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.
Use the comparison engine to filter policies by dental service
Tired of trawling through multiple policies trying to work out which type of dental treatment is covered? Simply complete the form, hit Search Policies and use the refine search button in the top right-hand corner to sort policies by general dental, major dental, endodontic and orthodontic. You can also use this feature to sort by fund or by other extras services.
- How is dental covered by health insurance?
- What treatments are included under general and major dental?
- Factors to consider when comparing dental policies?
- What waiting periods apply to dental claims?
- Is a dental plan worth considering?
- Does the public health system offer any cover for dental?
- Are there any risks associated with dental tourism?
- Dental coverage offered by participating health funds
- More information about specific dental services
How is dental covered by health insurance?
- Extras cover. This is where the majority of cover for dental services can be found. Health funds break dental into two sections in extras, which are general dental and major dental (orthodontics is sometimes separate as well but typically falls under major dental). Most basic extras include general dental while major dental can be found in higher level extras policies.
- Hospital cover. Is only needed for in-patient dental procedures, such as wisdom teeth removal. If your hospital cover includes oral surgery, you may be able to claim for the full cost of the procedure (Medicare pays 75%, your fund pays the remaining 25%), as well as accommodation, theatre and anaesthetist fees.
Can you get dental only health insurance?
What treatments are included under general and major dental?
- General dental. This can include 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.
Keep an eye out for no-gap dental programs
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. These 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:
| Type of dental cover | Pros | Cons |
|---|---|---|
| Dental health insurance |
|
|
| Discount dental plan |
|
|
Does the public health system offer any cover for dental?
When can Medicare cover you as an adult?
- 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. Eligible dental services include:
- Examinations
- X-rays
- Teeth cleaning
- Fissure sealing
- Fillings
- Root canals
- Extractions
- Partial dentures
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, a new industry has sprung up known as dental tourism. Major dental procedures are often much cheaper in developing countries, so many Australians are now opting to travel overseas to receive treatment since fees can be as low as one-quarter of the cost of having it done at home.
The Australian Dental Association (ADA) commented on this through a media release on 29 June 2017 and outlined four key risks associated with dental tourism:
- Procedures may be rushed. Most major dental procedures require numerous dental visits, with ample time between them to allow the gums and teeth to heal. Reducing this period down to a couple of weeks, or even days, while on holiday greatly increases the risk of complications, even if the actual treatment is up to standard.
- You may end up paying more. Fixing a botched procedure can end up being more costly, with the money saved on the initial 'cheap' overseas trip wasted if you have to return to the foreign practitioner for follow-up treatment. Additionally, if you try and get it rectified in Australia, dentists may charge more for treating you 'mid-stream'.
- Lower standards and regulation. Australian dental training and standards are high, and practitioners must also be registered. This kind of regulation is not always enforced to the same degree in other countries. The equipment available to dentists overseas can also be of lower quality than compared to Australia.
- Higher risk of infection. The growth of antibiotic-resistant 'Superbugs' is a growing area of concern among health professionals worldwide, and have appeared to a higher degree in overseas hospitals and clinics that have low infection control standards. In Australia, these processes are strictly enforced.
As the ADA Deputy Chairman of the Oral Health Committee Dr Michael Foley said,
Don’t risk the ‘cheap health holiday away’ only to have a ‘big health bill’ after you come back.
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.
| Health fund | Annual benefit limits for dental treatments* | Waiting periods |
|---|---|---|
| ahm | General. Unlimited Complex. Up to $1,000 Major. Up to $1,100 | General. None Complex. 12 months Major. 12 months |
| Australian Unity | General. Up to $1,000 Major. Up to $800 | General. 2 months Major. 6 to 12 months |
| CBHS Health Fund | Preventative. Unlimited General. Unlimited Major. Up to $7,340 | Preventative. 2 months General. 2 months Major. 6 to 12 months |
| CUA Health | General. Unlimited Major. Up to $1,100 | General. 2 months Major. 12 months |
| GMHBA | Preventative. Up to $500 General. Up to $2,000 Major. Up to $2,000 | General. 2 months Major. 12 months |
| HCF | Preventative. Unlimited General and Major. Up to $1,000 | Preventative. 2 months General. 2 to 12 months Major. 12 months |
| health.com.au | General. Up to $850 Major. Up to $850 | General. 2 months Major. 12 months |
| HIF | Preventative. Unlimited General. Up to $1,500 Major. Up to $1,500 | General. 2 months Major. 12 months |
| NIB | Preventative. Unlimited General. Up to $1,000 Major. Up to $1,300 | Preventative. 2 months General. 2 months Major. 12 months |
| Teachers Health Fund | General. Unlimited Major. Up to $1,300 | General. 2 months Major. 12 months Orthodontics. 24 months |
| UniHealth | General. Unlimited Major. Up to $1,300 | General. 2 months Major. 12 months Orthodontics. 24 months |
*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
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