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Health insurance for endodontic services

Looking for a policy that includes endodontics? Find out which health insurers cover this type of dental treatment.

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Endodontics is a field of dentistry that exclusively deals with teeth interiors, or the soft organic tissue beneath the hard exterior. Endodontists are the specialists that handle the procedures.

Depending on the circumstances and the procedure required, you may or may not be able to claim endodontic procedures on your private health insurance.

Compare health insurance policies that cover endodontics

Just click "Refine Search" and tick Endodontic under extras cover.

How Australian health funds cover endodontics

FundExtras cover that pays towards endodontics and the benefit limits* for treatmentApply
ahm_logo_150x100

  • Black 60. Shared annual benefit limit of $600.
  • Black 70. Shared annual benefit limit of $600.
  • Lifestyle Extras. Shared annual benefit limit of $600.
  • Family Extras. Shared annual benefit limit of $600.
  • Black 70 Boost. Shared annual benefit limit of $750.
  • Super Extras. Shared annual benefit limit of $1,000.
More info
HCF Logo
  • Mid Extras. Shared annual benefit limit of $650.
  • Vital Extras. Initial shared annual benefit limit of $800 which increases each year until it caps at $1,100 in year three.
  • Top Extras. Initial shared annual benefit limit of $1,000 which increases each year until it caps at $1,300 in year three.
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  • Active 60. Shared annual benefit limit of $800.
More info
Picture not describedmedibank logo
  • Healthy Start Extras. Shared annual benefit limit of $500.
  • Growing Family Extras Only. Initial shared annual benefit limit of $800 which increases each year until it caps at $1,000 in year four.
  • Top Extras. Shared annual benefit limit of $1,200.
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nib helath insurance logo
  • Core Extras. Shared annual benefit limit of $600.
  • Core and Wellbeing Extras. Shared annual benefit limit of $600.
  • Core Extras Boost. Shared annual benefit limit of $1,000.
  • Top Extras. Shared annual benefit limit of $1,300.
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  • Basic Extras. Shared annual benefit limit of $600.
  • Family Extras. Shared annual benefit limit of $600.
  • Lifestyle Extras. Shared annual benefit limit of $600.
  • Active Extras. Shared annual benefit limit of $1,000.
  • Top Extras. Shared annual benefit limit of $1,300.
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*Unless otherwise stated all benefit limits are per person.

A complete list of Australian health insurers who offer cover for endodontics can be found at the end of this article.

What is endodontics?

While general dentists primarily take care of the outside of the tooth, endodontists deal with the inside. Endodontic treatments include:

  • Root canals. If the tooth pulp (interior tissue) becomes inflamed or infected, then a root canal may be required. This involves carefully removing the infected tissue, cleaning and disinfecting the area and then resealing the tooth.
  • Endodontic retreatment. If a previously-treated tooth suffers a fracture or other damage, it may become reinfected and need endodontic retreatment. This can happen if decay or injury reopens the tooth, an undetected dental issue presents before the first treatment causes problems, or the previous treatment was otherwise incorrectly carried out or not permanently effective.
  • Endodontic surgery. This refers to specific procedures like apicoectomy, or root-end resection, which is required when infection persists in the bony area at the end of a tooth following a root canal. There are a variety of endodontic surgery procedures that can be used in this situation, but apicoectomy is the most common.

What types of health insurance cover endodontics?

Both private health funds and Medicare cover endodontic treatments to a certain extent.

Private health insurance

The majority of private health funds will cover endodontic procedures with either extras or dental policies. Limits, waiting periods and whether or not endodontics are actually covered will vary depending on the chosen provider and policy.

When looking for coverage of endodontic treatments in a private health insurance policy, you will almost always require an extras or a dental plan. General dentistry and basic health insurance policies typically do not offer any cover. Endodontics itself will typically be grouped within a policy in one of three ways:

  • Endodontics and periodontics. These are often grouped together.
  • Endodontics. It may also be its own distinct category.
  • Major dental. Many policies will group endodontics within the major dental category. Some may also have additional categories like “complex dental”, which might cover endodontics instead.

