What is a waiting period?
A waiting period is a period of time (e.g. two, six or 12 months) you must wait before you’re able to claim benefits for certain services and treatment as part of a health insurance policy. Waiting periods may vary, but must be no more than 12 months in length 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.
Waiting periods are designed to discourage people from joining a health fund only when they know or suspect they need treatment, which can lead to higher overall costs for all other 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.
Which providers offer no-waiting periods 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, typically for combined policies. These usually only apply to general and restorative dental services and not major dental.
While it’s a nice bonus to have waiting periods waived, it shouldn’t be the sole reason you choose one provider over another. If you're taking out a new policy, be sure to check the fine print included in a policy’s Private Health Information Statement (PHIS), 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 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.
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 also important to consider the following:
- How the premiums compare with the rest of the market
- What other treatments and services the policy covers
- When any promotion or 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 PHIS or contact the provider directly for more information.
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 Schedule (CDBS) provides a range of free dental services to eligible children—up to $1,158 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.
