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4 min readGetting orthodontic treatments is a necessity for many Australians who are dealing with dental issues or want to achieve that picture-perfect smile. But the costs of these treatments can be staggering, which is all the more reason to take out private health insurance.
Looking to find the best health insurance for braces and orthodontics? We’ve got all the information you need to start searching.
In terms of private health insurance, providers generally define ‘orthodontic treatments’ as being a number of different procedures – all of which are aimed at correcting dental problems.
The main treatment – as you’ve probably already guessed – is braces. Modern-day dentistry means there are multiple solutions beyond the traditional metal braces, including ceramic braces and clear aligners like Invisalign. These treatments take care of common issues like misaligned teeth, overbites, underbites and overcrowded teeth.
Depending on your provider and what’s included in your extras policy, orthodontic care might also cover initial consultations with a dentist, regular adjustments, retainers and sometimes even jaw surgery for more severe cases.
The bottom line is that the overarching goal of braces and orthodontics is to improve dental function and your overall oral health.
That’s a tough one to quantify, simply due to the sheer range of dental procedures and different problems and diseases associated with teeth and gums. However, we know that it’s important you have at least a ballpark figure so you can start to budget for your braces.
On average, traditional metal braces tend to range from $6,000 to $9,000 for a standard treatment period. Ceramic braces, which are less noticeable, are a little more expensive at between $6,500 and $9,500. Clear aligners like Invisalign are similar to ceramic braces, while the most expensive option is something called lingual braces, which attach to the back of your teeth and can cost anywhere from $9,500 right up to $15,000 or more.
There are other factors that can influence the overall cost, so make sure you take these into account when budgeting for dental work:
Because of these potential extra costs, it’s extremely important that you get a detailed quote from your orthodontist before starting treatment. Also speak to your private health insurance provider to understand exactly what will and won’t be covered – even with an extras plan, you may still have to pay a gap fee. The good news is that many dental surgeries have payment plans and financing options available to help you manage these expenses over time.
Yes, many private health policies can provide some level of cover for orthodontic treatments. However, bear in mind that the full extent of the coverage will depend on your policy. A basic policy for young adults, for example, may not give you much – if any – cover compared to a comprehensive hospital and extras policy.
Most extras cover will include some level of orthodontic benefit, which can help reduce those nasty out-of-pocket expenses for treatments like braces. But you’ll need to do your research and carefully review and compare policies to find out exactly what is and isn’t covered.
In most cases, private health insurance will cover a percentage of the orthodontic costs up to an annual or lifetime limit. For example, a policy might cover 50% of the treatment cost up to a maximum benefit of $2,000 per year or $4,000 over the lifetime of the policy. Be aware that not all health policies include orthodontics, so if you expect to need dental work in future then you’ll need to pick a plan that specifically mentions braces and orthodontics – and see out the waiting period before making a claim.
Waiting periods are an unfortunate but necessary part of having private health insurance. And that includes orthodontic procedures. It’s important that you see out any waiting period before locking in your surgery, as you can’t make any claims on your policy until the waiting periods are over.
For orthodontics, waiting periods are usually 12 months from the time you purchase a policy. This means you may need to wait a full year before you can claim any benefits for braces or other orthodontic treatments.
The length of the waiting period can sometimes differ between insurers – while some may have policies with shorter waiting periods for orthodontics, bear in mind that these plans often come with much higher premiums.
On a more positive front, if you are switching from one health insurance provider to another and have already served part of your waiting period, your new insurer may recognise the time already served and not require you to start again for another 12-month waiting period. If in doubt, speak to your insurer to get across everything.
As the name suggests, limits for orthodontic health insurance simply refers to the maximum amount your insurance policy will pay towards orthodontic treatments. These limits can be annual or lifetime caps.
Your policy might have an annual limit of $1,500, for example, which means your insurer will cover up to $1,500 of orthodontic expenses each year. There may also be a lifetime limit of $4,000. In this case, the total benefit for orthodontics over the life of the policy can’t exceed $4,000 – so after hitting the annual limit two years in a row ($3,000), you will only have $1,000 of orthodontics cover left on your policy.
Once you reach your policy’s limit, you will have to foot any additional costs out-of-pocket. Some policies also have sub-limits for specific services, such as consultations or retainers. It sounds complicated, but it’s really not. Again, if you’re not sure about the specifics either go through your PDS in detail or give your provider a call.
As with any private health insurance policy, choosing the best plan for braces and orthodontics requires plenty of planning and comparing of policies. Don’t just look at the premiums – also take note of the waiting periods, benefit limits and what services are actually included under their orthodontics cover.
Once you’ve done all that, you can pick the best health insurance plan and start working towards a healthier smile.
