When it comes to your teeth, we all know the drill—so to speak. Brush twice a day, floss regularly, and don’t forget your regular checkups. This is why dental cover is often one of the most popular extras when it comes to health insurance.
While you may think dental insurance just covers you for your half-yearly check-up and clean, there may be extra value you haven’t yet unlocked. Here are some unexpected ways you could be getting more out of your cover.
1. Playing contact sports? You could get a custom-fitted mouthguard with no gap
Put the kettle away, because the old boil and bite mouthguard could be a thing of your past. Depending on your chosen health fund and policy, your insurance may cover you for the cost of one custom-fitted mouthguard with no gap (out-of-pocket expense) via your fund’s preferred providers. That's some peace of mind for the coming sporting season, although it’s important to note you may only be able to claim one of these per person per year, depending on your policy.
My most recent custom mouthguard was fully covered by my policy, and has seen plenty of work over the last two rugby seasons. As I often say, it’s worth protecting your teeth as they can be one of your greatest assets!
2. Ready for a straighter smile? Your cover could include Invisalign
Invisalign is a popular choice for those looking to straighten and re-align their teeth without the commitment of braces. While these clear aligners need to be on for about 20-22 hours a day, you can take them out when eating, drinking, brushing, and flossing, giving you more flexibility than traditional braces.
If you have orthodontics cover as part of your policy you may be able to claim a rebate towards the cost of Invisalign. The extent of your coverage, as well as if any waiting periods or lifetime orthodontics limits will apply, will depend on your policy.
3. Wisdom teeth coming in? You may only need general dental to get them out
If it’s time for your wisdom teeth to come out, or you have another tooth that needs extracting, you may be able to claim for this sooner than you thought.
“Some health funds also offer surgical tooth extractions under general dental, rather than major, so you don't need to wait 12 months before you can claim,” Canstar Health Insurance Specialist Chloe Stonehouse says.
Whether your policy will cover tooth extractions will depend on how your insurer classifies them, either under general or major dental, as well as the kind of procedure you require, be it a simple extraction your dentist can do in the chair or a surgical one that’s more complex.
4. Your insurance could help with relief for overnight teeth grinding
If you have TMJ/TMD issues due to overnight teeth grinding, you may be able to claim towards the cost of ‘night guards’, also known by the more technical name occlusal splints. Canstar’s Ratings Manager Keely Robinson suggests these can cost upwards of $500 without insurance, so this could prove to be a real saving.
Bear in mind that cover for occlusal splints may be more specialised, and you may only find it on mid- or high-tier extras policies, in the major dental category. Additionally, you may have to serve a 12-month waiting period before you can claim them, and many funds may restrict you to claiming one set per person every one to three years.
5. Some restorative ‘cosmetic’ repairs could be covered
While purely aesthetic treatments like teeth whitening are usually excluded from private health cover, cosmetic work that’s medically necessary may be claimable. If you chip or fracture a tooth accidentally, major dental cover may help with the cost of fitting a porcelain veneer or placing a crown to restore both the function and appearance of your teeth.
If you have dentures, major dental can also help cover the cost of denture relines (resurfacing the base for a better fit) or repairing broken acrylic and clasps.
6. If you’re waiting for a major procedure, you could have cover for pain relief
If you’re painfully waiting for a full root canal or other similar procedure, you may be able to claim short-term treatment for acute pain or infection. This form of treatment will usually be covered under general dental as well, meaning there may only be a two-month waiting period.
One more thing: Don’t forget your twice-yearly checkup!
Even with dental insurance, a trip to the dentist can mean pulling your wallet out to cover the gap. But there are some services that are completely covered, like preventative care options, which can help keep your teeth in good condition.
“Most major health funds offer up to two fully covered preventive visits a year with no out-of-pocket costs through their preferred provider networks,” says Ms. Robinson. This can mean check-ups, teeth cleanings, and x-rays are covered with no out of pocket costs.
Your policy may also cover you for fissure sealants or fillings and even personalised oral hygiene coaching, which may be useful for children who only listen to a professional.
Before you start booking in …
There’s an important catch when it comes to dental insurance: no two policies or health funds are alike, and cover is not standardised. What's included in one policy could be completely excluded from another. Annual limits, waiting periods, preferred provider networks, and clinical requirements also impact whether or not you'll be able to make a claim.
If you’re not familiar with your policy’s fine print and can’t find the answers you’re looking for, it could be time for a quick call to your health fund to make sure you’re getting the most bang for your buck when it comes to your dental insurance.
And if you’re interested in reviewing your options, you could book a call with one of our health insurance specialists who can assist you with finding new cover.
