Top 5 Health Plans Covering Invisalign, Implants & Veneers

5 Best Health Insurance plans for invisalign, Dental Implants, and Veneers

Considering Invisalign, veneers, or dental implants? Wondering about insurance coverage? Cosmetic dental procedures vary by insurer – some may cover parts, others none. This guide clarifies how health funds handle costs to help you plan.

In this in-depth guide, you will learn:

✅ How Do Health Insurers Tackle Cosmetic Dentistry Costs?
✅ 5 Best Health Insurance Plans for Invisalign/Dental Implants and Veneers
✅ Understanding Dental Health Insurance and Major Dental Treatment Coverage
✅ How Can You Maximise Your Health Insurance for Dental Work?

and much, MUCH more!

Unlocking the Mystery: How Do Health Insurers Tackle Cosmetic Dentistry Costs (If They Do)?

Navigating dental insurance in Australia can be tough, especially for cosmetic treatments like Invisalign, implants, and veneers.

These are usually classed as “major dental,” which means high costs, annual limits, and long waits. Implants, for example, cost $3,000 – $5,000 per tooth, but most insurers only cover up to $1,500 yearly, leaving you to pay the rest.

Invisalign falls into a grey area. Some insurers cover it for minors or if medically necessary, but don’t expect full reimbursement. Veneers are usually excluded unless medically required, and even then, coverage varies.

5 Best Health Insurance Plans for Invisalign/Dental Implants and Veneers in Australia

According to our research, here are the top five funds that offer coverage for Invisalign/Dental Implants and Veneers:

Onemedifund
Phoenix Health Fund
Queensland Country Health Fund
Mildura Health Fund
RT Health

Onemedifund

Onemedifund doesn’t call out Invisalign by name, which already says something. Orthodontic treatment is included under their extras, with a lifetime limit of $2,100. That might sound decent, but there are a few caveats:

The benefit is only payable if the patient is under 24.
There’s a 12-month waiting period before you can claim anything.
Your return amount depends on how long you’ve held your cover.

You’ll need to provide a treatment plan up front.

Dental Implants Coverage

Dental implants sit in the “major dental” basket. That means:

Coverage is technically available, but no line item for implants exists
Claims are limited by annual caps – $2,650 total per policy.
Sub-limits apply per procedure type (for example, a full crown is capped at $850).

You’ll still need to cover specialist costs, hospital fees, and surgical components not classed as dental.

Veneers Coverage

Onemedifund doesn’t cover veneers. Not even a little. That’s because they’re classified as cosmetic, and cosmetic = excluded.

The only exception might be if you’re having reconstructive work for medical reasons. However, nothing’s guaranteed unless pre-approved and your dentist codes it a certain way.

Major Dental Cover vs. Basic Dental Cover

The split between basic and major dental is important if you’re comparing benefits:

Basic dental: Check-ups, cleans, fluoride, fillings.
Major dental: Crowns, dentures, bridges, surgical extractions.

Only major dental gets anywhere near the treatments we’re talking about here. But don’t confuse “covered” with “fully paid.” Even with major dental, there’s a decent chance you’ll still be dipping into your savings.

Pros and Cons

✅ Pros	❌ Cons
Good annual limits for major dental compared to some others	No veneers cover at all
Lifetime ortho limit can be useful (if you're under 24)	Orthodontic cover doesn’t apply to most adults
Itemised dental rebate info is relatively clear	Dental implants are not specifically detailed
Covers some specialist dental under extras	Sub-limits mean you're unlikely to claim full treatment costs

Phoenix Health Fund

If you’re interested in getting Invisalign through Phoenix Health Fund, here’s the reality: orthodontic benefits are capped, and there are conditions. The fund offers up to $2,400 as a lifetime orthodontic benefit, with a $1,200 max per year. Here’s additional info:

You’ll need to serve a 12-month waiting period.
Treatment has to be recognised as orthodontic (not just cosmetic teeth straightening).
Reimbursement is percentage-based, not fixed-fee.

Adults chasing an aesthetic result may find this benefit hard to access. It’s more likely to suit dependent children or teens under a family plan.

Dental Implants Coverage

Dental implants are included under their major dental benefits. However:

There’s a $1,000 sub-limit per policy year.
You’ll also be subject to the overall major dental cap of $2,000.
You’ll still pay out of pocket for any oral surgery or prep work outside the dental chair.

If you hope your entire implant procedure will be covered, you’ll need to pair this benefit with a serious budget, or stagger treatments over time.

Veneers Coverage

This is where Phoenix edges ahead of some competitors. Veneers are claimable but fall under the same $1,000 sub-limit for certain high-cost dental treatments. Whether that gets you one veneer or part of two will depend on your provider’s fees.

