Want a winning smile? With dental insurance, you can maintain your dental health without the exorbitant costs.
In Australia, dental treatment can be expensive, especially if you don’t have private health insurance. Beyond the fear of drilling, the high cost for dental care is a big reason why many Aussies want to stay well clear of the dentist.
Unfortunately, you only get one set of teeth and keeping those pearly whites in great health requires more than just daily brushing and flossing. If you want to avoid extractions and root canals, maintenance is key.
The question is how do you choose the best health insurance for dental that suits your current situation? It might be tempting to select the first cheap dental insurance policy you find, but understanding your options will ensure all your needs are covered at the right price.
The types of available dental cover
Private health funds will offer dental as part of your health insurance policy. Dental cover only plans are relatively rare, with most benefits falling under a hospital or extras cover.
Does Medicare cover dental care?
As an adult, Medicare only covers the cost of dental treatment when it’s essential to protect your general health. The public health system may also cover the cost of dental work if it’s part of a Medicare approved treatment. For example, dental treatment required prior to radiation for oral cancer.
Medicare may also cover the costs if you required hospitalisation following a dental-related procedure. For example, if you need to be admitted for treatment of an infection that developed after having a wisdom tooth extracted.
Typically, Medicare will not pay for any follow-up dental treatment required once the general health condition has been resolved. The fees for specialists not related to the treated condition are also not covered.
Are you eligible for the Child Dental Benefits Schedule?
The Australian Government introduced a program known as the Child Dental Benefits Schedule (CDBS) which 3 million children are eligible for. Under the scheme, children can receive up to $1,000 in benefits over two consecutive calendar years.
The CDBS may cover the cost of dental services in a public or private clinic such as examinations, cleaning, fillings, X-rays, root canals, extractions, partial dentures and fissure sealing. Orthodontic, cosmetic dental and treatments in a hospital are not covered under CDBS.
To be eligible for the CDBS the child must:
- Aged between 2 – 17 years old
- Be eligible for Medicare
- Have received financial assistance from the Australian Government such as Family Tax Benefit A
In most cases, if your child is eligible for the CDBS, you’ll be notified at the beginning of the year.
There’s no one size fits all when it comes to private dental insurance. That’s why comparing different policy options to find the right plan for you is vital. If you don’t, you’re likely to be paying much more than you need or risk being improperly covered when unexpected dental costs arise. Don’t get caught out - take advantage of our comparison tool to find the right plan for you.
OUT-OF-POCKET EXPENSES, LIMITS AND WAITING PERIODS
The level of dental cover and the insurance fund you choose will determine 3 important factors:
- your out-of-pocket expenses
- the limits of your cover
- when you can claim.
Some procedures will be covered 100% by your insurer and Medicare. However, there will be other dental treatments where you’ll be charged an out-of-pocket expense, otherwise known as a medical gap. It’s worth checking with your potential fund to understand the gap cover arrangements and any excesses that may need to be paid.
Additionally, there will be set limits as to how much dental treatment you can claim on your dental insurance policy. Some will have no limits for certain services like preventable dental check-ups and others will apply annual limits. For the more expensive treatments like orthodontics, there’s likely to be a lifetime limit. Typically, the higher the annual limits, the more you’ll save on premiums.
Extra policies have waiting periods that are set by the individual health insurer. These are in place to prohibit people from taking out health insurance right before they have to undergo an expensive root canal or get braces.
For major dental, you can expect to wait anywhere from 6 – 12 months depending on your fund and the type of treatment. For general dental, waiting periods can be as little as 2 months. In some cases, the waiting period of minor treatments such as preventive check-ups will be waived entirely.
Saving with no gap dental cover
Health funds don’t want to pay for expensive dental work just as much as you don’t want to endure it! That’s why many funds offer a “no gap” dental cover option to encourage you to maintain your dental health and reduce your need for expensive treatments later in life.
With the no gap scheme, your health fund will cover any out-of-pocket expenses you may incur after one of the covered preventative treatments. These treatments are designed to reduce the occurrence of more serious dental problems developing.
Some of the dental services that may be covered by a no gap dental scheme include:
To be eligible for gap free dental you must receive treatment from a dentist who is affiliated with your insurer. That’s a small price to pay for a potentially big saving!
By making these preventative treatments more affordable and accessible for their members, health funds are protecting themselves from having to pay out for more expensive procedures. They’re also encouraging you to look after your own health and finances too!
THE ADVANTAGES AND DISADVANTAGES OF A DENTAL PLAN
Beyond dental insurance for fillings, cleaning and orthodontics, some people choose to take out a discount dental plan. This is a membership-based program which results in discounted prices in exchange for an annual fee.
Unlike dental insurance, the dental plan does not cover the costs of the treatment. It only provides a discount from a network of participating dentists.
The advantages of a dental plan are that the membership fees are relatively low and you’ll receive discounts on your health care. There are also no waiting periods that need to be served before you’re able to claim.
The main disadvantage of the discounted dental plan is that you can’t choose your own dentists to treat you unless they participate in the scheme. There’s also no guarantee the discounts will cover your entire bill.
Dental insurance on the other hand, does allow you to choose your own dentist. There’s a wide range of services offered where your costs are fully or partially covered. The downside is that you’ll have to serve a waiting period before you can claim and your benefit limit will cap the number of times you can claim per year.
What to consider when comparing dental cover
To find the right dental cover for you and your family you’ll need to consider a variety of factors. Taking out cover which doesn’t take into account your personal needs will be a waste of money.
Here are a few things you should consider when comparing dental policies:
DENTAL HEALTH HISTORY
GAP FREE DENTAL
Comparing health insurance couldn’t be any easier with our comparison tool! Simply decide the level of cover you need and in a few minutes, you’ll be able to see a range of dental cover options to suit singles, couples or families.
If you have a questions regarding dental cover or other health insurance policies, you can call one of our experienced team members on 1300 806 119. We’ll be more than happy to answer your queries and help you find the right insurance for your health needs and budget.