Private Health Insurance: Perhaps you think that basic dental services, like medical services, are provided by Medicare? It’s simply not the case. Let’s take a quick look at what a visit to the dentist can mean!

You might be surprised to learn that only about 60% of Australians go for regular dental check ups. If fact, as many as 30% of Australians put off going to the dentist until they have a serious problem*. We all know that a trip to the dentist isn’t fun, but putting it off will only end up costing you a lot more in the long run. Let’s look at some of the costs for common dental treatments and how health insurance can help, you might be surprised!

Firstly, you might think that dental treatment is covered by Medicare? Medicare only provides limited dental care when related to a chronic illness or sometimes at public hospitals. In Australia the public waiting list for dental treatment has been estimated at 650,000 people and the average waiting period for treatment is over 3 years!**. So if you’re relying on Medicare you’d better be prepared to be patient and wait.

The Australian Dental Association estimates that the average cost for a dental examination, clean, scale and fluoride treatment to be $130.00. Sounds like a lot, but if you have health insurance with Extras cover at least part of the cost will be covered. There are some health funds (like nib) that will cover the cost in full if you go to one of their dental centres or preferred providers - up to twice per year.

Having regular check-ups is a good idea. It can help you to avoid more serious, and expensive, treatments for tooth decay or gum disease. Looking at what nib’s customers were charged (on average) by their dentists in 2010:

  • Fillings can cost between $156 for a basic 2 sided metallic filling to $197 for a white filling.
  • Root canal therapy can cost $461 or more.
  • And each time you have a simple treatment for the infection caused by gum disease it can cost $208.
So it’s easy to see why it’s not worth putting off a trip to the dentist for a check-up, especially if your health fund will help cover the cost.

Sometimes major dental work is simply unavoidable, but the good news is health insurance can cover some of these costs too - providing you have an appropriate level of dental coverage.

How much you’ll get back varies, but as an example - nib’s Top Cover allows you to claim 75% of the cost up to $600 per person per year for ‘general dental’ (like check-ups, fillings and basic extractions) or up to $1,200 per person per year for major dental (like root canal, implants or crowns).

If you have children you’ll be aware that Orthodontia treatment is notoriously expensive. The average course of treatment costs $5,000 to $8,000^. Health insurance won’t normally cover the full cost but often orthodontia benefits can accrue over time. So if you have young children and think you may need expensive or lengthy treatment in the future, such as orthodontics, it’s worth looking into a higher level of cover early so you can get that maximum amount back from your health insurance.

It’s important to remember that if you’ve just taken out private health insurance for the first time, or have increased your level of cover you’ll probably be required to serve a waiting period before you can claim. If you’re considering orthodontics or more complex dental work such as root canal therapy you’ll probably have to serve a 12-month waiting period.
The waiting period for regular dental check-ups and most other general dental work is just 2-months. Many insurers, including nib, often have special offers where this 2-month waiting period is waived when you first join - so you can go to the dentist for a check-up and claim straight away. Some conditions might apply so be sure to check when you join.

Remember having a thorough dental check-up twice a year will keep your teeth in great shape and help prevent problems. Plus you may be entitled to 100% of the cost back on your dental check-ups through your health insurance. So there’s no need to put if off any longer.


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