Orthodontics claiming
Orthodontics is included on some nib Extras covers and is a benefit that increases by $100 per year up to the maximum amount you can claim in a lifetime.
About Orthodontics claiming
Orthodontics has a starting annual limit that increases each year. You can start claiming up to this annual limit once you have served your 12 month waiting period for orthodontics.
For each calendar year that you are with nib, the orthodontics annual limit will increase by $100, even if you haven’t had cover for orthodontics 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 up to the lifetime limit.
The lifetime limit on orthodontic benefits is the maximum nib will pay in total benefits over the lifetime of your policy. Once you reach this limit, you are unable to make any further claims for orthodontics. This lifetime limit includes any orthodontics treatments you have claimed with a previous health fund.
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 or dentist. Just scan your nib card at the terminal and all you have to pay is the difference. Other claiming options are also available.
If you pay for your orthodontics up front or pay a large lump sum during the course of your treatment, you can continue to claim for orthodontics 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.
Upgrading your health cover to include orthodontics
We recognise member loyalty when you upgrade your cover to include orthodontics. If for example you've been with us for 10 years on a cover that didn't include orthodontics and you upgrade to a cover that does include orthodontics, you'll be entitled to 10 years of benefits for orthodontics, but can only make a claim for it once the 12 month waiting period has been served.
Switching from another health fund
If you're switching from another health insurer and had orthodontics included on your previous health cover, the length of time you held cover for orthodontics will be recognised, and your orthodontics annual limit will be automatically increased.