Dental Insurance Australia

Dental Insurance

Find a dental health insurance provider that’ll give you something to smile about.

Dental cover is one of the primary reasons Australians take out private extras cover. Because of the high cost of dental treatment, it can be prohibitively expensive for many without dental health insurance. This guide looks at what dental cover is available in Australia, what advantages and limitations it offers and what alternatives there are, if any.

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Compare the best health insurance for dental from the panel

Getting the *best health insurance for dental can vary from person to person. The table below displays one product from each of the funds in our panel. We selected the policy for this table based on the highest cover for general and then major dental. For a complete list of the policies on offer, please consult the comparison table at the end of this article

HIF PremiumGeneral dental waiting periods: 2 months General dental annual limit: $1,500 Major dental waiting periods: 12 months Major dental annual limits: 1,500 Heart HighGeneral dental waiting periods: 2 months General dental annual limit: $750 Major dental waiting periods: 12 months Major dental annual limits: $750
Australian Unity Platinum 80%General dental waiting periods: 2 months General dental annual limit: $1,000 Major dental waiting periods: 6-12 months Major dental annual limits: $2,100
ahm super extrasGeneral dental waiting periods: None General dental annual limit: No annual limit Major dental waiting periods: 12 months Major dental annual limits: $1,100
GMHBA Gold Extras 75% BenefitsGeneral dental waiting periods: 2 months General dental annual limit: $2,000 Major dental waiting periods: 12 months Major dental annual limits: $2,000
HCF Platinum ExtrasGeneral dental waiting periods: 2 months General dental annual limit: No annual limit Major dental waiting periods: 12 months Major dental annual limits: $900
nib Top ExtrasGeneral dental waiting periods: 2 months General dental annual limit: $1,000 Major dental waiting periods: 12 months Major dental annual limits: $1,300
Transport Health Single Top ExtrasGeneral dental waiting periods: 2 months General dental annual limit: $800 Major dental waiting periods: 12 months Major dental annual limits: $800

What type of dental insurance do you need?

The type of cover you choose will generally depend on your age, family status, income and dental health. Dental cover is divided into two main types:

  • General dental. This includes cleaning, smaller fillings, plaque removal and x-rays. Who is this best for? Those who are young, healthy and single and only visit the dentist once or twice a year for minor treatments can often get away with just general dental cover.
  • Major dental. This includes orthodontics, wisdom teeth removal, crowns, bridges, root canal work and dentures. Who is this best for? Families and older couples on the other hand, tend to opt for major dental cover as well, particularly if they anticipate a lot of future dental care (e.g everything from braces to dentures).

Other factors to consider when choosing a dental policy include:

  • Whether there is any gap between what is covered and what the dentist will charge
  • Whether the insurance provider has a preferred dentist network to help reduce costs
  • The length of waiting periods involved, which differ with every policy.
What is no gaps dental?

No gaps dental services

One way to help reduce the cost of dental health insurance is to have healthy teeth in the first place and many insurers are now encouraging this through what are known as ‘no gaps dental services’. These are preventative dental measures such as cleaning and scaling, fluoride treatments and mouth guards. Many funds are now including these services free with basic dental health insurance, with the long-term aim of avoiding costly payouts for major dental work in the future.

How do I choose the right policy?

There is no single "best* dental insurance", only what is best* for you and your particular circumstances and needs. There are, however, some general factors to look for which apply equally when shopping for any kind of health insurance. Policies offering better value than most are generally those which:

  • Have few or no exclusions or benefit limits
  • Have low or no gaps between what is being charged and what your insurer will pay
  • Are issued by an insurer with a good claims history, few complaints and high retention rates
  • Have only minimum waiting periods or waive the waiting periods altogether
  • Include extras and benefits, such as discounted or free access to healthy lifestyle services
  • Have lower management expenses.

How do waiting periods work?

Waiting periods are used by health insurance providers to protect themselves from those people who only wish to take out dental cover if they are faced with the prospect of an expensive dental procedure. For this reason, waiting periods for major dental cover are often up to 12 months, while waiting periods for general dental cover can be as little as two months or waived altogether by some insurers. Waiting periods for major dental cover benefit both long-term policy holders and insurers, as abuse of the system would quickly result in increased premiums. And no waiting periods for preventative and basic dental services encourages people to get regular check ups, which promotes good dental health overall.

