What is the best health insurance plan for orthodontics?

It seems braces are becoming more and more popular for both adults and children, and for anyone over the age of 40, they have almost been a staple of childhood. Not all of us are blessed with perfect teeth, so the need to find the best orthodontics health insurance plan is important.

What is orthodontic cover?

Most funds will offer two types of private health insurance – Hospital and Extras. Hospital insurance covers you for admissions to hospital and all the treatments and services that entails. Extras cover is about the health services and treatments that are outside hospital. Things like physiotherapy, chiropractic, optical and dental treatments are usually coved under Extras insurance, as well as other allied health treatments. Orthodontic treatments may also covered under Extras insurance. Most funds define orthodontics as treatments dealing with the alignment of teeth and jaws.

While most treatments are carried out by orthodontists, the best orthodontics health insurance plan for you can also recognise that some dentists can also carry out orthodontic treatments. Some funds may pay a lower limit if orthodontic treatments are undertaken by a dentist, so make sure you ask those questions of your fund before joining up or making a claim.

Bronze Hospital & Bronze Extras Set Benefits

Entry level hospital cover. Includes preventative dental and optical.
$ 20.35
per week
Select

Bronze Hospital & Silver Extras Set Benefits

Entry level cover. Cover for a range of popular services that suit your lifestyle.
$ 24.35
per week
Select

Silver Hospital Plus & Bronze Extras Set Benefits

Moderate cover. Includes private hospital with some exclusions. Includes cover for preventative dental.
$ 29.90
per week
Select

Bronze Hospital & Bronze Extras Set Benefits

Entry level hospital cover. Includes preventative dental and optical.
$ 20.35
per week
Select

Bronze Hospital & Silver Extras Set Benefits

Entry level cover. Cover for a range of popular services that suit your lifestyle.
$ 24.35
per week
Select

Silver Hospital Plus & Bronze Extras Set Benefits

Moderate cover. Includes private hospital with some exclusions. Includes cover for preventative dental.
$ 29.90
per week
Select

* The price shown is per week and applies to a Single living in VIC with a $500 excess. It excludes LHC loading and includes a Base Tier Government Rebate

Why do I need orthodontics cover?

Orthodontic treatment is not cheap, and finding the best orthodontics health insurance plan for you and your family can offset some of that cost.

Orthodontic treatment can be very effective and beneficial, and usually results from two things – normal growth overcrowding or accidents. Knowing you have cover that could help make orthodontic work affordable can help mitigate against any hesitation in beginning treatment.

Braces can cost anywhere from $2000 to $9000, which is a lot of money to be out of pocket. That cost usually includes consultations, the braces themselves, maintenance and ongoing visits and treatments, including the need for any retainers. It can also cover things like teeth removal and periodic check-ups, to ensure things are moving along as planned. Orthodontic treatment is usually expensive because the equipment and the expertise needed to solve problems can be complex and specialised. One size usually does not fit all. 

Medicare is unlikely to cover orthodontic treatment of any kind, so that cost will usually come out of your pocket. Most orthodontists will have payment plans to make things a little easier, but will still require it all before the treatment ends. Before you begin any orthodontic treatment, make sure you have a good understanding of exactly what will be done and why. Practitioners or their staff should fill you in on all this as soon as they have decided on the best plan for your mouth.

The best orthodontics health insurance plan can be important for families. It can quickly become about economies of scale for some families, and with the possibility of more than one child needing braces or other treatments, sometimes at once, the best orthodontics health insurance plan can save you a lot of money over a lot of years.

How do the best orthodontics health insurance plans work?

While orthodontics cover can be a part of most funds’ Extras plans, there can be a few significant differences with the best orthodontics health insurance plans.

The first is around treatment plans. Some funds will require the orthodontists or dentist to provide you with a plan outlining what they intend to do. It is likely your fund will need to see and agree with that plan before agreeing to cover the work. The plan will include things like details of the treatment, how much it will cost and how long it will take.

The amount of money you can claim back on most Extras treatments can vary between funds. Usually, the higher the level of cover, the higher percentage you can claim back. Most funds will also limit the actual dollar amount you can claim back each year for different treatments. However, for the best orthodontics health insurance plans, yearly limits can be treated a little differently. Most funds step up their yearly limits. What this means is that the longer you are a member of a health fund, the more you can claim each year for orthodontic treatment, up to a ceiling.

Benefits and limits will vary between funds, but they should all let you know all these details before you sign up. You will also likely face a 12-month waiting period before making a claim for orthodontic treatments. If you come across to GMHBA from another fund, we may be able to include any waiting period already served under another fund to ours.

There is little doubt about the importance of the best orthodontics health insurance plan, especially to families. There are a lot of different funds that have a lot of different policies that cover orthodontic treatments, but make sure you do your homework to choose the best one for you and your family. A great place to start is here.