Best Health Insurance for Dental

Published: May 29, 2017

Teeth, choppers, pearly whites, fangs, ivories, whatever you call them, looking after your teeth is paramount to good health. Unfortunately, oral health is often neglected, which is why tooth decay is one of the most prevalent health problems in Australia. This could be due to a few reasons, including affordability and lack of awareness of how to get the right cover for your needs and your budget.

Dental cover

  • General dental
  • Major dental
  • Limited & unlimited

How to choose

  • Your age
  • Family size
  • Annual limits

Compare cover

  • nib
  • Bupa
  • HIF

Dental health insurance could be the answer, providing you with cover for a wide range of general and major dental services, from routine check-ups and tooth cleaning to orthodontics. This article aims to help you navigate your way through the workings of dental cover. We’ll explore the differences between private and public dental cover, and help you find the best option for you.

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Dental insurance in Australia

Australian adults lose 3 million hours of paid work each year due to dental issues. If you’re one of these millions, then worry not, because most of these issues are preventable with the appropriate dental treatment. In fact, one of the best ways to keep your teeth in good condition is to go to your dentist for cleanings and check-ups every 6 months.

These check-ups might include teeth cleaning, x-rays and when needed a dental filling, which can cost you around $200. However, with dental health insurance you can get access to both general and major dental treatments without breaking your budget.

There are 2 types of dental treatments that you can get cover for:

  1. General dental
  2. Major dental

What’s included with General Dental Cover?

General dental cover, also known as basic dental insurance, will help you offset the cost of minor dental treatments. While each private health insurance provider is different, dental insurance policies will cover regular dental check-ups, to prevent cavities and gum disease, as well as teeth cleanings, small fillings, x-rays, and plaque removal.

The difference between limited and unlimited general dental insurance

Private dental health insurance is a good option to help you manage high or unexpected costs. However, when choosing general dental cover, it’s important to know that there are two subgroups:

  • Limited: A maximum financial limit applies to the total rebate your private insurance provider will pay out for a specific dental item each year.
  • Unlimited: You can claim on certain items as many times as you need to.

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Bronze Plus Hospital 750 and Lite 70 Extras
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What Does Major Dental Cover Include?

There are some dental issues that require a bit more attention and are much more expensive. In these situations, you will look to major dental cover, which includes wisdom teeth removal, crowns, orthodontics, braces, dentures, and bridges.

General dental vs Major dental

General Dental CoverMajor Dental Cover
Regular Check-Ups: Examining the teeth, gums, and mouth for signs of cavities or gum disease.Periodontics: Treatment of gum disease, including gingivitis, infection, inflammation, or other oral tissue problems.
Cleaning & Scaling: Keeps your teeth and mouth clean by removing plaque, tartar, and extrinsic stains from the outer surface of the teeth.Inlays/Onlays: Fillings made from solid substances, like gold or porcelain, used to repair moderately damaged or decayed teeth.
Removal of plaque: The sticky, colourless film of bacteria that covers our teeth.Crowns & Bridges: Dental implants and crowns are for single teeth, and bridges are for multiple teeth.
Removal of tartar: Hardened plaque that is visible above the gum line and requires dental treatment to remove.Dentures: Removable prosthetic teeth which can replace any number of missing teeth.
Fillings: A treatment to restore a tooth damaged by decay back to normal shape.Major Restorative Fillings: This includes veneers; specially made dental implants that are placed over existing teeth.
Minor Tooth Extraction: This excludes the pulling of wisdom teeth.Orthodontics & Braces: This includes the treatment of irregularities in the teeth and jaws, including the use of braces.
Tooth Whitening: A procedure to whiten your teeth and remove stains and discolouration.Root Canal Therapy: Endodontic procedure to dig into a tooth to extract inflamed tissue.
Dental X-Rays: These are pictures of the teeth, bones, and soft tissues around the teeth to help the dentist pinpoint dental issues.Wisdom Teeth Removal: A procedure necessary when wisdom teeth push/damage other teeth or the gums as they grow out.

The average cost of dental treatments

When it comes to dental costs in Australia, you face a certain amount of uncertainty, because private dental professionals in Australia have no standard fees for services. However, if it’s certainty you want, then treatments that are covered by Medicare, give you exactly that, because all medical services provided by Medicare have prescribed fees.

Average dentist prices

Diagnostic and Preventative treatmentsPrice Range
Regular Check-Ups$51 - $92
Cleaning & Scaling$91 - $157
Dental X-Rays$30 - $58
Restorative treatmentsPrice Range
Anterior Tooth Filling$115 - $206
Posterior Tooth Filling$121 - $220
Cusp Capping$35 - $41
Adhesive Restoration$127 - $152
Endodontic treatmentsPrice Range
Root Canal Therapy$183 - $410
Prosthodontic treatmentsPrice Range
Full Veneered Crown$1261 - $1945
Oral surgeryPrice Range
Tooth Extraction (excluding wisdom teeth)$135 - $295
Does Your Dental Cover Offer Value for Money?

What Does Medicare Cover?

Medicare provides some cover for certain dental treatments. In fact, you can get free dental treatment if your health service provider accepts the Medicare benefit as full payment. This is what is referred to as Medicare bulk billing. These treatments are only covered if they are strictly necessary for your wellbeing, meaning that dental services like check-ups and teeth cleaning will not be covered, but wisdom teeth removal might be.