In addition, the fund applies a 12-month wait, so if you plan to upgrade your smile soon, you must act early to be eligible later.

Major Dental Cover vs. Basic Dental Cover

There’s a clear line between Phoenix’s major and basic dental benefits. Here’s the info:

Basic covers everyday stuff – cleans, exams, x-rays, small fillings.
Major steps are involved for anything complex – implants, crowns, surgical extractions, and veneers.

Only major dental gives you access to the higher-value benefits, but you’ll hit a limit quickly if you plan multiple treatments in one year.

Pros and Cons

✅ Pros	❌ Cons
Covers veneers and implants (rare for many funds)	Annual limits and sub-limits add up quickly
The lifetime ortho benefit of $2,400 is generous	Orthodontic claim rules are rigid, mostly suiting younger members
12-month wait for major dental gives time to plan	No coverage beyond dental (e.g., surgery or anaesthetics related to implants)
Simple, well-explained policy structure	You’ll still be out of pocket for most complex cosmetic work

Queensland Country Health Fund

Orthodontics is covered under Queensland Country’s Ultra Extras policy, but if you’re an adult looking at Invisalign, it’s not exactly easy.

Benefits have a lifetime limit that grows the longer you’re a member.
You’ll need to wait 12 months before thinking about claiming.
Claims are percentage-based, not full-cost reimbursements.
The benefit is more accessible for younger dependents still on a family plan.

Invisalign isn’t listed by name, but you might be able to claim it if the provider codes it as orthodontic treatment and it’s medically necessary. It’s not guaranteed and not tailored for cosmetic adult aligners.

Dental Implants Coverage

Dental implants are technically covered because they fall under the “major dental” umbrella. However, don’t expect seamless coverage.

There’s a set annual limit for major dental that increases with your years of membership.
A 12-month wait applies before you can claim for implants.

Depending on how the procedure is billed, you’re likely to hit a sub-limit cap per service.

Veneers Coverage

You can claim veneers with QCHF, which already puts them ahead of other funds. Here’s the catch:

Veneers fall within the major dental category.
There’s a per-person sub-limit each membership year.
Coverage only applies if veneers are part of restorative (not cosmetic-only) treatment.

If your dentist codes it right and the purpose is not purely aesthetic, you might get part of the cost back.

Major Dental Cover vs. Basic Dental Cover

Queensland Country makes a distinction between the two:

Basic

Covers routine care like exams, cleaning, and fillings. Benefits are usually paid as a percentage of the cost.

Major

Includes crowns, bridges, dentures, surgical extractions, implants, and eligible veneers. Higher limits, but more restrictions and wait times.

Pros and Cons

✅ Pros	❌ Cons
Offers veneers and implants under extras, not just the basics.	Invisalign coverage isn’t clearly defined.
Loyalty boosts your annual and lifetime limits.	Requires at least 12 months on cover before major dental kicks in.
Strong long-term value if you stick around.	Sub-limits make full procedure coverage difficult.
Transparent tiers between basic and major dental.	Restorative-only coverage for cosmetic-style treatments.

Mildura Health Fund

If you want to claim Invisalign through Mildura, here’s what’s on the table (and what’s not).

Orthodontic treatment has a lifetime cap of $1,500.
Yearly limits apply (starting at $600).
There’s a 24-month waiting period before you can claim anything.
Benefits are percentage-based and tiered over time.

There’s no mention of Invisalign specifically; whether it is approved depends on the provider’s item codes and how “medically necessary” the treatment is.

Dental Implants Coverage

Mildura does offer some support for implants under its major dental extras, but there are a few catches.

Coverage starts after just 2 months, which is shorter than most funds.
Your benefit starts at $350 and increases by $60 annually, maxing at $650 after six years.
You can only claim for the prosthetic portion, not the surgical side of implants.

If you need a full-mouth job, it will outpace your annual limits quickly. If you only need one implant and are happy to co-fund it, it could help ease the financial strain.

Veneers Coverage

Veneers are listed, but you must read the fine print.

A full crown veneer is covered at $650.
This falls under major dental, so the stepped benefit applies.
Claims are subject to how your provider classifies the work.

This means that if it’s strictly cosmetic, it’s a “maybe.” If there’s any medical necessity, you might be covered. Either way, asking your dentist to break down the billing codes before you start the process is the best.

Major Dental Cover vs. Basic Dental Cover

Mildura splits dental into two clear categories, and your benefit levels increase the longer you remain a member. Here’s the breakdown:

Basic Dental

Covers general cleaning, check-ups, and simple work like small fillings. Benefits are paid as a percentage and are usually accessible early.

