Health insurance for orthodontics
Why take out orthodontics cover?
When you take out extras cover that includes orthodontic benefits, you could significantly reduce the out-of-pocket costs for treatment like braces and retainers. Here are a few other reasons to consider an extras policy with orthodontic insurance:
- Australia’s public health system (Medicare) doesn’t pay towards the cost of most dental services, including orthodontist appointments. Without insurance, you’ll have to pay the full cost out of pocket.
- A health insurance policy with cover for orthodontics will typically also include other types of treatment like major dental, general dental and endodontics.
- Taking out cover could be cheaper than you think with the Australian Government rebate.
Choosing cover for orthodontic treatment
If you’re interested in taking out a policy for orthodontic dental benefits, the best way to choose a policy is to compare your options side by side. Here are a few things to think about while you browse:
- Treatment plans. Some health funds will require a treatment plan outlining the total cost for your course of orthodontics and how you’ll pay before providing a benefit.
- Other extras services. You’ll rarely find an extras policy that only includes dental care, so make sure you’re happy with the other services provided like physiotherapy and optical.
- Types of orthodontics. Some health funds may have exclusions for certain types of orthodontics, so if you have a specific brand’s product in mind (e.g. Invisalign), make sure it’s included before taking out cover.
Private health cover for orthodontics
Does health insurance cover orthodontics?
Yes, with the right level of extras cover, your health fund will be able to pay some of the cost of orthodontic dental treatment. Due to the high cost of orthodontic dentistry, these services are typically only covered by high to top extras policies.
Depending on your level of cover, an extras policy can also pay towards other dental costs like x-rays, fillings and wisdom tooth extractions. These services are typically classified under major or general dental, although each health fund can choose how they group their cover.
Limits and waiting periods
When you take out cover for the first time or upgrade your policy, you’ll need to serve a waiting period before you can claim on the new cover included on your policy. For extras cover, these waiting periods vary between funds. However, the waiting periods for orthodontics are typically 12 months or longer.
Health funds will also impose limits on how much you can claim for a particular extras service. There are several different types of limits that you might come across, including:
- Annual limit. This is the maximum amount you’re able to claim on an individual item within a year. This can be based on the calendar year, financial year or policy anniversary.
- Lifetime limit. This is the maximum you can claim over the life of your policy. In many cases, this will carry across funds, so switching won’t refresh your lifetime limit.
- Group limit. This is a limit on the amount claimable across a group of services; for example, you might have a group limit shared by general and major dental.
Cost of orthodontics without insurance
According to the Australian Dental Association, the average cost of a full course of orthodontics by a specialist orthodontist was $8,621 in 2022.1 However, the total cost of your braces will depend on several factors like your state of residence, the length and complexity of your treatment and the type of braces you get.
Below are some of the most common types of braces and a range of their costs without insurance:2
| Types of braces | How they work | Cost range |
|---|---|---|
| Metal braces | The most common type of braces, consisting of metal brackets attached to the front of the teeth joined by metal wires. | $6,000 – $9,000 |
| Ceramic braces | These are similar to metal braces, but they use clear brackets and wires for a more subtle look. | $6,500 – $9,500 |
| Lingual braces | These braces are fixed to the backs of your teeth and can’t be seen from the front. They’re the most subtle visually but are likely to affect your speech. | $9,500 – $15,000 |
| Clear aligners | This treatment involves a series of clear custom aligners worn to slowly ease your teeth into a new position. | $6,500 – $10,000 |
Are orthodontics covered by Medicare?
No, orthodontics aren’t covered by Medicare. This means that without private health insurance, you’ll most likely have to pay the entire cost out-of-pocket. However, each state and territory in Australia does provide public dental services for free or reduced-cost dental care to eligible recipients.
To be treated through your state’s public dental service, the treatment cannot be solely for cosmetic reasons, and you may be required to hold a health care card, be under a certain age or meet other criteria.
Meet our health insurance expert, Steven Spicer
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.
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1 Australian Dental Association, Dental fees survey. 2022.
2 Orthodontics Australia, Does Health Insurance Cover Orthodontics in Australia? October 2021.