Major Dental Insurance

Major dental insurance helps pay for complex and costly dental procedures from around $27 a month. It usually has a 12 month waiting period, so if you think you need major dental, start comparing now.

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Compare major dental insurance coverage

Here are some policies from Finder partners with major dental coverage. All have a 12 month wait period, with other extras like physio or optical also included.

Name Product Crowns and bridges Root canal therapy Removal of wisdom teeth Implants Endodontic cover Annual Limit Price Per Month Hide CompareBox
Medibank Healthy Start Extras
$500
$26.50
HBF Flex 50
$800
$27.59
HCF Mid Extras
$650
$32
Frank Some Extras 50%
$500
$32.65
Qantas Basic Extras
$600
$33.05
ahm black 60
$600
$38.60
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Compare up to 4 providers

*Quotes are based on single individual with less than $90,000 income and living in Sydney.

Compare more extras cover for major dental

Want to research 30+ Australian health funds? Use our free tool. Don't forget to tick dental cover under 'what's important to you?'

What services are classed as major dental procedures?

  • Wisdom teeth removal. This may be required if the tooth damages or pushes aside other teeth or the gums as it emerges.
  • Tooth extraction. Tooth extraction is when a tooth is removed entirely due to extensive damage or decay. Whether this is a basic or major dental procedure generally depends on the tooth, how many are being removed and your fund. Wisdom tooth extraction is generally classified as major dental.
  • Dentures. Dentures are removable prosthetic teeth that can be fitted to replace any number of missing teeth. In some cases dentures might replace an entire row of teeth, such as the top or bottom, with a single prosthetic device, or might replace as few as one or two.
  • Dental crowns and bridges. Dental crowns and bridges are two different but very closely related types of dental implant. The main functional difference between them is that a dental crown is for a single tooth while a dental bridge is for multiple teeth. If a tooth has suffered partial damage such as chipping, decay, or damage from repeated replacement of fillings then a crown or bridge is installed. These act like partial fake teeth permanently installed on top of damaged existing teeth.
  • Dental veneers. Dental veneers are very thin, specially made dental implants that are placed over the front of existing teeth. Costs vary depending on material and manufacture, and they are typically used for cosmetic rather than medical purposes. As such, most major dental insurance policies don't cover veneers.
  • Root canals. Root canals are a fairly common endodontic procedure. If a tooth has fissured or cracked then it is possible for the interior pulpy tissue to become infected and inflamed. A root canal involves digging into the tooth with very fine tools and extracting the inflamed tissue.
  • Periodontics. Periodontics encompasses a variety of fairly specific treatments focused on the gums, such as treatment of gingivitis and attention to infection, inflammation or other oral tissue problems. Periodontic procedures are generally only covered by major dental plans, although you may be required to have been referred by a dentist.

How does private health insurance cover major dental and orthodontics?

Complex and major dentistry includes intensive dental work, specifically endodontics and periodontics, prosthodontics like dentures and restorative dentistry like crowns, bridges and veneers.

  • These may be available with lower-level extras policies but are more likely to be covered with higher-level extras.
  • Your major dental insurance policy product disclosure statement (PDS) will specify the exact procedures considered to be complex or major.
  • Periodontics refers to treatment of the gums, including gingivitis and similar diseases. This is relatively common and important to treat but is not covered by Medicare, so check for periodontics in private health insurance policies.
  • Endodontics refers to the treatment of inner tooth tissue, such as root canals. These are also relatively common and important to get treated but are also not covered by Medicare. Familiarising yourself with the endodontic cover offered by a policy might be a prudent move.
  • Benefits payable will generally vary widely, even for the same type of treatments. A single tooth denture, for example, might pay as little as a $20 benefit, while a denture for ten teeth might pay up to $800 or more.
  • Complex dentistry benefits offered by private health funds will generally also include ongoing treatment, maintenance and repair of devices.
  • Complex dental treatments are typically more expensive than basic ones, and will generally have higher claim limits.

Orthodontics is covered by comprehensive or major dental plans. Some private health funds may have a separate dental category for orthodontics that is only available with certain dental or extras plans.

  • The total cost of orthodontics is typically quite high as it involves many sessions over months or even years, as well as costs for radiology, assessments, specialist consultations and more.
  • Some policies will have limits for orthodontics, such as a particular specialist services limit.
  • Orthodontic services typically have a 12-month waiting period from when the insurance is taken out.

