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Orthodontia claiming

Each cover that incldues orthodontia has a starting annual limit, that increases each year. You can start claiming up to this starting annual limit once you have served your 12 month waiting period for orthodontia.

For each calendar year that you are with nib, the orthodontia annual limit will increase by $100, even if you haven’t had cover for orthodontia previously. For example, if you join an nib Extras cover with a starting annual limit of $800, after the 12 month wait has been served you are entitled to $900 in your second year with nib, $1000 in your third year, and so on.

Each cover has a lifetime limit on the orthodontia benefit, and once you reach this limit, you are unable to make any further claims for orthodontia.

How do I make a claim for my orthodontic treatment through nib?

If you are considering orthodontic treatment, please contact us to discuss your options, as each nib policy has a different benefit. You may also have a greater benefit dependent upon the number of years of cover you have had with nib.

Send us a copy of your treatment plan. We can use this to quote you an estimate based on the payments you are required to make and the length of your treatment.

You can claim for your orthodontic benefits via the HICAPS terminal at your orthodontist. Just scan your nib card at the termainl and all you have to pay is the difference. Other claiming options are also available.

If you pay for your orthodontia up front or pay a large lump sum during the course of your treatment, you can continue to claim for orthodontia in the following years as long as you are still undergoing active treatment (i.e. if you still have your braces on). We will continue to pay your orthodontic benefits up to your annual limit and the lifetime limits that are applicable to your policy.

I’m a long-time member of nib but recently upgraded my health cover to include orthodontia - does my loyalty count towards my orthodontia limit?

A: Yes. For example, if you have been with us for 10 years on a cover that does not include orthodontia and you upgrade to a cover that does include orthodontia, you'll be entitled to 10 years of benefits for orthodontia, but can only make a claim for it once the 12 month waiting period has been served.

If I switch health funds will my previous orthodontia benefits be carried over?

If you're switching from another health fund and had orthodontia included on your previous health cover, the length of time you held cover for orthodontia with your previous health fund will be recognised, and your orthodontia annual limit will be automatically increased.

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