Dental cover in Australia

Average customer rating: 4.3/5
Written by Joshua Malin
Reviewed by Steven Spicer
Updated 9 April 2024

Dental cover explained

Dental insurance explained by Dr Ginni Mansberg.
Dr. Ginni Mansberg
Health
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Why take out dental cover?

Dental cover plays an important role in looking after your oral health. Since Medicare typically doesn’t pay for dental treatment, you will need to take out dental cover or pay the full cost out of pocket. Here’s why dental cover can be beneficial:

  • On average, Australians spend around $253 on dental fees each year.1 Between the cost of check-ups, cleanings, braces and more, the cost of dental care can really add up. Dental cover can pay some or all of the cost of your regular care up to the annual limit and give you the peace of mind that you won’t have to break the bank if the unexpected arises.
  • Depending on your policy, dental cover can also pay towards cosmetic dental work. This means you could be covered for teeth whitening, new crowns or even implants to replace missing teeth.
  • Just because Medicare doesn’t cover out-of-hospital dental care, doesn’t mean it’s not important. In fact, poor oral health has been linked to several other health issues including heart disease and respiratory illnesses.2

Choosing cover for dental

Dental cover is a common benefit included on extras health insurance policies. With so many policies offering cover for dental services, it can be hard to decide the right one for you. Here are a few things you should consider when purchasing dental cover:

  • Limits. When you claim on an extras insurance policy, there are limits on the total amount you can claim. These limits vary between policies, so it’s important that you choose a policy with limits that suit your insurance needs.
  • Level of cover. Extras health insurance policies are typically divided into levels based on their cost and the services they cover. The right level of cover for you will depend on personal circumstances like your budget, healthcare needs and lifestyle.
  • Life stage. The right cover for you will also depend on your stage of life. For example, you may want cover for orthodontics if you have young children who might need braces, or you may be an older Australian who wants cover for dentures, implants or tooth removal.

Expert tips for choosing the right dental cover for you

Our health insurance expert, Steven Spicer, has put together some tips on how to find the right dental cover for you.

Steven Spicer
Executive General Manager – Health, Life & Energy

Look out for your health fund’s agreement dentists.

You’ll be glad to know that with dental cover, you’re free to visit any qualified registered dentist of your choice. The difference is whether your health fund has preferred dentists that they have agreements with. These agreements usually provide members with more transparent pricing before seeing the dentist, reduced costs due to better negotiation and, in some cases, even gap-free treatment.

Decide if you want dollar or percentage limits.

The amount you get back on your dental work can vary from fund to fund. Some policies provide percentage-back refunds for your dental bills, up to an annual limit, compared to others who provide fixed-dollar benefits. If your dentist is more expensive than others, the percentage option may be more in your favour.

Understand all the limits that apply.

When you take out an extras policy for dental treatment, make sure you’re aware of the different claim limits that apply. Not only will you have an annual limit (which limits how much you can claim per year), you may also be subject to group limits, sub-limits, service limits and more. While a policy with more limits may be cheaper, it will also restrict how you can use your new cover.

How dental cover works

Can I get health insurance for only dental treatment?

Waiting periods for dental cover

Do I have to re-serve my dental waiting period if I change health funds?

Out of pocket dental expenses

Dental cover for kids

What dental cover includes

What are the different levels of cover?

General dental

Major dental

Endodontic

Orthodontic

Does health insurance cover visits to any dentist?

Does health insurance cover the cost of dental implants?

Does extras health insurance cover cosmetic dental surgery?

Does health insurance cover Invisalign?

Dental cover limits

Your limits will depend on your policy; some health insurance policies offer higher dental claim limits than others. That’s why it’s so important to compare policies and look for those with generous claim limits on the services you need!

With extras policies, your dental cover may be subject to:

  • Annual limits (e.g. $700 per year on dental)
  • Sub-limits (e.g. maximum of $300 out of the $700 on major dental)
  • Dollar limits per item number
  • Group limit with other ancillary services (e.g. a group limit to spend across all general dental, major dental and endodontic services)
  • Lifetime limits (e.g. $2,900 to spend on orthodontics in each persons lifetime)
  • Service limits (e.g. periodic and oral exam payable once every six months)
  • Per person limits (e.g. $500 annual limit per person).

These limits mean your health fund will only cover up to the stated limit, and you will have to contribute the rest. Benefits can be paid as a set dollar amount or a percentage of the total cost.

Meet our health insurance expert, Steven Spicer

Steven Spicer
Executive General Manager – Health, Life & Energy

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.

1 Australian Institute of Health and Welfare, Oral health and dental care in Australia. Updated March 2023.
2 Better Health Victoria, Teeth and mouth care. Accessed May 2023.
3 The Commonwealth Ombudsman – Waiting periods for private health insurance. Accessed February 2023.