Annual limit of $850 with a lifetime limit of $2550. Everyday Extras. Annual limit of $700 with a lifetime limit of $2100.00	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.}

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