Health insurance for major dental
Why take out major dental cover
We all know how important it is to look after your teeth, but it can be hard to know which types of dental treatments to get covered for. Here are some of the benefits of extras cover for major dental services:
- For many, the cost of major dental procedures without insurance can be prohibitively expensive, but with a sufficient level of cover, you’ll have a more reasonable out-of-pocket cost, or in some cases no gap at all!
- In Australia, dental care is rarely covered by Medicare, as it’s not considered medically necessary. However, looking after your oral health now could prevent a medical emergency in the future.
- If you have kids, there’s a good chance they’ll need some dental work as they grow up. General dental could cover some of these costs, but something like a wisdom tooth extraction might be classified as a major dental treatment. In some cases, such as wisdom tooth extraction, a hospital admission may be required which would require an appropriate level of hospital cover.
Choosing cover for major dental
Once you’ve decided you want extras cover with major dental insurance, all that’s left to do is compare your options and pick a private health insurance policy that works for you. Here are a few things to consider while you browse:
- What’s covered. The way that dental treatments are sorted into different categories varies between health funds, so remember to check which item numbers sit under major dental.
- Waiting periods. Before you can claim on your policy, you’ll need to serve a waiting period. These periods vary between health funds and are occasionally waived for promotional purposes. Although, waiting period waivers typically only apply to 2 and 6 month waiting periods, while major dental traditionally has a 12 month waiting period.
- Annual limits. This is the maximum amount you can claim on a service in a year. Other types of limits may also apply (e.g. lifetime limits, sub-limits and policy limits).
What major dental covers
What is classified as major dental?
It’s up to each individual health fund to decide how they categorise the dentistry services they offer. However, most funds choose to use the same or similar classifications: general dental, major dental, orthodontics and endodontics.
With that in mind, here are a few treatments that are often included in major dental:
- Root canal therapy
- Dentures
- Dental crowns
- Dental implants
- Indirect restorations
- Bridgework
- Veneers
- Some periodontics.
General dental vs major dental
Most Australian health funds will have at least two categories for dental services (general and major), and the right category for you will depend on your personal health needs. The table below outlines some of the typical differences between the two.
| General dental | Major dental |
|---|---|
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Health insurance and major dental
The cost of major dental without insurance
Undergoing a major dental procedure without health insurance can get quite expensive. However, the exact cost of your procedure will depend on where you live, the dental clinic you’re treated at and any products or prosthetics.
To give you an idea of the types of costs associated with major dental treatment, here’s a list services and their average costs across Australia. Keep in mind that you may need multiple of these services as part of your dental treatment.
| Dental service | Average cost |
|---|---|
| Full crown – metallic | $1,650 |
| Complete maxillary denture | $1,446 |
| Tooth-coloured restoration – one surface | $890 |
| Debridement of root canal (Removal of nerve) | $210 |
| Obturation of root canal (Filling of canal) | $298 |
| Adhesive restoration – veneer | $381 |
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Source: Australian Dental Association – Dental fees survey, 2022. |
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Can you get major dental cover with no waiting periods?
While some health funds will waive waiting periods on occasion for promotional purposes, this is more common for extras categories with lower waiting periods like general dental. While it’s unlikely that you’ll be able to completely avoid your major dental waiting periods, you may be able to find a fund that offers lower waiting periods for the cover you require than their competitors.
Meet our health insurance expert, Steven Spicer
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.