Dental Insurance

Looking for dental health insurance? Compare 30+ Australian health funds and find cover to smile about.

Dental treatment in Australia can be a prohibitively expensive, especially if you don't have health insurance. Here we take a look at how dental procedures are covered by the private health system, and discuss the advantages and limitations.

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What type of dental treatments can I get cover for?

The type of dental cover you choose generally depends on your age, family status, income and health. Individual dental services are typically categorised under:

• General dental. This includes cleaning, small fillings, plaque removal and X-rays. If you're young, healthy and single and only visit the dentist once or twice a year for minor treatments, it might be all you need.
• Major dental. This option may be more suitable for families and older people, as it covers more complex procedures such as braces, dentures, orthodontics, wisdom teeth removal, crowns, bridges and root canal work. 

Factors to consider when comparing dental policies

What waiting periods apply to dental claims?

Waiting periods exist to stop people from only taking out health insurance if they suddenly have to undergo an expensive procedure. This benefits both policy holders and health funds, as abuse of the system would quickly result in increased premiums:

• Major dental. Waiting periods generally range from six to twelve months depending on the treatment.
• General dental. Waiting periods can be as little as two months or waived altogether for simple preventative treatments.

In order to attract new members health funds regularly offer sign up deals that allow you to instantly claim on extras services such as general dental. However, it's uncommon for major dental treatments to be included in these promotions.

Is a dental plan worth considering?

As well as taking out private dental cover, there is the option of a discount dental plan (queue in everyone's collective minds, "Lisa needs braces ... Dental plan ... Lisa needs braces ... Dental plan ... Lisa needs braces ... Dental plan ... etc.). These plans do not pay for dental expenses, but provide discounted prices from a network of participating dentists in exchange for an annual membership fee. Both schemes have their advantages and drawbacks, which are summarised below:

Does the public health system offer any cover for dental?

The only instances where Medicare covers dental work for adults are:

• If it is needed to protect the patients general health.
• If it forms a part of a Medicare approved treatment, such as dental work prior to radiation treatment for oral cancer.

Hospitalisation for dental-related treatment may also be covered by Medicare (e.g. if you develop an infection from having a tooth removed), but it typically won't pay for any follow-up dental care once the condition has been treated, or for specialist fees not related to the specific condition being treated.

What is the Child Dental Benefits Schedule?

The Child Dental Benefits Schedule (CDBS) is a program run by the Australian Government for around 3 million eligible Australian children. It provides up to $1,000 in benefits over two consecutive calendar years. Dental services that are covered include:

Services can be provided in a public or private clinic, although no cover is available for orthodontic or cosmetic dental work, and there are no benefits for treatments in a hospital.

To receive benefits under the CDBS, a child must be eligible for Medicare, aged between 2 and 17 years at any time in the calendar year and have received a specified payment from the Australian Government (e.g. Family Tax Benefit A) at any stage during the calendar year. In most cases you will be notified if your child is eligible at the beginning of the year.

Are there any risks associated with dental tourism?

Due to rising health insurance costs in Australia, a new industry has sprung up known as dental tourism. Major dental procedures are often much cheaper in developing countries, so many people opt to travel overseas to receive treatment. You can pay as little as one quarter of the cost of having the same procedure in Australia. However, you must be aware of the dangers associated with this industry:

• No travel insurance. Medical tourism is typically excluded from travel insurance policies. This means you cannot claim for any direct or related costs if there are complications with the treatment.
• Higher chance of something going wrong. Developing countries often don't have the same standards and expertise as medical professionals in Australia.
• You may end up paying more. Fixing a botched procedure can end up costing you even more, especially if it has to be rectified in Australia.
• No recourse for reimbursement. If you fall victim to fraud or medical malpractice your ability to pursue legal action is minimal to non-existent.

Dental coverage offered by participating health funds

This is a broad overview of how dental treatment is covered by health funds in the finder.com.au fund panel. You can find a complete breakdown of how each Australian health fund covers specific dental treatments by using the navigation portals at the top of this guide.

*Disclaimer: The benefit limits listed on this table are taken from the highest level of extras cover offered by these health funds. Lower tier policies may pay a smaller benefit amount or not cover certain dental services. Benefit limits are based on a policy quoted for a single male under 65 years of age earning less than $90,000 living in NSW. 

More information about specific dental services

General dental

Services such as routine checkups and dental X-rays.

Major dental

Complex procedures such as wisdom teeth removal and bridges.

Orthodontics

Corrective dental appliances such as braces and retainers.

Endodontics

Inner tooth treatments such as root canals and root end surgery.

Compare health insurance for dental from 30+ Australian health funds

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