What is a waiting period?
When you sign up to a health insurance policy, there will usually be waiting periods during which no benefits are payable for services and treatment. The Department of Health, Disability and Ageing says waiting periods may vary, and must be no more than 12 months for hospital cover. Insurers can apply any waiting period for extras cover, though in practice, most policies on the market tend to be fairly standard.
According to the Private Health Insurance Ombudsman, waiting periods are designed to discourage people from joining a fund only when they know or suspect they need treatment, which can lead to higher costs for all health insurance customers
In some cases, if you switch to a similar or lower level of cover with a different provider, you will not need to re-serve any waiting periods you’ve already completed.
Who offers no waiting period on dental treatments?
Health insurance providers may waive dental waiting periods as part of a promotion, sign-up deal or special offer for new members. A number of providers may also offer to waive two and six month waits on services such as general dental, optical and physio if you sign up to their combined hospital and extras cover.
If you're taking out a new policy, be sure to check the fine print, double-check that the policy as a whole covers what you need and compare policy prices (including both premiums and excesses) before signing on the dotted line. Keep in mind that other waiting periods may apply, depending on the provider and policy you choose.
What types of dental cover are there?
Dental treatments are generally covered under the extras component of private health insurance, which is reserved for treatments that are not typically subsidised by Medicare.
Health insurers tend to split dental services into two categories: general dental and major dental. General dental usually covers common procedures such as teeth cleanings, check-ups and fillings, while major dental typically covers complex and expensive procedures such as wisdom teeth removal, root canals and orthodontics (like braces and retainers). Depending on the extras policy you choose, you may be covered for both general and major dental services.
What is the waiting period for dental benefits?
It's common for health insurance providers to have you serve a waiting period before you can claim for dental care. Most providers in Australia have a two to six-month waiting period for general dental services and a 12-month waiting period for major dental procedures and orthodontics.
Does Medicare cover dental services?
Medicare does not typically cover dental treatment for adults, with the costs usually being paid for by the patient. If you have a concession card such as a Health Care Card, or a Pensioner Concession Card issued by Centrelink, you may be eligible for publicly funded dental care. It’s important to be aware that there may be lengthy waiting lists for public dental care. You could be waiting more than a year (or several) to be treated, depending on which state or territory you live in.
Options for children may be slightly different. The Child Dental Benefits Scheme (CDBS) provides a range of free dental services to eligible children—up to $1,132 for each child over two calendar years, for children from birth to age 17. Only basic services are provided under the scheme, such as routine checks, cleaning, fillings and extractions. To be eligible, you or your child must be receiving certain Centrelink payments.
What do I need to consider when taking out dental health insurance?
You can often find special offers from providers that waive some waiting periods for dental care benefits. But it’s important to also consider the following:
- How the premiums compare with the rest of the market
- When the offer ends
- Which dental services are covered by the waived waiting period
- Whether the special offer provides the cover you’re looking for
- Other terms and conditions associated with the policy
Read a policy's Private Health Information Statement (PHIS) or contact the provider directly for more information.
