Major dental insurance helps pay for complex and costly dental procedures from around
per week*. It usually has a 12 month waiting period - so if you think you need major dental, start comparing now.
Major dental covers non-routine procedures, including crowns, root canal and periodontics.
The cheapest extras policies covering major dental start from around
Major dental typically comes with a 12-month waiting period before you can claim.
*Prices are based on a single person living in Sydney earning less than $93,000 a year.
The table below compares policies from Finder partners that cover major dental. It's sorted by value using the Finder score algorithm our experts use for the Finder health insurance awards. Prices are for a single person earning less than $93,000 living in Sydney, with a $750 excess - learn why this matters here.
The Finder Score ranks every health policy in our database on value for money. We updated this monthly with data provided by Ombudsman.
We consider the 38 hospital treatment categories, plus the covered extras categories and the total extras benefit. We also use the average price for each product. Here's the breakdown of factors we consider.
Compare prices from 30+ Aussie funds in under 30 seconds.
What does major dental insurance cover?
Complex oral surgery. For example, some wisdom tooth extractions are classed as major dental.
Dentures. Dentures are removable prosthetic teeth that can be fitted to replace any number of missing teeth.
Dental crowns and bridges. These are two different but very closely related types of dental implant you may need. They act like partial fake teeth permanently installed on top of damaged existing teeth.
Root canals. For example, if a tooth has fissured or cracked and the interior pulpy tissue becomes infected and inflamed, you may need root canal.
Periodontics. This encompasses a variety of non-tooth related treatments such as treatment of gingivitis and other oral tissue problems.
How does private health insurance cover major dental?
Major dental is covered by most mid-range extras policies which let you claim up to around $800 per year. They generally cover more complex procedures such as root canal therapy (endodontics), root planing, more complex fillings and non-tooth related surgery (periodontics). Major dental usually doesn't include orthodontics – you'll need to pay extra for that – and most treatments come with a 12-month waiting period.
General dental is available in most extras mid-tier policies, including every policy that also includes major dental. This can cover you for the basics like your 6 month exam, scale and clean, fluoride treatments, X-rays, some fillings and simple extractions.
Policies that cover major dental services and the annual benefit limits
Find out more
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.
*Restricted funds only provide cover to members of specific industries, groups and organisations. In some cases family members may also be eligible to join.
Major dental waiting periods and claim limits
Major dental waiting periods. Most extras policies will come with a 12-month waiting period. This means you need to hold cover for a year before you can start claiming on treatments like endodontics, root planing and periodontics. Basic dental usually comes with a two-month waiting period.
Claim limits. A benefit limit is the most the insurer will pay per year, per person. Most mid-range major dental insurance policies come with a $500 to $800 limit. In some cases, sub-limits may apply for specific treatments, such as periodontics.
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Frequently asked questions
No, all major dental cover policies come with a 12-month waiting period. However, you don't have to serve waiting periods for chiro, general dental and optical with some extras policies, such as ahm Lifestyle Extras.
Root canal, periodontics, crowns, bridges, veneers and dentures all generally come under major dental, though this can vary slightly between insurers.
Yes, major dental usually covers periodontics. This can include a wide range of gum-related treatments.
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
No, Medicare doesn't cover major dental, which is why many Australians take out extras cover. However, you might be eligible for free major dental if you can't afford to pay and are a concession card holder or you have children.
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.
Here are the benefit limits you'll commonly see with extras insurance:
Sub-limit. A sub-limit is the largest possible amount you can claim for a specific service, which is then deducted from a larger overall benefit limit. For example, your dental cover might include an overall benefit limit of $900 with sub-limits of $300 being applied to bridgework, endodontics and dentures. In this case, the maximum you could claim for any one of those services is $300.
Shared or combined benefit limit. This means that the benefit limit is shared amongst multiple services, rather than applying a limit to each one individually. While you are not restricted to claiming a capped amount like you are with sub-limits, your total overall benefit amount is spread over a wider range of treatments, so be sure not to claim excessively on one service and leave yourself without cover for others.
Lifetime benefit limit. This is the maximum amount you can claim for a service throughout your lifetime. Be aware that if you've reached your lifetime benefit limit with one insurer and switch to a new one, they may deduct that amount from your new policy. It is recommended that you check with your new provider to find out if these penalties apply.
Gary Ross Hunter is an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, news.com.au, The Telegraph, Explore Travel and Escape. Gary holds a Kaplan Tier 1 General Insurance (General Advice) certification and a Kaplan Tier 1 Generic Knowledge certification which meets the requirements of ASIC Regulatory Guide 146 (RG146).
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