Best health insurance plans for dental

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We get it – no one likes going to the dentist. But you know what’s even worse than a visit to your local tooth doctor? Having to fork out for expensive treatments because they aren’t covered under Medicare. That’s where having private health insurance and especially extras cover can really make a difference to your hip pocket.

Dental treatments can be costly, so it’s time to provide you with some practical insights into how you can choose the best health insurance for dental cover in Australia. Want to compare policies with confidence and say goodbye to eye-watering dental bills? Here’s what to look for in extras cover so you can start making smarter decisions around your oral health.

What does dental cover include?

As with most types of cover, it really depends on things like your budget, your preferred insurer and the level of cover you actually need. Not all dental policies are created the same, so start by writing down what’s most essential for your individual circumstances.

Here's a breakdown of what you can typically expect from a dental cover policy. Bear in mind that your preferred policy might not include every service listed here:

  • Dental assessments: Routine check-ups and exams with your local dentist to assess your oral health.
  • Preventive services: Cover for things like cleaning, fluoride treatment and sealants to ward off further dental issues.
  • Extractions: Cover for removing teeth when necessary – whether it’s due to decay or damage.
  • Fillings: Covers part of the cost for treating dental fillings, cavities, and restoring tooth structure.
  • Restorative work: Some policies include cover for restorative services like crowns, bridges and even dental implants.
  • Dentures: Dentures can be expensive. These are artificial teeth and gums that can replace any missing natural teeth.
  • Gum-disease treatment: Cover for treatments related to gum disease, including periodontal cleanings and procedures.
  • Orthodontics (e.g. braces): Some policies cover orthodontic treatments like getting braces, which can correct misalignments and improve the positioning of your teeth.

When comparing health insurance for dental cover, also bear in mind things like claim percentages and ‘no gap’ policies are important considerations. Claim percentages refer to the amount covered by your insurer – policies with higher claim percentages will ultimately give you more financial support. ‘No gap’ policies are designed to eliminate out-of-pocket expenses so you can trust that your provider will cover the entire cost – or a significant portion – to reduce the financial burden on you.

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What’s the difference between general and major dental?

One of the most important questions you’ll need to ask yourself when searching for a dental cover policy is the extent of cover that you want. Are you just looking for general services to be covered under your private health insurance, or will you eventually need it for more serious and major dental work? The latter costs more, but the former might not give you enough cover for what you need. Here’s a quick breakdown.

General dental services cover all the routine and preventive care that can help you maintain good oral health. These include things like regular check-ups and cleaning, as well as fluoride treatments or sealants. General dental cover can help you manage the costs associated with common dental issues – without breaking the bank.

On the other hand, major dental services involve much more complex – and costly – scenarios. Everything from restorative treatments such as crowns, bridges and dental implants, to surgery to fix damaged or missing teeth are covered under ‘major’ dental.

Orthodontics also tends to fall under major dental services. Be aware that any major dental work can run up into the thousands of dollars, which is why it’s a good idea to make sure your dental policy covers these services. If not, then it may be time to compare and switch to a more comprehensive dental policy.

Does every private health insurance policy include dental?

Not exactly. While it’s true that most insurers do have policies that include dental, they tend to be restricted to extras cover. That means your Basic tier hospital policies won’t give you any cover for dental.

So how do you rectify that to ensure you are covered for regular check-ups and services at the dentist? You will need to either take out an additional extras policy on top of your hospital cover, or you will need to switch to extras-only cover.

Bear in mind that some dental services, such as wisdom teeth removal and dental implants in hospital may already be included in some of the more premium Gold tier private health insurance policies.

Does dental cover include orthodontics?

The reality is that every private health insurance company includes their own preferred services in their policies. That means when it comes to orthodontic treatment, whether or not it’s actually included in your dental cover will vary from provider to provider, and from policy to policy.

The most likely case is that any basic dental cover will only include services like dentist visits, cleaning and other basic procedures. For orthodontics, which includes braces and other corrective procedures, this will only be included in higher tiers of private health cover or as an add-on to your dental or extras plan – and will therefore translate to higher premiums.

As always, speak to your insurer and read the PDS to see whether what you need covered for orthodontics is actually included in your policy.

Why doesn’t Medicare cover dental?

Back when the Whitlam Government established what’s now known as Medicare in 1974, they did – believe it or not – want to get dental care included in the service. After all, dental treatment isn’t a nice-to-have like many cosmetic services covered by private health insurance. It’s an essential part of maintaining our overall health.

The bad news is it was just going to cost too much. That meant dental cover was dead in the water before Medicare even launched. It was a major decision that hasn’t changed in the decades since, despite growing calls for dental to become part of Medicare. The original belief was that dental care would be better handled by private insurance companies, and that’s still the case today.

While a small number of the population can get access to some Medicare cover for essential dental services, that’s not the case for the vast majority of us. So in order to get any type of financial support for dental, you’ll need to take out private health cover that includes dental.

What waiting periods apply to dental cover?

Depending on the services you need covered, you’ll likely serve waiting periods of anywhere between two and 12 months. Check with your provider to learn about the specific waiting periods.

If you are looking to get support for major dental or orthodontics work, then you will most likely be waiting 12 months before you can make a claim.

Final word

While it’s not nice to think about having to visit the dentist, having private health insurance and extras cover for dental can make it slightly more palatable. Ultimately, we all need to take good care of our teeth, and extras cover can make sure any required services or medications are covered under your private health insurance.

Simon Jones
Written by
Simon has spent more than 15 years covering the technology and finance sectors as both a journalist and content marketer. He is fascinated by the convergence of AI and big data, and spends what little free time he can scrape together either wrangling two kids or expanding his gin collection.

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