Things to consider when getting dental insurance

Keep the following factors in mind when searching for the best dental insurance policy:

  • Your age. The older you get, the more dental coverage you may need.
  • Your dental health. Although age can be a factor, for many people it is no indicator of their dental health. With this in mind, consider your overall dental health when deciding on the right level of cover.
  • Your finances. If you’re already enrolled in an employer sponsored health care plan, or if you’re a high income earner, taking out extra dental coverage may not be beneficial.
  • Your family. If you’ve got a couple of young kids, the potential overall dental costs for your family will be much greater than those for a 21-year-old with a single policy.
  • Annual limits. Most health funds impose an annual limit on the amount they will pay for dental costs and other extras. Make sure you’re aware of the maximum amount of cover your policy will provide each year.
  • Waiting periods. Check the fine print to find out how long your health fund will require you to wait before you can receive cover for a dental procedure. General dental procedures commonly attract a two-month waiting period, but major dental services may require you to wait 12 months.
  • Out-of-pocket expenses. To get a better idea of the benefits offered by your dental cover, ask what your out-of-pocket expenses will be for a range of general and major dental procedures.
  • No-gap benefits. Some health funds offer no-gap cover for certain dental treatments and procedures, which means you will not have any expenses to pay out of your own pocket. Commonly included services include check-ups, plaque removal, cleaning and dental x-rays.

What is the Child Dental Benefits Schedule?

The Child Dental Benefits Schedule (CDBS) is a dental benefits program, run by the Australian Government, for around three million Australian children aged from two to 17. Commencing at the beginning of 2014, the CDBS provides up to $1,000 in benefits to each eligible child for basic dental services. Some of the dental services for which the program offers a benefit include examinations, x-rays, teeth cleaning, fissure sealing, fillings, root canals, extractions and partial dentures. The services can be provided in a public or private setting, but restrictions do apply to the benefits available for many services. No cover is available for orthodontic or cosmetic dental work, while no benefits are payable for services provided in a hospital. In order to be eligible to receive benefits under the CDBS, a child must:

  • Be eligible for Medicare
  • Be aged 2-17 years at any time in the calendar year
  • Receive a specified payment from the Australian Government, for example Family Tax Benefit A, at any stage during the calendar year

In most cases, children or their parent/guardian will be notified of their eligibility at the beginning of the year. The amount of benefits each eligible child can receive is capped at $1,000 over two consecutive calendar years.

Do you want private vs public?

Dental care in Australia is expensive and many people on low incomes simply don’t go to the dentist for that reason. Fortunately, the changing nature of private health insurance means that you can now select dental extras cover as a standalone product or in conjunction with a few chosen extras such as optical and physio. Thanks to the growing use of preferred service provider networks, you can now receive good dental care at a reasonably affordable price. Whether you choose private or public health care in Australia depends largely on three factors:

  • Whether you want a private hospital room and your own doctor
  • Whether you are prepared to join a waiting list for elective surgery
  • Whether you can afford the rising cost of private health insurance

However, Medicare does not cover services such as dental care. So, if you want to look after your teeth, your choices are limited when it comes to dental. Basically, you have two options: Dental insurance or a dental plan. Both will be discussed in the next section.

Can I get any dental cover with Medicare?
As mentioned previously, one of the major reasons for taking out private extras cover is because dental treatment is not covered by Medicare. The only instances where Medicare will cover dental work are:

  • If it is needed to protect your general health
  • If it is needed to ensure that another treatment you are having which is covered by Medicare is successful (i.e. dental work prior to radiation treatment for oral cancer)

Medicare will also cover some dental-related hospitalisations (e.g. if you develop an infection from having a tooth pulled), but it will not pay any associated fees for dentists, doctors, radiologists or anaesthesiologists. And while it may pay initially in these few circumstances, Medicare will not pay for any follow-up dental care once the condition has been treated.

Dental insurance vs dental plans

As well as taking out private dental cover, a new option that is growing in popularity in Australia is discount dental plans (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 any dental expenses for you but instead provide discounted prices from a network of participating dentists in exchange for an annual membership fee. Both schemes have their pros and cons, which are summarised below:

Dental health insurance

  • Pros. The ability to choose your own dentist, a choice of general dental cover, major dental cover or both, peace of mind knowing major dental bills will be fully or partially covered.
  • Cons. Can be expensive, waiting periods apply for major dental treatment, limitations on pre-existing conditions, deductibles and capped benefit limits.

Discount dental plans

  • Pros. Low annual membership fee, no health checks, no contracts, no waiting periods, good discounts on dental care.
  • Cons. Must use a participating dentist, must pay all costs (after discounts) yourself.

Dental tourism – Pros and cons

Due to rising health insurance costs in Australia, a new industry has sprung up known as dental tourism. Because major dental procedures are often much cheaper in developing countries, many people opt to travel overseas to have their treatment, which can be as little as one quarter of the cost of having it done in Australia. This applies equally to most other medical procedures and there are now a variety of medical tourism agencies who will organise your trip and help you with the arrangements. But there are dangers associated with dental tourism as well.