Are there any limits or waiting periods?

  • Major dental benefit limits. A benefit limit is the most the insurer will pay per year, per person, per procedure and/or per policy.
    • For example, you may be able to claim a $50 benefit on a limit of two dental check-ups per person each year. Or you may be able to claim a maximum of $800 every three years for all denture-related costs.
  • Major dental waiting periods. A waiting period is the amount of time you have to wait after taking out a private health insurance policy before you can make a claim. These times vary depending on the claim and the insurer.
    • The typical waiting periods for dentistry are 12 months for orthodontics and complex or major dentistry, and a two-month waiting period for basic dental work.

Is there any major dental specific exclusions?

Exclusions may vary between health funds, but some you may encounter include:

  • No payout for claims made more than one or two years after a procedure
  • No benefits payable for pre-existing conditions
  • No cover for treatments or procedures that an independent medical professional deems unreasonable or inappropriate
  • No benefits for services not provided face to face, such as phone or online consultation, unless stated otherwise
  • No cover for cosmetic procedures without a specific condition being treated or the presence of symptoms, illness or injury
  • No cover if you are visiting a dentist or specialist who is not registered with or approved by your private health fund

How do I claim dentistry from my health insurer?

The claims process can vary depending on your fund and practitioner. However, here are some general guidelines to claiming:

  • If your dentist or specialist is associated with your health fund then they may be able to liaise directly with the insurer and arrange payment.
  • Most funds will provide you with a membership card, which can be swiped at your treatment facility.
  • You may be able to download a health insurance app to your phone which lets you claim and pay benefits on the spot.
  • In some cases you will be required to fill out a claims form and send it to your insurer.

Full list of providers who offer cover for major dental

Health fundPolicies that cover major dental services and the annual benefit limitsFind out more
ahm health fund
  • Super Extras. Benefit limit of $1,100 per person.
  • Family Extras. Benefit limit of $750 per person.
  • Lifestyle Extras. Benefit limit of $750 per person and $1,500 per family.
  • Black 60. Shared benefit limit of $600 per person and $1,200 per family.
More info
Picture not described
  • Advanced 80% Extras. Benefit limit of $2,400 per person (includes orthodontics).
  • Comprehensive Extras. Benefit limit of $2,400 per person (includes orthodontics).
  • Intermediate Extras. Benefit limit of $300 per person.
  • Standard Extras. Shared benefit limit of $600 per person with a sub-limit of $300 for crowns, bridges and dentures.
More info

