Orthodontic treatment is a huge decision, both medically and financially. But it can sometimes be confusing to work out if your orthodontic treatment is covered by private health insurance. At Fresh Smiles Geelong Orthodontics we can provide guidance to get the ideal cover to meet your needs.
While orthodontics is not covered under Medicare, you might be covered under private health insurance, depending on the details of your policy.
If you have ‘extras cover’ on your health insurance, you may be entitled to claim a portion of the cost of braces back from your health fund.
As there is no ‘one size fits all’ standard when it comes to coverage, it depends on your health fund and your level of extras cover, so it’s important to check with your private fund prior to starting treatment.
Orthodontic treatment, such as braces, generally isn’t covered by basic extras cover, so you’ll usually need a higher level of cover to receive a rebate. Orthodontic rebates from private health insurance range from a few hundred dollars to over $2,500 – so it pays to do your research. Most private health funds require a 12-month waiting period for orthodontic treatment so you’ll need to think ahead if you might need it.
What type of private health insurance do you need for orthodontic treatment?
Orthodontic treatment may be covered within the extras policies of some insurance providers. While orthodontics will generally fall under the umbrella of dentistry, it is not considered to be general dental care (e.g. regular dental check-ups, cleaning and simple restorations) and may not even be included under major dental care (often classified as oral surgery, root canals or crowns). It’s important that you check with your own private health insurance policy to see what is included with your individual plan.
How do you claim for orthodontic treatment?
At Geelong Fresh Smiles Orthodontics we can help make the Claiming for your orthodontic treatment easy. It is not much different to claiming for other extras you may be covered for. Although each private health fund may differ there are specific item codes that will be associated with the treatment which we can provide and make the process easy.
What are the limits applied for orthodontic insurance?
There are two primary limits set to insurance that covers orthodontics, which people should investigate before choosing a policy:
- Lifetime limit: The maximum amount that can be claimed during a lifetime.
- Annual limit: The maximum amount that can be claimed during a year.
How to choose the best private health insurance for orthodontics
Choosing the best private health insurance for orthodontics requires some research. When comparing online, it is important to look at if the policy you are looking at has lifetime or annual limits (a maximum total benefit you can claim in a lifetime or a year respectively). It is also worth looking at what you will be paying back in premiums over the life of the treatment. To make it worthwhile, you may want to claim for other extras too. Also important to note is a policy’s percentage back price, which can be calculated online, through an insurance rebate calculator.
Health funds that cover orthodontics
This is a non-exhaustive list of Australian health insurers which provide some orthodontic cover:
- Frank health insurance
- Bupa
- HBF
- Medibank
- AHM
- Qantas Insurance
- HCF
- Peoplecare
Are there government programs for braces in Australia?
There are no specific government programs in Australia that subsidise the cost of getting braces. The Australian Government’s Child Dental Benefits Schedule (CDBS) helps for 2 to 17-year-olds to access a range of dental services and procedures for free. However, benefits for orthodontic treatment such as braces are not covered under the CDBS.
If your child has a cleft or craniofacial condition, then some proportion of the orthodontic treatment provided may be covered under Medicare, which can help parents of children with a cleft or craniofacial condition. Additional paperwork will need to be completed to assess the patient’s eligibility.
The Australian Society of Orthodontist operates a charitable organisation called Give A Smile, Which at Fresh Smiles Orthodontics we are proud to support and provide exceptional care to those who are in need.
For further advice an recommendations book a free consultation at https://www.freshsmiles.com.au/