  • You will not be able to purchase travel insurance, as medical tourism is excluded by most insurers
  • There is a greater likelihood of something going wrong, as developing countries often do not have the same standards and expertise as medical professionals in Australia
  • If something does go wrong, you will be out of pocket for nothing and may end up paying even more to have the mistake rectified back in Australia
  • If a mistake is made, you will have no recourse to reimbursement, unlike in Australia, where medical professionals can be held accountable for their actions

Speak with an adviser about getting cover

General and major dental health insurance waiting periods and annual limits

FundGeneral dental waiting periodsGeneral dental annual limitMajor dental waiting periodsMajor dental annual limits
HIF Vital2 months$800No cover$0
HIF Saver2 months$750No cover$0
HIF Special2 months$1,00012 months$1,000
HIF Super2 months$1,30012 months$1,300
HIF Premium2 months$1,50012 months$1,500 Extras 502 months$50012 months$750 Simple Essentials2 months$50012 months$500 Base 652 months$60012 months$600 Base Middle2 months$70012 months$700 Heart Basic2 months$60012 months$600 Heart Middle2 months$70012 months$700 Heart High2 months$75012 months$750 High2 months$75012 months$750
ahm black 50 saver2 months$400No cover$0
ahm black 602 months$65012 months$600
ahm lifestyle extrasNone$50012 months$750
ahm family extrasNone$50012 months$750
ahm super extrasNoneNo annual limit12 months$1,100
ahm black+white starter flexi2 months$550No cover$0
ahm black+white lite flexi2 months$700No cover$0
ahm black+white classic flexi2 months$900No cover$0
ahm black+white deluxe2 months$1,10012 months$1,100
Australian Unity Basic Extras2-6 months$350No cover$0
Australian Unity Bronze Extras2-12 months$600 6-12 months$600
Australian Unity Silver Extras0-2 months$600 for general dental, $300 for crowns, bridges and dentures6-12 months$800
Australian Unity Gold Extras0-2 months$800 for general dental, $400 for crowns, bridges and dentures6-12 months$1,600
Australian Unity Platinum 80%2 months$1,0006-12 months$2,100
Australian Unity Basic Starter0-2 months$300No cover$0
Australian Unity Smart Start®2-6 months$600No cover$0
Australian Unity Smart Essentials0-2 months$75012 months$750
Australian Unity Smart Combination0-2 months$90012 months$900
GMHBA Bronze Extras 55% Benefits2 months$1,000No cover$0
GMHBA Bronze Extras Set Benefits2 months$1,000No cover$0
GMHBA Silver Extras 65% Benefits2 months$1,50012 months$1,500
GMHBA Silver Extras Set Benefits2 months$1,50012 months$1,500
GMHBA Gold Extras 75% Benefits2 months$2,00012 months$2,000
GMHBA Gold Extras Set Benefits2 months$2,00012 months$2,000
HCF Bronze Extras2 months$350No cover$0
HCF Bronze Plus Extras2 months$400No cover$0
HCF Silver Extras2 months$50012 months$500
HCF Silver Plus Extras2 months$50012 months$500
HCF Gold Extras2 monthsNo annual limit12 months$600
HCF Platinum Extras2 monthsNo annual limit12 months$900
HCF Young Starter $2502 months$50012 months$500
HCF Young Starter $5002 months$50012 months$500
nib Core and Family Extras2 months$60012 months$600
nib Core and Wellbeing Extras2 months$60012 months$600
nib Core and Young at Heart Extras2 months$60012 months$600
nib Core Extras2 months$60012 months$600
nib Core Extras Plus2 months$70012 months$1,000
nib Core Plus and Family Extras2 months$70012 months$1,000
nib Core Plus and Wellbeing Extras2 months$70012 months$1,000
nib Core Plus and Young at Heart Extras2 months$70012 months$1,000
nib Core Plus, Family and Wellbeing Extras2 months$70012 months$1,000
nib Core Plus, Family and Young at Heart Extras2 months$70012 months$1,000
nib Core Plus, Wellbeing and Young at Heart Extras2 months$70012 months$1,000
nib Core, Family and Wellbeing Extras2 months$60012 months$600
nib Core, Family and Young at Heart Extras2 months$60012 months$600
nib Core, Wellbeing and Young at Heart Extras2 months$60012 months$600
nib Top Extras2 months$1,00012 months$1,300
Transport Health Single Healthy Choice Extras2 months$50012 months$500
Transport Health Single Top Extras2 months$80012 months$800
Transport Health Young Singles Cover2 months$30012 months$300

Speak with an adviser about getting cover

Picture: Shutterstock *The offers compared on this page are chosen from a range of products has access to track details from and is not representative of all the products available in the market. Products are displayed in no particular order or ranking. The use of terms 'Best' and 'Top' are not product ratings and are subject to our disclaimer. You should consider seeking independent financial advice and consider your personal financial circumstances when comparing products.

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