Bupa Health Insurance Logo

  • Top Extras 90. Benefit limit of $1,200 per person.
  • Top Extras 75. Benefit limit of $1,100 per person.
  • Top Extras 60. Benefit limit of $1,000 per person.
  • Your Choice Extras. Initial benefit of $500 after 2 years of retaining cover, increasing by $100 for each additional year until it caps at $1,000 after 7 years.
More info
cua
  • Total Extras. Shared benefit limit of $1,600 per person.
  • 75% Extras. Shared benefit limit of $800 per person.
More info
GMHBA health fundGMHBA allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table.
  • Top Extras 75%
  • Top Extras Set Benefits
More info
Frank
  • Lots Extras Cover. Shared benefit limit of $2,000 per person and $4,000 per couple/family.
  • Some Extras Cover. Shared benefit limit of $500 per person and $1,000 per couple/family.
More info
HBF Health Insurance
  • Top 70. Benefit limit of $1,000 per person.
  • Complete 60. Benefit limit of $800 per person.
  • Flex 60. Combined limit of $1,000 per person.
  • Flex 50. Combined limit of $800 per person.
More info
HCFHCF Platinum and Gold Extras benefit limits for major dental increase each year you retain your policy. The increase caps at year six.
  • HCF Top Extras. Benefit limit of $1,000 per person.
  • HCF Vital Extras. Benefit limit of $800 per person.
  • HCF Mid Extras. Benefit limit of $650 per person.
More info
hcilogoHealth Care Insurance allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table.
  • Premier
  • Active Life
More info
logo health partners
  • Freedom Max Extras. Benefit limit of $1,000 per person.
  • Freedom Extras. Benefit limit of $900 per person.
More info
HIF LogoThe HIF major dental benefit will increase each year you retain your policy. The increase caps at year five.
  • Premium Options. Initially $1,500 per person, capping at $3,000 per person.
  • Super Options. Initially $1,300 per person, capping at $2,500 per person.
  • Special Options. Initially $1,000 per person, capping at $2,000 per person.
  • Saver Options. Initially $750 per person, capping at $1,250 per person.
More info
latrobehealthlogoAll of Latrobe Health Services' extras policies, except for Premier Silver, increase their major dental benefit limits for each year you retain cover.
  • Premier Extras. Benefit limit of $1,500 per person.
  • Core Extras. Benefit limit of $1,000 per person.
  • Basic Extras. Benefit limit of $500 per person.
  • Premier Singles & Couples Extras. Benefit limit of $875.
  • Premier Families Extras. Benefit limit of $300 per person.
More info
medibank
  • Top Extras. Benefit limit of $500 per person.
  • Growing Family Extras Only. Initially $400 per person, increases by $50 each year until it caps at $600 after four years of continuous cover.
More info
mildurahealthfundlogo
  • Five Star Extras. Shared benefit limit of $390 per person during the first year of cover, increases to $1,400 per person from year two onwards.
  • Dental Cover. Shared benefit limit of $350 per person during the first year of cover, increases to $1,000 per person from year two onwards.
More info
onemedifundlogoonemedifund allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table.
  • Gold Hospital - $250 Excess & Comprehensive Extras
More info
nib health insurance logo
  • Top Extras. Benefit limit of $1,300 per person.
  • Core Extras. Benefit limit of $600 per person.
More info
peoplecare provider page link
  • Premium Extras. Benefit limit of $1,500 per person.
  • High Extras. Benefit limit of $1,000 per person.
  • Mid Extras. Benefit limit of $500 per person.
More info
phoenix health fund provider link
  • Complete Extras 70. Benefit limit of $1,000 per person.
  • Everyday Extras 60. Shared* benefit limit of $800 per person.
More info
St. Lukes Health Logo
  • Super Extras. Benefit limit of $1,200 per person.
More info
Transport Health Logo
  • Top Extras. Initial benefit limit of $800 per person, increasing to $1,000 per person after three years and $1,200 per person after five years.
  • Healthy Choice Extras. Benefit limit of $500 per person and $1,000 per policy.
More info
westfund provider link
  • Ultimate Extras. Benefit limit of $1500 per person.
  • Advantage Pro Extras. Benefit limit of $1400 per person.
More info
CBHS health insurance logoRestricted fund*CBHS allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table.
  • Top Extras
  • Intermediate Extras
More info
defencehealthlogoRestricted fund*
  • Premier Extras. Benefit limit of $1,100 per person.
  • Value Extras. Benefit limit of $900 per person.
More info
navyhealthlogoRestricted fund*
  • Premium Extras. Benefit limit of $2,000 per person.
  • Healthy Living Extras. Benefit limit of $1,500 per person.
  • Budget Extras. Shared benefit limit of $500 per person.
More info
doctorshealthfundlogoRestricted fund*
  • Total Extras. Benefit limits vary depending on the service. You can find the amounts for each treatment below this table.
  • Essential Extras. Shared benefit limit of $1600 per person.
More info
policehealthlogoRestricted fund*
  • Rolling Extras. Benefit limit of $1,500 per person.
More info
rthealthlogoRestricted fund*
  • Premium Extras Cover. Benefit limit of $1500 per person
  • Smart Extras Cover. Benefit limit of $1200 per person
More info
rbhslogoRestricted fund*RBHS allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table.
  • Premium Extras
More info
Teachers Health Fund LogoRestricted fund*
  • Top Extras. Initial benefit limit of $1,300 per person. Increases for each year you hold cover until it caps at $2,800 on year six.
  • Essential Extras. Benefit limit of $300 per person.
More info
TUH health insurance logoRestricted fund*
  • Comprehensive Extras. Overall benefit limit of $3,400 per person.
  • Family Extras. Overall benefit limit of $2,000 per person.
  • Everyday Extras. Overall benefit limit of $2,000 per person.
  • Healthy Options Extras. Shared benefit limit of $1,000 per person.
  • Mid Range Extras. Overall benefit limit of $1,000 per person.
More info

*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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