What Medicare will cover:

  • Procedures, like x-rays, to diagnose a dental issue.
  • Preventative treatments are covered up to certain limits for eligible groups, like cleaning and scaling, to stop more expensive issues from developing.
  • Oral surgery is covered in a limited capacity for specific procedures required for specific purposes.
  • Restorative treatments are partially covered, although not in all states and territories, and there are waiting limits and some out-of-pocket expenses.

What Medicare will not cover:

  • Check-ups
  • Cleanings
  • Fillings
  • Dentures

How to find the best health insurance for dental

It can be somewhat daunting to find affordable dental insurance that will also offer you value for money. However, it is possible. It’s just a matter of being aware of your specific circumstances, like your age, budget, and current dental health, and then comparing policies to suit your circumstances.

The Factors that will determine which policy is best for you:

  • Your age: As you get older, you’ll most likely need a higher level of dental cover. For instance, you might want cover that includes treatment for crowns and bridges.
  • Your current dental health: The condition of your teeth will also determine the level of cover you’ need, to either maintain or restore your teeth.
  • Your finances: Weighing up what you can afford vs. what you need will help you determine whether a plan is worth it for you or not.
  • Family size: If you have a family, especially one with young children, then you might want to consider a meatier policy that gives you more dental cover for treatments like orthodontics.
  • The level of cover you want: Really consider what you need cover for, because this will help you decide how much cover you need.
  • Read the fine print: It’s important to know exactly what you are and are not covered for, because there might be some services you want covered but are excluded from one policy and included as a standard service in another.
  • Annual limits: Some treatments are subject to an annual limit, which is simply the total amount you’ll be paid out in a year. Make sure you know what the annual limits are on each treatment and remember that the lower the limit, the less you will benefit.
  • Waiting periods: These vary between funds, but usually there are two-month waiting periods for general dental services and 12-month waiting periods for major dental services, which can’t be shortened or waived.
  • Out-of-pocket expenses: Even though you pay for dental cover, you will still pay out of pocket expenses, so you need to check what these expenses will be for general and major dental procedures.
  • No gap dental: There are some insurers that offer no gap benefits, which means that their members have no out-of-pocket payments for general dental services, like check-ups, cleaning, x-rays, and others.
  • Exclusions: These refer to the circumstances in which your dental insurance will not cover you. For example, a claim will not be valid if you don’t follow the advice of your dentist, or receive treatment from someone who isn’t a registered practitioner, or receive treatment outside of Australia.

Compare dental health insurance funds

You can easily find affordable dental health insurance when you take the time to compare policies from reputable health funds. It’s important that you evaluate their costs, what’s included, the waiting periods, what the annual limits are, and of course, if there are any other features, like no gap dental, included.

What's offered nib Dental Cover Bupa Dental Cover HIF Dental Cover AHM Dental Cover Medibank Dental Cover
Waiting periods for general treatments 2 months 2 months 2 months None 2 months
Other waiting periods 2 months for preventative treatments
12 months for complex treatments
Annual limits for general treatments Up to $1,000 Unlimited Up to $1,500 Unlimited Unlimited
Annual limits for major treatments Up to $1,300 Up to $1,200 Up to $1,500 Up to $1,100 Up to $1,000
Annual limits for preventative treatments Unlimited
Annual limits for complex treatments
Up to $2,800
Up to $1,000
What about the gap? Offers no gap dental for check-ups, cleanings, and fluoride treatments. Offers gap free for most kids dental on selected covers, up to your yearly limits at Members First providers. Offers AccessGap Cover, which Australian doctors can nominate to opt in or out of. Offers GapCover to members, which Australian doctors can choose to opt in or out of. Offers GapCover to members.

What is dental tourism?

Major dental procedures are often much cheaper in developing countries, than in Australia, causing people to travel overseas to get the treatment they need. However, there are some real dangers that comes with dental tourism.

  • You could endanger your life: Because developing countries don’t always have the same standards and expertise as medical professionals in Australia, you could be risking your life.
  • You could end up paying even more: If your treatment is botched, you’ll incur bigger costs to fix it.
  • You could be a victim of fraud: Fraud or medical malpractice is always a possibility when trying to find cheaper cover.
  • You can’t get travel insurance: Most travel insurance policies exclude medical tourism, meaning that you can’t claim for any direct or related costs if there are complications with your treatment.

FAQs about dental health insurance

Will my health insurance cover dental implants?

Yes, your health insurance might cover dental implants. However, regardless of who your insurer is, you will need to have an extras policy which includes cover for major and complex dental treatments. That’s because hospital policies don’t cover dental services and extras policies will only cover these more expensive services under their more comprehensive options.

Does health insurance include dental and vision?

Yes, health insurance does include cover for dental and optical treatments. It’s important to know that you need the right kind of plan, with the right level of cover to cover these kinds of services. These services are covered by extras policies. Many private health funds give you the option to buy extras cover as a standalone product.

Can you get dental insurance without health insurance?

Yes, you can get dental insurance without health insurance. Many private health funds give you the option to buy extras cover as a standalone product so that you can cover dental treatments.

What is Bupa dental?

Bupa dental consists of more than 130 Bupa owned Members First dental clinics across Australia, which are accredited according to National Safety Quality Health Service Standards. Each clinic prioritises your oral health, offering its members gap free for most kids dental at Members First providers (up to your yearly limits) and the certainty of out-of-pocket expenses.

Is private dental health insurance worth it?

Private dental health insurance is worth it for those wanting to protect themselves against unexpected dental costs. Some issues can be put off until you have enough money saved up, but others require immediate attention, like a root canal. These issues, in particular, can be rather expensive, and quite painful if left untreated.

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