Check your health fund’s benefit schedule to see how endodontics is classified on your policy.

Medicare

The only endodontic-related costs that Medicare will cover are those related to dental radiology. This is when X-rays are used to diagnose dental issues. Endodontic treatments themselves are not covered by Medicare.

Can I get dental-only health insurance?

Some health insurance funds may also offer dental-only insurance policies. These will only cover dental procedures and will cost a lot less than standard hospital or extras policies. This can be useful if you are interested in finding a health insurance plan that only covers dentistry, or if you have extensive oral surgery needs and ongoing dental health requirements.

  • Dental-only plans typically offer high levels of cover for general dentistry such as check-ups and plaque removal.
  • The insurer may categorise endodontics as major dentistry, as “endodontics and periodontics”, or as a separate endodontics group. Alternatively, they might only list specific procedures, such as root canals, which are covered.
  • Dental-only health insurance policies typically cost less than most extras plans.
  • As with other policies, you may be able to select different types of dental-only health insurance, ranging from basic to comprehensive.
  • Because they are used for specific purposes, it is not uncommon for dental-only policies to have up to a 12-month waiting period for certain dental procedures. The same is true of many health insurance extras plans.

A complete extras plan rather than a dental-only policy will typically be more cost-effective if you intend to claim for things other than dental procedures, or if you want to be able to claim for more unexpected health issues and treatments.

What to be aware of when comparing policies

Extras policies cover important things that Medicare doesn’t. Endodontic treatments are a perfect example of this. When comparing extras insurance, look for the following features:

  • Waiting periods. This is the minimum amount of time you must wait between taking out a policy and being able to claim benefits with it. For endodontics and other major dental procedures, this is typically 12 months with most policies.
  • Limits. This is the most you can claim for either certain treatments, such as endodontics, or for certain categories of treatments, such as major dental or all dental. The main limit to consider is the annual amount per person. There may be separate limits for families all under the same policy, sub-limits that apply to certain treatments or types of treatments and lifetime limits that apply for the entire lifespan of the policy.
  • Exclusions. These are conditions under which you cannot claim benefits. Exclusions could include certain causes of damage, such as not following the advice of your dentist, being treated by someone who is not a registered practitioner, or receiving treatment outside of Australia.
  • Required dental cover. If you are looking for a health insurance policy that covers endodontics in particular, then you should pay close attention to how it is categorised. Endodontics will typically fall into the major dental category, but it might also be separate.

Compare health insurance in just a few clicks

Complete list of providers that cover endodontics

FundExtras cover that pays towards endodontics and the benefit limits* for treatmentApply
ahm_logo_150x100

