Jan 21, 2026

Braces, Aligners & Medicare: What Does Insurance Really Cover?

Quick answers to your big questions

Are braces covered by Medicare, or is orthodontics covered by Medicare?
In most cases, no. Medicare does not cover routine orthodontic treatment like braces or aligners. There are rare exceptions for complex medical or surgical cases treated in public hospitals, but this is not typical for standard orthodontic care.

Are braces under Medicare?
Not for standard treatment in private clinics. You will usually pay privately or claim through your private health fund if you have orthodontic extras.

Can you get braces for free in Australia?
Free or very low cost treatment may be available through public dental services for eligible children or special needs cases. Waitlists are often long and eligibility is strict. Most people choose private treatment to access modern options and flexible start times.

Do braces take longer for adults?
Sometimes. Adult teeth no longer grow and bone remodelling can be slower. With modern systems like clear aligners, many adults finish within 12 to 24 months. Complexity, gum health and compliance matter more than age.

Medicare vs private health cover - what you need to know

Medicare

Medicare covers medically necessary dental services in hospitals for certain conditions. It does not pay benefits for routine orthodontics in private practice.

Some families may access state based public dental programs for children. These are separate from Medicare and focus on essential dental care, not comprehensive orthodontic treatment.

Private health insurance

Orthodontics is usually part of extras cover and often has a lifetime limit per person. Common features include:

• A 12 month waiting period before orthodontic benefits are paid.
• A lifetime limit that may be reached over one or several years.
• Annual sub limits that cap how much you can claim per year.

Benefits vary widely. Bring your health fund details to your consultation and we will provide item numbers so you can confirm your entitlements.

Out of pocket costs

Your out of pocket cost is the total fee minus any private health benefits. Medicare usually does not reduce the fee for private orthodontics.

Spreading payments with an interest free plan can make the gap more manageable.

What does private health usually cover for braces and aligners

Most funds contribute to the active treatment phase, whether you choose braces or clear aligners such as Invisalign®. Inclusions and limits differ, however you may expect:

• A portion of the initial records and planning appointment.
• A portion of appliance placement and active treatment visits.
• Possible contributions toward retainers at the end of treatment, depending on the fund.

Funds rarely cover:

• Missed appointment fees.
• Replacement retainers due to loss or damage.
• Cosmetic upgrades that are not clinically necessary.
• Always confirm with your insurer, as terms and waiting periods can change.

How interest free payment plans work

We offer flexible, interest free options so you can start treatment without a large upfront cost. Typical features include:

• Low or no deposit options, subject to eligibility and credit checks.
• Weekly or fortnightly instalments, for example a weekly from $67 illustration.
• Direct debit for simpler budgeting.
• Ability to combine private health benefits with your plan. Your fund may reimburse you directly, while you continue installments for the remaining balance.

Promotions may include deposit match offers up to a stated limit or pay in full discounts during campaign periods. These are time limited, so ask our team what is active now and how it applies to your case.

Braces vs aligners - what affects the price and timeline

Several factors influence cost and treatment length:

• Complexity of tooth movement and bite correction.
• Appliance choice such as traditional braces or clear aligners like Invisalign®.
• Compliance with wear and care instructions. Aligners typically need 20 to 22 hours of wear per day.
• Oral health and lifestyle. Healthy gums and regular hygiene visits help keep treatment on track.
• Remote monitoring with the DentalMonitoring app, which can reduce in person visits and help maintain momentum.

Many patients finish in 12 to 18 months, while more complex cases can take longer. Adults and teens both achieve excellent results when they follow the plan.

What about kids and teens - can they access public help?

Public dental programs may provide essential dental care for eligible children, and some states offer limited orthodontic services for complex needs. Access, criteria and wait times vary. If you want faster access, modern appliances and flexible scheduling, private treatment is the most reliable option. We are happy to explain both pathways so you can make an informed decision.

Current offers at Clear Orthodontics

We regularly promote interest free plans and seasonal offers, such as deposit match campaigns up to a set amount. Because promotions change, please ask at your initial consultation for current details, eligibility and terms.

Where we are and how we support you

Clear Orthodontics serves Melbourne’s northern and western suburbs and Ballarat, providing Specialist Orthodontist led care, digital planning and remote monitoring. If you are searching for an orthodontist western suburbs Melbourne or a Broadmeadows orthodontist, our team is ready to help you get started with a plan that fits your budget and lifestyle.

Your next step - book a specialist consultation

Every smile and every policy is different. The best way to get exact figures is to book a consultation. We will:

• Assess your teeth, bite and gum health using digital scans.
• Explain clear aligners and braces, including pros, cons and timelines.
• Provide item numbers so you can check your private health benefits.
• Outline interest free payment plans and any current promotions.

Ready to get clear on costs and coverage? Book your consultation today and move forward with confidence, armed with a personalised quote and timeline.