Woman benefiting from no gap dental cover

No gap dental

It's possible to get dental work done and pay nothing with extras offering no gap dental.

More and more health funds have heard your pleas and are offering extras policies with "no gap dental", a special dental benefit where you can visit any participating dentist and pay zero out-of-pocket for checkups, cleanings, x-rays, fluoride treatments and sometimes even mouthguards.

But first, you'll need to find a fund that offers this fantastic benefit. Lucky for you, we've already done the work.

No Gap general dental checkups

You can get 2 free dental checkups a year with several extras policies. Many of the ahm range includes no out of pocket costs at selected dentists for a check-up, scale and clean. You can get extras including this offer from $2.95 a week with ahm black 50 saver.

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Which health funds have a no gap dental scheme?*

Health fund What services are covered? Apply
  • With several extras policies including black 50, balck 60, black 70, lifestyle, family, black 70 plus and super extras - you can get 2 free check ups a year with no out of pocket costs at selected dentists.
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HCF health insurance
  • HCF’s More for Teeth program provides a range of diagnostic and preventative dental services for the whole family.
  • Over 7,000 dental providers across Australia participate in this program.
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  • Kids can get no gap dental for two visits a year up to a value of $250.
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nib health insurance
  • nib extras cover provides eligible members with 100% of any cost back for dental check-ups at nib Dental Care Centres.
  • Each check-up includes an examination, scale, clean and fluoride treatment.
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teachers health fund
  • Restricted health fund
  • If you visit a Teachers Health Fund Health Centre in NSW or VIC you can receive no gap cover for a range of preventative dental services including cleaning, polishing, x-rays and fluoride treatment.
More info
CBHS Health Fund
  • Restricted health fund
  • Eligible CBHS members are completely covered for selected preventative dental services including check-ups, scales, cleans and fluoride treatments at any CBHS Dental Choice Network Provider.
More info
  • Australian Unity No Gap Dental services offer eligible members preventative dental treatments at no out-of-pocket cost up to a set yearly limit from providers chosen by Australian Unity.
More info
Transport Health insurance
  • Transport Health members are eligible for 'No Gap' Dental if treated at Primary Dental Centres.
  • This includes check-ups, cleans and fluoride treatments. Limits for each service apply.
More info

*Table displays health funds from Finder partners

What is no gap dental?

No-gap dental is a type of dental cover where your insurer agrees to pay 100% of the cost for certain dental treatments if you use a dentist in their network.

The way most dental policies work is that your insurer will agree to pay a specific percentage of the cost toward treatments covered by your policy. For example, your policy might pay 60% toward toward dental work whether it's something simple like a cleaning or something more complex like a root canal.

You're responsible for the additional 40%, and this out-of-pocket expense is called your gap.

If your policy includes no-gap dental, your 40% contribution will be waived - leaving you will nothing left to pay. But again, it's only for certain treatments and it's only available if you use a dentist in your insurer's network.

What types of services are included in no gap dental?

No-gap dental schemes focus on preventative procedures so that insurers don't have to shell out the big bucks for expensive procedures down the track.

    • No-gap policies commonly cover the following preventative treatments:
    • Check-ups
    • Teeth cleaning
    • X-rays
    • Basic fillings
    • Fluoride treatments
    • Mouthguards

Even if your overall dental policy covers more complex treatments like root canals, crowns and implants, they won't be part of the "no-gap" scheme and you'll have to pay the gap on those treatments.

How does no-gap dental work?

To take advantage of your insurer's no-gap dental benefit, you have to follow a few guidelines. Each insurer will have a similar set of guidelines, but they can differ in the details.

Generally speaking, here's how to avoid your dental gap:

  • You must use a dentist in your insurers network. Your insurer can only offer this deal because they've negotiated a special rate with specific dentists. That means you have to see one of the dentists in this network or else you'll have to pay your gap.
  • The treatments must be covered by the no-gap policy. Most insurers with no-gap dental include a similar set of covered treatments, but there may be some minor differences. For example, not every insurer will cover mouthguards, x-rays and fillings as part of a no-gap policy.

You can only claim a certain number of times per year. Most insurers will limit the number of times you can claim for certain treatments. For example, you might be limited to only one or two "no-gap" check-ups and cleans per year.

What types of services are included in no gap dental?

No two no gap policies are the same, so you'll want to keep the following in mind

  • Does it cover the services you need? Not every insurer will pay for all the same services. For example, some will cover mouth guards and others won't. Make sure it has the benefits you need.
  • Is there a participating dentist near you? To take advantage of your no gap policy, you need to visit a dentist who already has an arrangement with your insurer. A no gap policy won't do you any good if the nearest participating dentist is 20km away.
  • Is the benefit limit high enough? Your no gap dental cover will come with a benefit limit. The insurer will continue to pay the dentist for your covered treatments until you hit this limit, and you’re responsible for everything after that. So make sure your limits are high enough to cover what you’ll need throughout the year.

What if you need additional treatment?

If you need treatment above and beyond what's covered by your no-gap policy, you'll still get the no-gap treatments covered at 100%. However, you will have to pay the gap for the additional treatments or pay for the entire cost of those treatments if your policy doesn't cover them.

Let's say you visit an in-network dentist for for a check-up and a clean but during the visit, the dentist notices a cavity that can only be filled with a complex filling. Most no-gap policies will cover the check-up and clean at 100%, but will not cover the complex filling.

You'll walk out of the dentist's office paying nothing for the check-up and clean but you will have to pay something for the filling. If your policy covers complex fillings, you'll pay the gap after the insurer pays their share (often around 60%). If it doesn't cover complex fillings, you'll pay 100% for that treatment and that treatment alone.

How to get the most out of your no-gap dental policy

No-gap dental benefits can certainly make a dental policy more attractive. However, before you choose a policy based on this feature alone, it pays to make sure it is right for you. Here's what to look out for:

  • Make sure there is a no-gap dentist near you. You can usually search insurers' websites for a list of dentists in your insurer's network.
  • Look at what's covered. Not all no-gap policies are created equal. If you have cavities, you might want to find one that covers fillings.
  • Understand how it affects your benefit limits. Some policies deduct no-gap treatments from your benefit limits, others don't.

Compare your dental options

Simply enter your details below to compare Australian health funds side by side. Don't forget to filter by dental.

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Richard Laycock

Richard is the Insurance Editor at finder, and has been wrangling insurance Product Disclosure Statements for the last 4 years. When he’s not helping Aussies make sense of the fine print, he can be found testing the quality of Aperol Spritzes in his new found home of New York. Richard studied Journalism at Macquarie University and The Missouri School of Journalism, and has a Tier 1 certification in General Advice for Life Insurance. He has also been published in CSO Australia and Dynamic Business.

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