Sep 22, 2025

Are Braces Covered By Medicare Or Private Health Insurance In Australia?

Thinking about braces for you or your child can raise plenty of questions, especially around cost.

You want to plan with confidence, understand what Medicare and private health insurance actually cover, and know how to keep treatment affordable. This guide walks you through the essentials in plain English, so you can make clear, confident decisions.

Are braces covered by Medicare in Australia?

In most cases, Medicare does not cover the cost of braces or clear aligners. Medicare is designed for essential medical care, not routine dental or orthodontic treatment in a private setting.

There are rare exceptions:

• Hospital treatment for severe jaw problems or facial trauma may be partly covered under the public system, usually via a public hospital waiting list.
• Public dental services in some states may provide limited orthodontic support for children with severe needs, but braces are rarely included.

What this means for families:

• Expect to self-fund orthodontic treatment or use private health insurance with extras cover.
• Medicare will not typically contribute to consultations, braces, or aligners provided in a private practice.

Can you get braces for free in Australia?

Free or fully subsidised braces are uncommon. Public orthodontic programs exist in some states for very specific medical or severe functional needs, but waiting lists are long and eligibility criteria are strict.

Most families choose private orthodontic care because:

• You can start treatment sooner.
• You can choose your Specialist Orthodontist, treatment type, and appointment times.
• You receive tailored care suited to your goals, lifestyle, and timeline.

If you are exploring public options, contact your local public dental service for current criteria and wait times. For most patients, planning for private treatment is the practical path.

Does private health insurance cover braces?

Yes, many extras policies include orthodontic benefits, but benefits vary widely. Before you start, contact your fund and ask for a detailed breakdown. Key points to check:

• Lifetime limit: The total orthodontic benefit per person, often $800–$2,500+.
• Annual limit and sub-limits: Some funds cap yearly payments or increase benefits over time.
• Waiting period: Usually 12 months for orthodontics. Upgrading cover usually restarts the wait.
• Percentage covered: Funds may pay a set percentage of invoices up to your limit.
• Item numbers: Confirm which orthodontic item numbers are covered.
• Family vs single policy: Family policies may offer better combined value if more than one child needs treatment.

Tip: Ask your fund for a written quote based on your orthodontic plan. Your orthodontist can supply item numbers to make this easier.

How can you make orthodontic treatment more affordable?

There are several strategies to reduce costs and spread payments:

• Flexible payment plans: At Marvel Orthodontics, we offer interest-free plans with fortnightly payments.
• Time your treatment: Start after waiting periods or schedule invoices to maximise annual benefits.
• Early assessment: Early interceptive care for children may reduce later complexity.
• Appliance choice: Metal braces are usually more cost-effective than ceramic. Invisalign^® and braces can be similar in cost depending on case complexity.
• Family discounts: Savings available when siblings or multiple family members start treatment together.
• Upfront payment discounts: Lower fees may apply if paying part or all upfront.
• Excellent oral hygiene: Good care prevents delays and additional costs.

What to expect at Marvel Orthodontics

We provide transparent fees, item numbers for insurance claims, and tailored advice. Treatment options include braces, ceramic braces, Invisalign^®, and Spark Aligners for children, teens, and adults.

Your first consultation includes:

• Photos and scans as needed.
• A personalised plan with clear pros and cons.
• Written costs, item numbers, and timelines.

Payment support at Marvel Orthodontics

• Interest-free plans up to 24 months.
• Fortnightly options to suit your budget.
• Discounts for families and upfront payments.
• Guidance on private health fund claims.

If you are comparing, it can help to check the cost of braces in Sydney to understand local price ranges and inclusions.

Quick answers to big questions

• Are braces covered by Medicare in Australia? Generally no.
• Can you get braces for free in Australia? Rarely, only in severe public cases.
• Does private health insurance cover braces? Yes, with orthodontic extras and subject to limits.
• How can I make treatment affordable? Use payment plans, family discounts, and check fund entitlements.

Who we help

We work with families across Sydney, including Gordon, Hurstville, and surrounding suburbs. If you are looking for a trusted orthodontist in Sydney, our Specialist Orthodontists are here with expert care and flexible scheduling.

• Kids and teens: Early checks, braces, Invisalign^® First, and interceptive care.
• Adults: Metal or ceramic braces, Invisalign^®, Spark Aligners, and discreet treatment options.

Final takeaways

• Medicare does not cover private orthodontic care.
• Private health funds may contribute, subject to lifetime limits and waiting periods.
• Interest-free payment plans, family discounts, and treatment timing can help reduce costs.

At Marvel Orthodontics, we make treatment achievable with clear quotes, flexible payment options, and family-friendly support. Ready to plan your smile journey? Book a consultation today.