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Health insurance for orthodontics
You will need an adequate extras health insurance policy to be covered for orthodontics treatments.
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*Prices updated September 2024, in line with Finder's database of health insurance policies. Prices reflect the cheapest available for a single individual with less than $97,000 income and living in Sydney with a $750 excess.
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Each month we analyse over 10,000 extras insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare extras cover a bit faster.
We want to compare apples to apples, not apples to apple pie. It doesn't make sense to compare a top extras policy with coverage for hearing aids and braces against a policy designed only for dental. So we've separated all the extras policies on the market into pools and categories. Once in their pools and categories, each product gets a price score and a features score, which are then combined to give the Final Score.
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. Be aware, not all extras policies that cover dental will cover orthodontics. You need to look for the actual word 'orthodontics' when checking the policy inclusions.
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.
Benefit amounts
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.
Waiting periods
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.
"If you have kids, take note of any waiting periods for orthodontic cover. My kids are enterting their teens so I made sure to make orthodontic cover part of my BUPA extras. With a 12-month waiting period, changing it well in advance will ensure you have it ready to go when the time comes."
Braces can cost anywhere from $6,000 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 costs you could be up for. This should be used as guide only as your own quote would differ based on your personal needs.
Type
Cost estimate
Metal braces (traditional braces)
$6,000 – $9,000
Ceramic braces
$6,500 – $9,500
Lingual braces
$9,500 – $15,000
Clear aligners
$6,500 – $9,500
What limits are applied to orthodontics?
Annual limits
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.
Lifetime limits
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.
FAQs
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.
An extras policy that includes orthodontics. In terms of the best provider, this will depend on your personal needs and what you can afford. You should also consider what waiting periods apply to each policy and if there's any promotions running that offer discounts on the premium as a whole.
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 $6,000 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.
Tim Bennett is a Finder insurance & utilities expert. For over 10 years he's reported on news, politics, finance and other topics as a journalist and radio presenter. Tim's roles have included radio news reader and breakfast at the ABC, news producer for SBS and producer for Fairfax Media. Tim regularly appears as a health insurance expert on programs like Sunrise and SBS news, as well as in the Australian, The Daily Telegraph, The Courier Mail and more. See full bio
Tim's expertise
Tim has written 121 Finder guides across topics including:
Peta Taylor is a publisher at Finder, working across all of insurance. She's been analysing product disclosure statements and publishing articles for over 2 years. Peta is passionate about demystifying complex insurance products to help users make well educated decisions with confidence. Peta is part of Finder's insurance awards team and works alongside editorial and insights experts to bring users the best insurance products every year. See full bio
We’ve got all the info on what endodontics services are, how Australian health insurance providers handle them and what policies will cover you.
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Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
