Dental insurance in Australia

There are a few things that will set you up for life. Be considerate, be brave, and have a winning smile. But when it comes to smiling, there are plenty of dental issues that Aussies have to deal with every day.

• 3 in 10 adults have untreated tooth decay. ¹
• 2 in 3 Aussies needed fillings during their last trip to the dentist, and
• 1 in 4 had an extraction.²

Adults and kids everywhere need to look after the only set of teeth they’ll ever have. To protect those pearly whites, you need to do more than just floss and brush: maintenance from a professional is crucial.

But just because you need this dental care, doesn’t mean it has to cost you an arm and a leg. Here’s how private health insurance can ease the costs of caring for your ‘chompers’.

What kind of dental cover is available?

Many Australians ask, “Is there such a thing as ‘dental insurance’?” The answer has historically been ‘no’ in Australia, with standalone products being relatively rare. For many of us, taking out private health cover is the best avenue we can take to care for our teeth.

If you require dental treatment, private health insurance provides varying levels of coverage.⁵

General dental covers preventative treatment services, like oral exams, scale and cleans, and fillings. You can get covered for general dental by taking out an extras policy.

Major dental chiefly covers surgery (e.g. veneers, treatment for gum disease, etc.) and emergency treatment..

You can also get covered for the following benefits:

• Orthodontic cover (e.g. treatment for jaw and facial irregularities) will help if you need braces.
• Endodontic work looks at the treatment of tooth decay and damage.

Depending on your level of cover, you may not have access to all these benefits. Check your policy brochure to be sure.

How much will you pay for dental treatment with a health insurance policy?

Getting covered for dental benefits has some key upsides. The main draw of health insurance is that your policy covers the cost of treatment (partially, or completely). According to PrivateHealth.gov.au, you can expect to pay the following (on average) for dental services whilst privately insured.

Treatment	Cost (national average)
Periodic oral examination	$53.11
Consultation	$62.67
Radiograph (per exposure)	$41.57
Removal of plaque and/or stains	$56.96
Removal of calculus (first visit)	$104.22
Fissure sealing (i.e. fillings) – per tooth	$51.51
Oral surgery (e.g. tooth removal)	$158.99
Full crown – veneered – indirect	$1,441.01
Source: Privatehealth.gov.au/healthinsurance/whatiscovered/averagedental.htm (2014). Table informed by data provided by private health insurers to the Department of Health.

These are average costs, however. Your expenses will vary based on the clinic you visit, the procedure you need, your health cover, and more. If in doubt, ask your insurer or dentist how much something costs before making any appointments.

Are there any out of pocket expenses?

Most Aussies (77%) with dental cover still paid for some of their treatment.⁴ So if roughly 1 in 2 Aussies have health insurance,⁴ why is this happening?

Depending on the procedure you need, you may find there are expenses that need to be paid above and beyond what your health insurance (or Medicare) give back. This is known as the medical gap. The amount you can claim will depend on your policy, so be sure you’re happy with any limits imposed by your health fund.

Annual limits, and what you can claim

While it would be great to keep accessing cheap treatment forever, there are limits to how much dental treatment you can claim on your insurance policy. For example, there will be lifetime limits for dental cover, especially for high cost treatment like orthodontics.

Additionally, the waiting periods for extras policies are set by each health insurer. For that reason, the length of time until you can begin claiming on dental benefits will vary, depending on which insurer you’re covered by.

The Private Health Insurance Ombudsman has published some examples of typical waiting periods for general treatment (i.e. extras), however.⁴ For dental services…

• Two months for general dental services
• Twelve months for major dental procedures (e.g. crowns, bridges)
• One, two or three years for high cost procedures like orthodontics.

Ready to buy?

Taking out dental insurance means your teeth will be regularly scrutinised by experts. However, you may need benefits besides dental – like physio, or optical – from time to time.

It’s just another reason why Extras Cover is a great idea if you want to take good care of your health. As of 2015, 54% of surveyed Aussies have some form of extras coverage.³ You should take your time to compare all the options for this popular product.

Compare Australian Polices either on our site, or give us a call and ask for help on 13 32 32. Give it a shot!