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A simple guide to orthodontics and how it works.
Orthodontics covers treatments that use various appliances to straighten teeth and correct problems with biting,
chewing, and jaw alignment. Orthodontics includes treatments like:
Uses bands and brackets to align and straighten teeth.
Involves a series of clear, custom-made removable aligners to gradually move teeth without the use of
metal wires and brackets.
Are appliances that widen the upper or lower jaw to prevent crowding of teeth and cross bites.
The maximum amount of benefits you can receive for orthodontic treatment within a calendar year.
The total amount of benefits you can receive for orthodontic treatment in your lifetime. Orthodontic benefits that
you receive from all health funds count towards your Lifetime Limit. If you’ve claimed for orthodontics and reach
your lifetime limit, HBF will not pay any further benefits towards orthodontic treatment for the duration of your
membership with HBF, even if you cancel your policy and re-join in future.
On some covers HBF pays a benefit per course of orthodontic treatment. A course includes the fitting,
adjustment and removal of the appliance, along with any additional removable or fixed appliances. For
these covers, HBF pays benefits up to your annual limit for that course on the date of diagnostics or
fitting. Benefits are paid once, even if treatment continues for multiple years. A lifetime limit may
For other covers, HBF pays a benefit per orthodontic item. For these covers, HBF pays 100% of the cost up
to your annual limit on your initial claim. If your orthodontic treatment continues across multiple
calendar years and you maintain cover for orthodontics, we may pay benefits up to your annual limits each
calendar year, until you reach your lifetime limit.
To be eligible to claim benefits in the next calendar year you must:
Ask your dental provider for a letter setting out your treatment for the current year, along with the expected treatment duration, item codes, fees and
total outstanding balance.
Submit your letter to HBF.
HBF will assess your entitlements and pay 100% of the eligible cost up to your annual limit
or lifetime limit.
For each subsequent calendar year that treatment continues, repeat steps 1 and 2.
If you reach your lifetime limit, HBF will not pay any further benefits towards orthodontic treatment for the
duration of your membership with HBF,
even if you cancel your policy and re-join in future.
Remember to always contact HBF to get a benefit quote before commencing treatment to understand what your
entitlements are, how benefits will be paid and which limits apply to your product.
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