Dental insurance in Australia

Dental insurance in Australia

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What is dental insurance?

Dental insurance refers to health insurance that provides coverage for dental treatment. There are several different types of dental cover available in Australia, with each covering different treatments and procedures.

Dental cover can be offered through an Extras policy, as well as a hospital policy. This means you can be covered for going to the dentist for a check-up or a filling, or going to hospital to get your wisdom teeth removed.

How dental cover works

Dental cover works similarly to many other forms of private health insurance. Once you’ve selected a policy and signed up, you’ll often need to serve a waiting period before you can make a claim for dental treatments. This length of time can vary between providers, but can be as little as two months.

You can typically claim part of the cost of each dental treatment on your private health insurance, though you may need to consider annual limits. You may also need to contact your provider to submit a claim, or you may be able to provide your membership details to your dentist for them to put in a claim on your behalf. This may be easier if your dentist is part of your health fund’s network of preferred providers.

What does dental insurance cover?

The services covered by health insurance for dental care depend on your policy, and whether you’re taking out Extras cover or a hospital policy.

Extras dental insurance is usually divided between two main categories:

  • General dental: Focused on the cost of routine dental treatments, such as check-ups, cleaning, filings, and x-rays.
  • Major dental: Designed for more complex (and often more expensive) dental procedures such as crowns, dentures and braces.

You can use our table to find Extras policies from our Online Partners that include general and/or major dental work.

Hospital policies can include cover for dental surgery in a hospital, such as surgery to remove wisdom teeth or apply dental implants.

Why take out dental cover?

Medicare generally doesn’t offer rebates for out-of-hospital dental treatment, which means you’ll usually need to pay the full amount yourself. The average cost of a dental check-up is $233, according to the most recent Australian Dental Association (ADA) Dental Fees Survey. This means you could be facing over $450 in dental bills per year for just two regular check-ups. Taking out a health insurance policy with dental cover can help to cover the cost of eligible dental treatments and services.

Looking after your oral health can be important to your overall wellbeing, as without it your quality of life and ability to speak, socialise and eat may be compromised. This can result in discomfort, pain and embarrassment, according to the Australian Institute of Health and Welfare.

How to find the best private health insurance for dental

Remember that the best dental insurance policy for you may be different to what’s best for other Australians. You’ll need to consider your own financial situation and lifestyle needs when comparing and selecting a private health insurance policy.

Some of the questions you may want to ask yourself include:

  • Do you want general or major dental cover?
  • Do you want Extras only, hospital only, or hospital and Extras cover?
  • Is your preferred dentist in the provider’s network?
  • How much are you prepared to pay in premiums?

The best dental insurance policy for you may also be affected by where you’re living and who it covers (e.g. yourself only, you and your partner, or your whole family). Overall, the more cover you want, and the more people you want the policy to cover, the more you may need to pay in premiums.

You can use our table to compare Extras-only health insurance policies from our Online Partners that offer general dental cover. You can get a health insurance quote from your chosen provider by clicking the ‘Get Quote’ button, or you can get a personalised quote from Canstar by clicking the ‘Get a Personalised Quote Now’ button at the top of the page.

For more involved dental treatment, you may need ‘major dental’ cover or hospital cover that specifies dental procedures. Change the filters on the table to explore the different types of cover.

Frequently Asked Questions about Dental Insurance

Medicare only covers basic dental treatments for eligible children under the Child Dental Benefits Schedule. Some adults, namely those who have a Health Care Card or Pensioner Concession Card, may be eligible for public dental services.

Otherwise, you’re expected to pay for dental treatment yourself.

Your policy with dental cover will usually contribute towards the cost of dental treatment performed by any qualified registered dentist. Some health funds also offer no gap payment options, which means you won’t have any out-of-pocket costs (depending on your annual limits) if you visit one of its branded clinics or a partner clinic.

It’s also worth checking whether your health fund accepts claims via HICAPS. The HICAPS system allows your dentist to process your claim immediately, rather than you paying the bill and then claiming it back from your health fund later.

For Extras policies, providers typically allow you to claim a percentage of the cost of your dental treatment or you may be entitled to a set amount.

In addition, Extras cover typically comes with annual limits, which is the maximum amount of money you can claim for a particular service.

Providers may also specify a combined annual limit which applies across a group of services, for example, a combined annual limit for general and major dental, physiotherapy and chiropractic.

Almost all health funds have a lifetime limit for orthodontic benefits such as braces, according to the Commonwealth Ombudsman. This means that once you have claimed the maximum benefit, you won’t be able to claim further benefits during your lifetime.

Several health funds offer 100% back on regular check-ups and other preventative services when you visit a dentist in the fund’s network. This is often known as ‘no gap dental’.

Preventative services typically include scale and clean, and fluoride treatment, with certain funds also including dental x-rays.

It’s worth checking with the individual fund to see what is and isn’t included and what other terms and conditions apply to its dental insurance policies. For example, no gap dental could be subject to annual limits. The fund may also have a cap on the number of check-ups you can claim 100% back on per year.

The waiting period is the amount of time you have to wait before you can make your first claim. How long your waiting period is will depend on the treatment or service, your policy and provider.

Typical waiting periods under Extras cover can be around two to six months for general dental, and 12 months or more for major dental procedures such as orthodontics.

For hospital policies, the maximum waiting period an insurer can set for dental surgery is two months though longer waiting periods may apply for pre-existing conditions (i.e. conditions you had or were showing symptoms of before your policy began).

Some health insurance providers may offer dental insurance with no waiting period as a part of a deal to attract new customers.

If you’ve already served a waiting period under one policy and switch to another health fund with the same or a lower level of cover, you’ll generally not have to re-serve the waiting period.

Your health fund may classify Invisalign treatments as orthodontics under Extras cover. If this is the case, there may be a maximum amount of benefits you can claim for orthodontic treatment within a calendar year, as well as an overall lifetime limit for claims involving orthodontic procedures.

Invisalign uses clear, custom-fitted ‘aligners’ to help straighten teeth.

Extras health insurance generally doesn’t cover cosmetic dental surgery, such as aesthetic veneers or teeth whitening, unless the treatment is deemed medically necessary. You may find that your policy does provide cover for cosmetic dental procedures and treatment like braces and dental aligners, crowns and implants to replace lost or missing teeth.

Coverage for cosmetic dental procedures will vary from policy to policy, so it’s important to check the Private Health Information Statement (PHIS) of any policy you’re considering or contact the provider directly for more information.

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