Are Invisible Aligners Covered By Insurance

Dental Insurance Australia

Clear aligners are on the rise in Australia, but is this invisible orthodontic treatment method correct for you?

There are several factors to think about before starting orthodontic treatment, including the type of treatment you want to have. It might not be easy to know what to expect if you’ve never been to an orthodontist. Fortunately, your orthodontist has much expertise in correcting misaligned jaws and teeth. They spend all day, every day doing this, so they’ve seen everything from very small to quite severe instances. You may be certain that they will provide you with thorough answers to your inquiries and suggest a treatment plan tailored to your needs.

Many people in Australia considering orthodontic treatment hesitate because of the expense involved. Metal and lingual braces, for example, will require different materials and equipment. Therefore their respective costs may vary. To get an idea of how much your treatment, with clear aligners, is likely to cost, we have curated this article to answer all your concerns.

What Are Clear Aligners?

Invisible aligners are constructed of a transparent plastic material shaped to fit your teeth. Teeth are gradually realigned using a series of aligners fabricated from an initial scan or impression. Since they are tailored to each individual’s teeth and are nearly undetectable, they are an excellent option for those who want a discreet alternative for teeth straightening.

Does Medicare Cover Aligners?

As previously indicated, Aligners are not covered by Medicare. No dental treatment, including Invisalign, is covered by Medicare. You will need to pay the entire price of your treatment if you do not have access to private insurance that will cover it.

Cost Of Clear Aligners In Australia

Clear aligners are, like traditional braces, one of the less expensive orthodontic treatment alternatives. Clear aligners are not advised in more difficult instances because of the nature of the material and the simpler motions necessary to straighten teeth and align jaws. Clear aligner treatment in Australia may cost between $6,500 to $9,500 on average, however this might vary from state to state. Treatment with clear aligners typically takes between 6 to 12 months. Costs can be much lower for shorter or more restricted treatments involving only some of the teeth, and significantly higher for more complex or lengthy treatments, depending on the number of trays and the intricacy of the case.

Are Invisible Aligners Covered By Insurance?

There is no standard private health insurance plan. Clear aligner treatment may be fully covered by an additional plan that covers orthodontics, much like traditional braces. Verifying this information with your preferred health insurance company is recommended since their policies may differ from those listed below.

Which Private Health Insurance Cover Orthodontic Treatment?

Numerous ‘Extras’ packages provided by private health insurance providers include coverage for various dental treatments;

General dental care insurance – covers hygienic procedures such as cleaning and scaling, x-rays, fillings, extractions, and so on.

Major dental insurance – entails more difficult dental treatments such as wisdom tooth extraction, crowns, implants, and bridges.

Orthodontic therapy – is a specialized treatment that corrects
misaligned teeth and jaws and is frequently included individually within the
Extras, so this is the coverage you’ll need to think about.

Although many general dentists now provide orthodontic services, it’s crucial to remember that if your insurance company requires a prescription from an orthodontic specialist, the treatment may not be covered under the Major Dental plan. Some health insurance companies may pay a smaller benefit if you get orthodontic treatment from a dentist.

A part of orthodontic treatment, such as braces and in most instances aligner treatment, may be covered by the Major Dental component of your private Extras policy; nevertheless, it is advisable to clarify this with specific funds.

Many ‘basic’ Extras policies exclude Major Dental, therefore you should opt for a more comprehensive Extras policy.

What Companies Provide Orthodontic Dental Insurance?

To name a few of the many health insurance companies in Australia that provide orthodontic and dental extras plans:

  • AHM
  • Bupa
  • Medibank
  • HIF
  • Nib

Additionally, it is important to remember that most dental and orthodontic coverage plans have a 12-month time delay before they kick in. In most cases, the orthodontic treatment can be begun before the completion of the waiting period if:

Even after the waiting time has ended, you will continue with your orthodontic treatment if you have not yet paid the full cost of your treatment.

But before beginning any orthodontic care or treatment, it is important to verify with your health fund or provider to be sure that it will cover it.

Some individual policy names and key fund details you should know.


HIF can provide excellent limits on orthodontic and Invisalign treatment. However, they have a few fund regulations that differ from most other health funds, which you should be aware of. To begin with, if you have already started orthodontic treatment, HIF will not pay a single dime if you transfer to them.

Second, your orthodontic lifetime limit is determined by how long you have been with HIF at the time of your first claim. HIF’s orthodontic lifetime restrictions grow for each year of coverage. However, the year you claim is the year your lifetime restriction takes effect.

Assuming you had Super Options for three years and submitted a claim within that period in this case, the lifetime maximum for orthodontic treatment would be $1,700.


AHM now offers three stand-alone extras insurance that will cover a clear braces benefit: Lifestyle Extras, Family Extras, and Super Extras. The two most important things to understand about AHM policies regarding orthodontic/Invisalign claims are that AHM is a financial year fund and that your yearly limit grows with loyalty.

Unlike most other health funds, AHM has a fiscal year. This implies that, unlike most other health funds, your yearly restrictions reset on July 1 rather than January 1. This means you can maximize your claim potential by claiming in June for your top teeth and July for your bottom teeth.

AHM, like HIF, will reward your loyalty by gradually raising your annual orthodontic treatment limits.


Both the Top Extras insurance and the Family Extras add-on policy have coverage for reimbursement of Invisalign treatment.

The yearly maximum with Top Extras begins at $800 and rises by $100 for each successive year; you are covered up to a maximum of $2,600. For instance, if you went with Top Extras but didn’t claim on invisible aligners for two years, nib would pay $1,000 instead of $800. This coverage may be worth considering if you have young children who are still a few years away from needing orthodontic treatment.

The Family Add-Ons Bundle is an optional upgrade. There is no option to buy only the Family Extras add-ons separately. You’ll need to supplement your Family Extras purchase with either the base cover of Core Extras or the enhanced package of Core Extras Plus.

Should You Choose Clear Aligners?

Since each patient and their condition is unique, it is critical to always contact an expert to assist you make an informed choice.

Whatever treatment method you pick, it is essential to see a licensed orthodontist who will assist you in making the best decision for the health of your smile.


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