Aussie’s losing out of pocket on dental coverage

We explain how to get the most out of your dental cover in Australia 

New research shows Australian’s are losing out when it comes to dental coverage on private health insurance. A good portion of people are paying for dental services but not taking advantage of what is offered to them. In a recent report, Nine’s Money Editor Effie Zahos revealed that 86% of private health insurers now offer no gap dental on at least one or more extras.  

Is private health insurance for dental worth it?

It has also been shown that one in two of us are paying out of pocket for a routine dental check-up. Most private insurance extras cover include an annual dental check-up and clean. If you have health insurance and haven’t been taking advantage of the included rebates, then you might be missing out.

Major dental procedures can be costly, so knowing all the details of your extras policy and using them before December 31 each year can save you a lot of money. You have paid for the insurance so be diligent in using as much of it as you can. 

Dental cover policy check list: 

• Annual Limits: Check your yearly limit on the benefits for selected
  dental services.  

• Waiting Periods: Waiting periods for dental insurance in Australia usually range from two to 12 months, depending on the type of treatment.  

• Level Of Cover: Look up what procedures are included in your extras cover. There’s a big gap between routine and major dental benefits.  

• What’s Not Included: Check what treatments are excluded from your policy, like orthodontics. 

Making the most of your dental insurance cover

Maximise your private health insurance extras by knowing what is included in your dental cover, double checking what’s listed as inclusions can save you a substantial amount of money.  

For example, if you are a nib member and depending on your extras cover level, you could be eligible no gap check-ups each financial year. These check-ups include: 

• Comprehensive dental examination – to assess your overall oral health
• Professional scale and clean – to remove plaque and tartar buildup
• Fluoride treatment – to help strengthen your teeth and prevent decay
• X-rays (if clinically necessary) – for a detailed assessment of your dental health 

Details of Pacific Smiles preferred insurance partners are listed here. 

What is a dental preferred provider?

Pacific Smiles dental centres across Australia have partnered with nominated health funds to help reduce out-of-pocket dental costs for you and your family. 

While we welcome members of all health funds*, you can contact your local Pacific Smiles Dental centre and check with your specific health fund to confirm your benefits and find out which of their clinics are preferred providers for your insurance. 

General and Major dental explained

There are some very big differences between the level of dental extras covered by your health fund and while it may seem obvious, a higher level of extras will cost you more each week or month, but you will also receive more back from insurance rebates on certain procedures. 

General dental is a basic level of cover that includes routine procedures as listed below. These may differ in detail and context from health fund to health fund, that’s why you need to be proactive and check your cover.   

• Regular check-ups
• Dental cleans
• Fluoride treatments
• Fillings
• X-rays
• Extractions (i.e having a tooth pulled out) 

Treatments like crowns, dentures, root canals, wisdom tooth removal and veneers would be considered major dental and without health cover can be very expensive. 

Maximise your extras dental cover and save money

According to Effie Zahos from Nine Money the trick is to pick the cheapest policy that covers only the services you want. You could be wasting money on outdated or unneeded cover. Check with your health fund if you could be paying less.  

The ultimate dental cost saving check list:

1. Comparison Tools – Visit government websites like privatehealth.gov.au for unbiased information on different policies. 
2. Know Your Extras Cover – Check annual limits and what you are covered for
3. Utilise Preferred Providers – Pacific Smiles has partnerships with health funds that may offer lower out-of-pocket costs or ”no-gap“ treatments. 
4. Ask for a Quote – Ask your dentist for a quote and contact your health fund to understand what your claim rebate will be.  

Preventative dental care can be the best thing you can do for your teeth and your bank balance. Pacific Smiles recommends that you make the most of gap-free dental services by making a booking for regular check-ups for you and your family. 

*Some exclusions apply, please check with your health fund for details 

Sources:

PrivateHealth.gov.au – Australian Health Insurance Information 

https://www.health.gov.au/resources/apps-and-tools/compare-health-insurance-policies

Avoiding paying too much for dental coverage on private health insurance | 9 News Australia