Major Dental

Includes more involved work, like crowns, dentures, surgical extractions, veneers, and implants. Annual limits increase each membership year, rewarding loyalty.

Never confuse your coverage tier with “unlimited value.” Even at the highest level, you might still pay a portion of the bill out of your pocket.

Pros and Cons

✅ Pros	❌ Cons
A short 2-month wait for major dental is rare.	Long wait (24 months) for ortho like Invisalign.
A gradual increase in limits rewards long-term members.	The starting benefit for major dental is low.
Veneers and implants get a mention.	Invisalign isn’t supported or itemised.
Dental cover is reasonably priced compared to some larger funds.	Full procedures will still leave you out of pocket.

RT Health

If you’re considering Invisalign, RT Health might help, depending on the situation. The Top Extras include orthodontic benefits, but there are a few things you need to know:

Coverage only starts after a 12-month wait.
The lifetime limit for ortho is $2,000 per person.
Claims are paid as a percentage of the total cost only if the treatment is classified as orthodontic (not cosmetic).
Generally more suited to younger members under family policies.

There’s no clear mention of Invisalign itself. If you are older than 25 and want a purely cosmetic fix, you’ll be on your own paying for this.

Dental Implants Coverage

Dental implants fall under major dental in RT Health’s extras cover. While it’s a step in the right direction, it doesn’t mean full coverage. Here’s the info:

Annual limits apply, and the amount reimbursed depends on how long you’ve been with the fund.
You’ll need to wait 12 months before making a claim.

The benefit generally only covers the dental prosthetic, not the surgical or hospital components of the procedure.

Veneers Coverage

Surprisingly, yes. Veneers are covered, but under very specific conditions.

Veneers fall within the major dental benefit.
A per-person sub-limit applies each year, capping how much you can claim.

The treatment must be restorative (not just cosmetic) to qualify.

Major Dental Cover vs. Basic Dental Cover

RT Health makes a clear distinction between dental categories:

Basic Dental

Covers exams, cleans, minor fillings, and fluoride. Available after just 2 months on cover.

Major Dental

Includes complex treatments – implants, crowns, dentures, bridges. Has higher limits and a 12-month wait.

These two work hand-in-hand, but only major dental benefits will apply if you need serious dental work.

Pros and Cons

✅ Pros	❌ Cons
Lifetime orthodontic benefit of $2,000	No Invisalign-specific guidance and coverage depend on item codes
Covers veneers if they're medically necessary	Cosmetic-only treatments won’t be covered
Major dental includes implants, with decent limits over time	Hospital or surgical components of implants aren't covered
The extras cover is simple and relatively easy to follow	12-month waits apply across most high-value treatments

Understanding Dental Health Insurance and Major Dental Treatment Coverage

Dental insurance in Australia sounds straightforward until you look at the fine print. The difference between what’s included under “general dental” and “major dental” matters, especially when planning anything beyond a routine check-up. H

Here’s how it works, broken down into the parts that affect your wallet.

What Counts as ‘Major Dental,’ and Why Does it Cost More?

Major dental refers to the big stuff: crowns, bridges, dentures, surgical tooth removals, implants, and orthodontics (sometimes).

These aren’t quick, single-visit treatments. They often span weeks or months, require multiple appointments, and involve lab work or surgery. Thus, major dental has higher limits and stricter rules, including longer waiting periods.

Insurers typically apply an annual cap (anywhere from $800 to $2,000), and many introduce sub-limits for each treatment type. You rarely get a full refund, even the best extras only cover part of the cost.

The Waiting Period Trap

Many sign up thinking they can claim for dental implants or braces the following week. That’s not how it works. Most funds impose a 12-month waiting period for major dental; some orthodontic policies even stretch to 24 months.

If you need treatment soon, you must either delay it or pay in full yourself. The clock starts ticking the day your cover begins, not when you want to claim. There’s no skipping the line unless you switch from another fund with equivalent cover (and even then, it’s not always honoured).

Why Sub-Limits Matter More Than You Think

The overall limit on your major dental might look impressive until you realise the real action is in the sub-limits. These hidden caps in your policy decide how much you get back.

Here’s what that might look like in practice:

Crowns often cap out at around $850 each, even if your total limit is $2,000.
Veneers can be restricted to $500–$600 per year, per policy, not per tooth.
Implants typically only cover the prosthetic tooth (not surgery or hospital fees).
Orthodontics has a lifetime limit, and rarely applies to adults.
Dentures might be partially covered, but usually spread across multiple years due to caps.
Surgical extractions could be classed separately and reimbursed at a lower rate.
Bridges may fall under their item category, with a lower payout per unit.

