Orthodontia information

Orthodontic treatment can be expensive. In Australia, you’ll usually be looking at somewhere between $4,000 to $8,000 – or more – for treatment. And although this amount generally covers the treatment itself, it doesn’t cover everything. Often, the initial consultation, photographs, teeth removal, or anything else you need to do to prepare your teeth for braces, aren’t included. They do attract a benefit under Top Extras or Essential Extras dental cover though.

Top Extras Orthodontia benefits

Your benefit will increase depending on the number of years you’ve held continuous Top Extras cover with Nurses & Midwives Health. There’s a lifetime limit of $2,500 per person.

Year Period (24 month waiting period) Increasing limits 
 Year 3 $1,500
 Year 4 $2,000
 Year 5+ $2,500

Essential Extras Orthodontia benefits

Under Essential Extras, Orthodontia is combined with the Major Dental benefit. Once you’ve held Essential Extras for 24 months, you can claim up to $300 for orthodontia per year, up to a lifetime limit of $2,500 per person.

What do you need to do?

  1. Discuss any treatment options and fees with your Orthodontist before your treatment starts.
  2. Send us a copy of your treatment plan so we can give you an accurate estimate on potential out-of-pocket costs.
  3. After your treatment, send us your receipts and a completed claim form (you can’t make claims for orthodontia through HICAPS or the online members area).

Important things to know

  • Orthodontic benefits are only available for members who have Top Extras or Essential Extras cover.
  • You can’t claim for any services you received during the 24-month waiting period.
  • You can’t claim any benefits before your treatment starts (even if you’ve paid upfront).
  • To be eligible to claim, your treatment must begin after you’ve served the 24-month waiting period.
  • If you choose to pay upfront, you can continue to claim each year, if you’re still undergoing treatment (i.e. your braces are still on). We’ll continue to pay benefits up to your annual limit and policy’s lifetime limit.
  • Recently transferred from another health fund? If you’ve received orthodontic benefits, they’ll be deducted from your benefit entitlement with Nurses & Midwives Health.