Explore nib dental cover and benefits

Medicare doesn’t cover most dental treatments, but nib Extras cover can help with eligible dental costs. You can visit any recognised dentist in Australia, or choose a provider in our First Choice network to access agreed rates* on common treatments and receive a percentage of the fee back on eligible services, up to your annual limit. Members can also get 100% back^ on preventative dental check-ups at participating No Gap providers.

The amount you get back can vary depending on the dentist you visit. If you visit a First Choice dental provider, you’ll receive a percentage of the provider’s fee back on eligible services. Eligible members can also get 100% back^{^} on preventative check-ups at participating No Gap providers within the network. If you visit a recognised dental provider^ˣ outside the First Choice network, you’ll receive a set benefit, which is a fixed dollar amount, towards each eligible service. These providers set their own fees, so your out-of-pocket cost will depend on what they charge. You can still visit any recognised dental provider in Australia, and your cover and annual limits stay the same.

An agreed rate is a price a First Choice provider has agreed to charge for for certain services provided to nib members,giving you greater certainty about what you'll pay and helping your annual Extras limits go further.

A set benefit means we pay a fixed dollar amount towards an eligible dental service, regardless of how much your provider charges. This applies when you visit a dental practitioner outside our First Choice network. Non-First Choice providers set their own fees, so your out-of-pocket cost will depend on what they charge for your treatment. Ask your dentist for a health benefit quote before you book so you know roughly what to expect out-of-pocket. You can also check your Private Health Insurance statement to see the common benefit amounts.

A benefit is the amount we pay towards an eligible service. How much you get back depends on your level of Extras cover and the provider you visit. An annual limit is the most you can claim for a particular Extras service each calendar year. Once you reach that limit, you won’t be able to claim for that service again until your limit resets. Some services work differently and may build up over time instead of having an annual limit. Check your cover in your member account or the nib App to see what applies to your cover.

A service limit is a restriction on the number of times benefits can be claimed for a particular service within a calendar year or membership year. In certain circumstances, a member's treatment plan will vary from standard treatment and can be assessed individually by nib on a case-by-case basis.

Use our Find a Provider tool before your appointment to check whether your dentist is in the First Choice network or find a participating provider near you. It’s worth checking each time, as network participation may change. At a First Choice provider, you can access agreed rates* and receive a percentage of the fee back on eligible services. Eligible members can also get 100% back^ on preventative check-ups at participating No Gap providers. You can still visit any recognised dental provider in Australia. If they’re outside the First Choice network, you’ll receive a set benefit, which is a fixed dollar amount, towards each eligible service. Your cover and annual limits stay the same, however non-First Choice providers set their own fees, so your out-of-pocket cost will depend on what they charge for your treatment.

General dental generally includes routine and preventive services such as check-ups, cleans, x-rays, fillings and simple extractions. Major dental generally includes more complex treatments such as crowns, bridges, dentures and some endodontic procedures, including root canal treatment. The services covered and the category they fall under can vary by product, so check your cover before booking treatment.

Orthodontics is a specialised area of dentistry that diagnoses, prevents and treats problems with the alignment of teeth and jaws. If orthodontics is included in your Extras cover, you may be able to claim benefits towards eligible treatment such as braces or plates. The amount you can claim depends on your cover, the treatment provided, the provider you visit and your available limits. Before starting treatment, check your cover and remaining limits in your member account or the nib App and ask your orthodontist for a quote before starting treatment.

Waiting periods depend on the type of dental treatment. General dental, like check-ups, cleans, fillings and simple extractions, generally has a 2-month waiting period. Major dental and orthodontic treatment, like crowns, root canals, dentures and braces, generally has a 12-month waiting period. Log in to your member account or the nib App to check the waiting periods that apply to your cover.