  • Black 60. Shared annual benefit limit of $600.
  • Black 70. Shared annual benefit limit of $600.
  • Lifestyle Extras. Shared annual benefit limit of $750.
  • Family Extras. Shared annual benefit limit of $750.
  • Black 70 Boost. Shared annual benefit limit of $750.
  • Super Extras. Shared annual benefit limit of $1,100.
More info
HCF Logo
  • Mid Extras. Shared annual benefit limit of $650.
  • Vital Extras. Initial shared annual benefit limit of $800 which increases each year until it caps at $1,100 in year three.
  • Top Extras. Initial shared annual benefit limit of $1,000 which increases each year until it caps at $1,300 in year three.
Go to Site
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  • Extras 50. Shared annual benefit limit of $750.
  • Active 60. Shared annual benefit limit of $800.
More info
Picture not describedmedibank logo
  • Healthy Start Extras. Shared annual benefit limit of $500.
  • Growing Family Extras Only. Initial shared annual benefit limit of $800 which increases each year until it caps at $1,000 in year four.
  • Top Extras. Shared annual benefit limit of $1,200.
Go to Site
nib helath insurance logo
  • Core Extras. Shared annual benefit limit of $600.
  • Core and Wellbeing Extras. Shared annual benefit limit of $600.
  • Core Extras Boost. Shared annual benefit limit of $1,000.
  • Top Extras. Shared annual benefit limit of $1,300.
Picture not described
  • Basic Extras. Shared annual benefit limit of $600.
  • Family Extras. Shared annual benefit limit of $600.
  • Lifestyle Extras. Shared annual benefit limit of $600.
  • Active Extras. Shared annual benefit limit of $1,000.
  • Top Extras. Shared annual benefit limit of $1,300.
Go to Site
Picture not describedHIF Health Insurance
  • Vital Options. Shared annual benefit limit of $800.
  • Special Options. Initial shared annual benefit limit of $300 which increases each year until it caps at $800 after five years.
  • Super Options. Initial shared annual benefit limit of $500 which increases each year until it caps at $1,000 after five years.
  • Premium Options. Initial shared annual benefit limit of $700 which increases each year until it caps at $1,200 after five years.
More info
Picture not describedGMHBA
  • Mid Extras. Shared annual benefit limit of $1,500.
  • Mid Extras 65%. Shared annual benefit limit of $1,500.
  • Top Extras. Shared annual benefit limit of $2,000.
  • Top Extras 75%. Shared annual benefit limit of $2,000.
More info
Transport Health logo
  • Healthy Choice Extras. Shared annual benefit limit of $500.
  • Top Extras. Initial shared annual benefit limit of $800 which increases each year until it caps at $1,200 in year five.
More info
Bupa logo
  • Your Choice Extras 60. Shared annual benefit limit of $500 after one year of holding cover. Increases each year until it caps at $1,000 after year seven.
  • Top Extras 60. Shared annual benefit limit of $1,000.
  • Top Extras 75. Shared annual benefit limit of $1,100.
  • Top Extras 90. Shared annual benefit limit of $1,200
More info
Frank health logo
  • Some Extras 50% Back. Shared annual benefit limit of $500.
  • Some Extras 80% Back. Shared annual benefit limit of $500.
  • Everyday Extras. Shared annual benefit limit of $800.
  • Lots Extras 50% Back. Shared annual benefit limit of $2,000.
  • More Extras. Shared annual benefit limit of $1,000.
  • Lots Extras 80% Back. Shared annual benefit limit of $2,000.
More info
Hbf Logo
  • Flex 50. Shared annual benefit limit of $800.
  • Flex 60. Shared annual benefit limit of $1,000.
  • Complete 60. Shared annual benefit limit of $800.
  • Top 70. Annual benefit limit of $1,000.
More info
Health Partners Logo
  • Good Extras. Shared annual benefit limit of $900.
  • Better Extras. Shared annual benefit limit of $800.
  • Best Extras. Shared annual benefit limit of $1,200.
More info
onemedifund logo
  • Comprehensive Extras. No annual benefit limit applies.
More info
Picture not describedPeoplecare health insurance
  • Mid Extras. Shared annual benefit limit of $500.
  • High Extras. Shared annual benefit limit of $1,000.
  • Premium Extras. Shared annual benefit limit of $1,500.
More info
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  • Select Extras. Shared annual benefit limit of $600.
  • Essential Extras. Annual benefit limit of $900.
More info
Picture not describedSt. Lukes Health Logo
  • Super Extras. Annual benefit limit of $1,000.
More info
Picture not described
  • Essential Extras. Shared annual benefit limit of $400.
  • Advantage Extras. Shared annual benefit limit of $1,125.
  • Advantage Pro Extras. Shared annual benefit limit of $1,400.
  • Esteem Extras. Shared annual benefit limit of $1,600.
  • Ultimate Extras. Shared annual benefit limit of $1,500.
More info
CBHS logo

Restricted fund**

  • Intermediate Extras. Shared annual benefit limit of $400.
  • Top Extras. Annual benefit limit of $660.
More info

*Unless otherwise stated all benefit limits are per person.
**Restricted funds only provide cover to members of specific industries, groups and organisations. In some cases family members may also be eligible to join.

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