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Dental Health Insurance in Australia

Maintaining good oral hygiene is a crucial aspect of overall health. It not only helps to prevent tooth decay and gum disease but also has a significant impact on systemic health. Poor oral hygiene can lead to various health problems such as diabetes, heart disease, and even stroke.
Fact Checked

Updated: 24 May 2024

Regular dental check-ups are an essential part of oral hygiene and can help detect early signs of any oral health problems. Early detection of such problems can prevent them from becoming more severe and requiring more invasive and expensive treatments. This is why it is important to have the right level of cover for your personal requirements.

Key facts

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What is dental cover?

Dental cover is a term used to describe the specific benefits and provisions offered by an insurance policy or health plan that caters to dental care needs. It encompasses a range of services, from routine check-ups and cleanings to more complex procedures such as root canals and orthodontic treatments.

The primary goal of dental cover is to reduce the financial burden associated with dental care, enabling individuals to access necessary treatments without being deterred by cost. By having dental cover, individuals can avoid the high expenses often associated with dental procedures and promote regular dental visits and proactive oral health maintenance.

How does dental health insurance work?

Dental insurance is usually included in Extras health insurance, which is separate from Hospital insurance. Extras insurance is a more cost-effective alternative that provides coverage for services received outside of the hospital environment, such as dental care, vision care, and physiotherapy, which Medicare does not cover. Dental insurance can work in different ways, depending on the policy.

What does dental insurance cover?

Here’s a breakdown of what dental insurance can cover:

Can I get
Dental
Only Cover

It’s rare to find a standalone policy exclusively for dental treatment; most dental services fall under Extras policies, covering areas like physiotherapy, optical, and chiropractic care. Hospital insurance typically doesn’t cover dental treatments since they’re often conducted outside of hospital settings. However, combined policies can offer coverage for dental procedures both in and out of hospitals, making them ideal for those requiring surgeries like wisdom tooth extraction and subsequent dental visits.

Compare Dental Cover

Private Patient
Public Patient
You can choose your doctor or specialist.
The hospital assigns Doctors and specialists.
Access to a single hospital room if available.
Room allocation is typically shared with other patients.
Shorter waiting times for elective procedures.
Waiting times may be longer for non-urgent treatments.
Additional perks like early discharge and tests.
Limited access to certain perks and services.
Possible out-of-pocket expenses due to gap fees.
Most services are covered by Medicare with no gap fees.

Source: Privatehealth.gov.au(September 2023; Premium estimates for a single individual living in NSW)

How to choose cover for dental treatment

Frequently Asked Questions and Answers

In Australia, general health insurance does not automatically cover dental treatments. Dental coverage is typically provided under Extras health insurance policies, which are separate from standard Hospital insurance. These Extras policies can cover a range of dental services, from routine check-ups to more complex procedures. However, the extent of the coverage varies depending on the specific policy and insurance provider.

Whether health insurance for dental is worth it in Australia largely depends on an individual’s dental health needs and financial situation. Having dental insurance can significantly reduce out-of-pocket expenses for dental treatments, especially for those who require regular check-ups or anticipate needing major dental work. However, it’s essential to compare the cost of the premium with potential savings on dental treatments to determine if the insurance offers good value for money.

If you’re facing financial constraints and need dental care, there are several options to consider. Many dental schools offer reduced rates for treatments as students (under the supervision of experienced dentists) perform the procedures. Additionally, some community health centres provide dental services on a sliding fee scale based on your income. It’s also worth checking for local charities or organizations that might offer free or low-cost dental clinics. Payment plans or financing options might also be available through some dental practices.

In Australia, Medicare provides limited coverage for dental services. Generally, Medicare does not cover most routine dental treatments like check-ups, fillings, or cleanings. However, there are specific circumstances, especially for children and some adults with chronic conditions, where Medicare might provide some coverage through schemes like the Child Dental Benefits Schedule. It’s essential to check the specific criteria and conditions under which Medicare would cover dental services.

Centrelink itself does not directly pay for dental treatments. However, individuals receiving certain Centrelink benefits may be eligible for public dental services at reduced costs or even for free, depending on the state or territory in which they reside. The availability and criteria for these services vary by location, so it’s advisable to check with local public dental clinics or health departments to understand the benefits available to Centrelink recipients.

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Specialist

Megan has extensive experience writing about health and life insurance in Australia. Megan has a special interest in health and wellness. She relies on her background in counselling psychology to convey the latest findings in a manner that is most beneficial to ComparingExperts readers. In every article she writes, Megan aims to uphold the standards of the Private Health Insurance Intermediaries Association (PHIAA) which ComparingExpert is part of.