Are Braces Covered By Medicare Or Health Insurance?

Are braces covered by Medicare?

Medicare does not routinely cover braces or aligners in Australia. Standard orthodontic care is typically considered elective, so rebates are not available under Medicare for assessments, appliances, or ongoing adjustment visits.

There are limited scenarios where Medicare may assist with related oral surgery in a hospital setting, for example jaw surgery or the exposure of impacted teeth, if a specialist surgeon and a public hospital are involved and strict clinical criteria are met. Even when surgery is covered, braces or aligners before or after surgery are not paid by Medicare.

In short, you should plan for orthodontic treatment to be self funded or supported by private health insurance.

Can you get braces for free in Australia?

Free braces are uncommon. Some public dental services offer orthodontic treatment to eligible children with severe clinical need, but waiting lists are often long and access criteria are strict. Eligibility usually depends on factors such as bite severity, age, and concession status.

Most families in Melbourne choose private specialist orthodontic care so they can begin treatment at the right time, select their preferred appliance, and receive consistent follow up without delays.

If you are hoping to reduce out of pocket costs, the most reliable strategies include using a private health fund with orthodontic cover, spreading payments over time with an interest free plan, and choosing a provider who offers a transparent, all inclusive quote.

At Knox City Orthodontics, you receive a personalised plan, a clear written fee, and interest free payment options that can be tailored to weekly, fortnightly, or monthly schedules.

Do health funds help with orthodontic costs?

Yes, many private health insurance policies include orthodontic benefits, but the details vary widely between funds and policy levels. Before starting treatment, it is important to review:

Waiting period

Orthodontic cover often has a 12 month waiting period that must be served before rebates apply.

Lifetime limit

Many funds apply a lifetime orthodontic limit per person. Once reached, it does not reset.

Annual sub limits

Some policies release a portion of the lifetime limit each year, which can affect how payments are scheduled.

Item inclusions

Confirm whether your fund pays benefits for records, appliances, adjustments, and retainers.

At your free initial consultation, bring your membership details and we can provide item codes for a complimentary benefits check with your fund. Clear information upfront makes it easier to plan a budget that works for your family.

What orthodontic options can be claimed with private health insurance?

Private health insurance rebates are based on item numbers, not on the brand of braces or aligners. This means both fixed braces and clear aligners may attract benefits when your policy includes orthodontics.

Your Specialist Orthodontist may discuss options such as traditional metal braces, ceramic braces, LightForce™ custom 3D printed brackets, and clear aligner therapy including Spark and Invisalign^®.

We will outline the item numbers relevant to your treatment plan so you can confirm expected rebates directly with your health fund before you begin.

How can families make braces more affordable?

There are several practical ways to reduce upfront costs and manage orthodontic treatment comfortably.

Use your health fund wisely

Start treatment after any waiting period ends and consider timing instalments to maximise annual sub limits.

Consider a payment plan

We offer interest free payment plans with flexible frequencies, allowing you to spread costs over the active phase of treatment without hidden fees.

Choose the right timing

Treating at the clinically ideal time can shorten treatment and reduce complexity, which may lower overall costs.

Ask for a complete quote

We provide all inclusive written quotes so you know exactly what is covered, including records, appliances, adjustments, and retainers.

Plan for retention

Retainers are essential for maintaining your result. Budgeting for long term retainer care helps protect your investment.

When comparing options for Melbourne braces and aligners, remember that the lowest headline price is not always the best value. Treatment planning, appliance choice, digital technology, and experienced supervision all influence comfort, efficiency, and final outcomes.

What to expect at Knox City Orthodontics

We are proud to be South East Melbourne’s leading specialist orthodontic team, offering personalised care supported by contemporary digital technology in a welcoming environment.

At your free initial consultation, we will:

Listen to your goals and concerns

Your priorities help guide every recommendation we make.

Complete a comprehensive assessment

We assess whether braces or aligners are most suitable for your needs.

Explain treatment options clearly

Including metal braces, ceramic braces, LightForce™ brackets, and aligners, with honest pros and cons.

Provide a transparent, personalised quote

Including flexible payment plan options.

Supply item codes for health fund checks

So you can confirm rebates before committing to treatment.

Our digital approach includes intraoral scanning, 3D treatment planning, and custom solutions where appropriate, helping support predictable and efficient treatment progress.

Simple steps to move forward

Book your free initial consultation

We will assess your needs and design a personalised orthodontic plan.

Bring your health fund details

So we can complete a complimentary benefits check.

Choose a payment schedule

Weekly, fortnightly, or monthly options are available.

Start treatment with confidence

Knowing exactly what is included, how long it will take, and how costs are managed.

At Knox City Orthodontics, our Specialist Orthodontist and friendly team combine expert guidance, personalised planning, and flexible finance to make orthodontic care achievable for Melbourne families. Book your free initial consultation today and take the first step towards a confident smile.