Health Insurance for General Dental

Want a Winning Smile? With Health Insurance for General Dental, You Can Maintain Your Dental Health without the High 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 of dental care is a big reason why many Aussies 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 general 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.

DOES MEDICARE COVER GENERAL 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, if dental treatment is required prior to radiation for oral cancer.

Medicare may also cover the costs if you require 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.

OUT-OF-POCKET EXPENSES, LIMITS AND WAITING PERIODS

The level of dental cover and the insurance fund you choose will determine 3 important factors:

1. your out-of-pocket expenses
2. the limits of your cover
3. when you can claim.

When it comes to health insurance for general dental, it's important to be aware of how your insurer and Medicare cover different procedures. While some treatments may be fully covered, others may require you to pay a portion of the cost out of pocket, known as a medical gap. To avoid any surprises, it's recommended to check with your potential insurance provider about their gap cover arrangements and any excesses that may apply.

Keep in mind that dental insurance policies often have limits on how much you can claim for certain treatments. Some policies may have no limits for preventive dental check-ups, while others may impose annual limits. For more expensive treatments like orthodontics, there may be a lifetime limit. Choosing a policy with higher annual limits can help you save on premiums and get more coverage.

It's important to note that extras policies typically have waiting periods set by the insurer. These waiting periods prevent individuals from taking out insurance right before undergoing expensive procedures like root canals or braces. Waiting periods for major dental treatments can range from 6 to 12 months, depending on your insurer and the type of treatment. However, for general dental, the waiting period can be as short as 2 months. In some cases, the waiting period for minor treatments like preventive check-ups may be waived entirely.

THE ADVANTAGES AND DISADVANTAGES OF A DENTAL PLAN

In addition to traditional dental insurance options that cover procedures like fillings, cleanings, and orthodontics , some individuals opt for a discount dental plan. This type of plan operates on a membership basis, offering discounted prices for dental services in exchange for an annual fee.

Unlike dental insurance, a dental plan does not directly cover the costs of treatment. Instead, it provides access to a network of participating dentists who offer discounted rates to plan members.

There are several advantages to having a dental plan. The membership fees are generally affordable, and you can enjoy discounts on your dental care without having to wait through any waiting periods. It provides a more immediate and accessible option for cost savings.

However, it's important to consider the limitations of a discounted dental plan. You may be restricted to choosing dentists who are part of the plan's network, limiting your options for dental care providers. Additionally, the discounts offered may not cover the entire cost of your treatment, so it's important to budget accordingly.

Dental insurance, on the other hand, allows you the freedom to choose your own dentist and provides coverage for a wide range of services, with some or all of the costs being covered. However, it typically requires serving a waiting period before you can make claims, and there may be benefit limits that cap the number of times you can claim within a given year.

Ultimately, the choice between a discount dental plan and dental insurance depends on your individual needs and preferences. It's important to carefully evaluate the coverage, costs, and limitations of each option to determine which one aligns best with your dental care needs.

FAQs

1. What does dental health cover typically include in private health insurance?

Private health insurance for dental coverage typically includes a range of services such as preventive care (cleaning, check-ups), general treatments (fillings, X-rays), major treatments (crowns, root canals), and sometimes orthodontic treatments (braces). The specific coverage may vary depending on the insurance policy and level of coverage you choose.

2. How can I determine the rebate amount I'm eligible for on dental treatments?

The rebate amount for dental treatments can be determined by checking the schedule of benefits provided by your private health insurance provider. The rebate is usually a percentage of the fee charged for the treatment, and it may vary depending on the specific treatment and your level of coverage. You can also contact your insurance provider directly to inquire about the rebate amount for specific dental procedures.

3. Are there preferred dental clinics or providers associated with private health insurance?

Yes, many private health insurance policies have preferred dental clinics or providers associated with them. These providers have agreements with the insurance company, offering services at negotiated rates. By choosing a preferred provider, you may be eligible for additional benefits such as reduced out-of-pocket expenses or gap-free treatments. You can check with your insurance provider for a list of preferred dental clinics or providers in your area.

4. Is dental care considered a part of general healthcare or a separate category?Dental care is generally considered a separate category from general healthcare. While general healthcare typically covers medical services and hospitalisation, dental care is often categorised as an extras or ancillary cover. This means that dental treatments are usually covered under a separate portion of your private health insurance policy, specifically designed for dental services.

5. Can private health insurance cover tooth extractions and fluoride treatments?

Yes, private health insurance can cover tooth extractions and fluoride treatments, depending on your level of coverage and the specific insurance policy. Tooth extractions, especially for wisdom teeth, are often covered under hospital cover or major dental cover. Fluoride treatments, which are preventive measures to strengthen teeth, are generally covered under general dental cover. It's important to review your policy or contact your insurance provider to confirm the coverage for these specific treatments.