These caps don’t appear in bold print; most people only find out about them after starting treatment. Knowing your sub-limits ahead of time can save you from expensive surprises. It can give you a better sense of how to time your claims across multiple years, if needed.

Basic vs. Major Dental: What You Should Know Before Choosing a Policy

🔎 Feature	🦷 Basic Dental	🧬 Major Dental
📉 Covers	Check-ups, cleans, small fillings	Crowns, implants, extractions, ortho
📈 Wait Period	Often 2 months	Usually 12 months (or more)
📊 Claim Type	Ongoing, minor procedures	Planned, complex, multi-visit
💶 Payout Style	Higher percentage, low cost	Lower percentage, high cost

Basic dental might be enough if you only need check-ups and the occasional filling. For anything structural or aesthetic, you must consider major dental coverage. However, even then, you must review the sub-limits before committing.

How Can You Maximise Your Health Insurance for Dental Work?

Dental cover can either be a money-saver or a monthly expense that never gives back. It depends entirely on how you use it.

If you pay for extras, there are a few smart ways to squeeze more value from your policy, especially regarding major dental treatments like implants, veneers, and orthodontics.

Know Exactly What You’re Covered For

It sounds basic, but most don’t know what their policy includes until they’re at the dentist and being told it’s not covered. Here’s what to look for:

Waiting periods for basic vs. major dental.
Annual and lifetime limits – some are tiny.
Sub-limits by procedure (e.g., crowns vs. implants).
Whether orthodontics applies only to dependents.
Definitions of cosmetic vs. restorative treatments.

Grab the full Product Disclosure Statement (PDS), not just the sales blurb.

Time Your Treatment Around Your Annual Limits

Health funds work on a calendar year, as should your treatment plan. This tactic works well for:

Crowns or bridges are done in stages.
Multi-step implant procedures.
Braces or Invisalign fitted late in the year, with reviews early the next year.
Dentures or partials that need adjustments over time.

Spacing procedures across two benefit years can double what you can claim.

Ask for Item Codes Before You Book

This is where being proactive pays off. Dentists and specialists use specific item codes when billing, which are what your insurer sees when processing your claim.

You won’t get anything back if a procedure is coded as cosmetic. It may be partially claimable if coded as restorative or medically necessary.

Call your insurer before you book treatment. Quote the codes, and confirm what’s claimable. It involves some admin, but it can save you thousands.

Don’t Ignore the Loyalty Bonuses

Some insurers increase your major dental limits the longer you stay with them. It’s not always huge, but if your benefit rises by $50 or $100 yearly, it can add up over time.

If you’re considering switching funds, factor in what you leave behind. A newcomer deal might be tempting, but it could reset your waiting periods or wipe out your loyalty-based increases.

Ask for Item Codes Before You Book

This is a game-changer, and most don’t do it. Dental treatment is processed through item codes, not descriptions. Why it matters:

Some codes are flagged as cosmetic, which voids the cover.
Others might let you claim under major dental or orthodontics.
It lets you confirm with your insurer before you’re out of pocket.
Some clinics will provide alternate codes if the treatment overlaps categories.

If the wrong code is used, your claim may be rejected, even if the treatment technically qualifies.

Split Bills Where It Makes Sense

Some dentists are open to spreading treatment across multiple invoices or item codes if your procedure spans weeks or months. This isn’t dodgy, but strategic.

For example, your implant work includes extractions, the implant itself, and then a crown. If billed all at once, you will quickly hit your benefit limit. You can maximize your claims across different services if it is spaced appropriately and within what your insurer allows.

In Conclusion

Making sense of dental cover in Australia involves more than skimming your extras policy. Between sub-limits, waiting periods, and what’s considered “cosmetic,” it’s easy to assume you’re covered.

Whether you plan for a full smile makeover or are just looking ahead, understanding how major dental works (and how to work it to your advantage) is the key to getting real value from your insurance.

The smartest move is to take the time to ask questions, read the fine print, and plan your treatment around what your policy pays for, and not what you hope it does.

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Frequently Asked Questions

Does health insurance cover Invisalign?

Sometimes, but usually only if it’s considered orthodontic treatment, not cosmetic.

Are dental implants fully covered?

No, not fully. Most funds only cover the crown, not the surgery or implant post.

What is a sub-limit?

It’s a cap within a cap – like $850 for a crown, even if your annual major dental limit is $2,000. Always check both.

Can I use my benefits at any dentist?

Usually, yes. Some funds offer better rebates or no-gap deals if you use preferred providers.

How long do I have to wait before I can claim major dental?

Most funds have a 12-month wait. Some orthodontic benefits take 24 months. Unfortunately, there’s no way around it unless you switch to an equivalent plan and have already served waiting periods.

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