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Which Level Of Dental Cover Should I Get?
●May 19, 2021●3 minute read
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Unfortunately, most dental work is not covered under Medicare. This means, without private health insurance, any dental work needed will likely have to be paid upfront. This can result in hundreds if not thousands of dollars in bills. This is where having dental insurance can be handy!
However, is dental cover included in all health insurance premiums? Are there different levels of dental cover and, if so, which level should I have?
In this quick guide, we’ll discuss dental insurance, the different levels of dental cover, and which one might be best suited for you.
What is dental insurance?
Dental insurance is included in a health insurance extras policy to assist in covering the costs of dental bills. While the specifics can vary from policy to policy, there are two main categories of dental coverage: general dental cover and major dental cover.
General dental cover
General dental cover generally includes annual checkups, cleaning and fluoride treatments, x-rays, minor fillings, and more. It can be categorised as mostly preventative work.
Major dental cover
Major dental cover, on the other hand, covers more complicated and expensive procedures including complex fillings, root canals, tooth extractions, bridges, crowns, and even orthodontics.
What type of health insurance policies cover dental?
Unless your dental work needs to be completed in hospital, dental cover is generally included under an extras health insurance policy. Depending on your level of coverage, the treatments and services included in your policy will vary.
Another important fact to consider is that dental treatments from one fund may be included as major, but considered general at a different fund. Extras policies are completely dependent on the individual insurance provider, which is why it can be helpful to compare policies to get the most suitable dental cover for you.
If you need dental work done in hospital (e.g. wisdom teeth removal or dental implant surgery), this can be covered under hospital insurance, rather than extras. As this is typically less common, dental surgery may only be covered under more extensive insurance policies.
What are the waiting periods for dental cover?
The waiting period, which is the time you need to wait from purchasing your policy to making your first claim, depends on the type of policy and insurer. Typically, the maximum waiting period for a hospital policy is two months. On the other hand, the waiting period for extras policies can vary from provider to provider.
According to the Private Health Insurance Ombudsman, these are the typical waiting periods:
- General dental: 2 months
- Major dental: 12 months
- High-cost procedures (such as orthodontics): 1 – 3 years
Will I be left with out-of-pocket expenses?
While extras policies can help reduce dental bills, you might be left with an out-of-pocket expense. However, there are dentists that offer gap-free dental treatment, meaning they only charge what your fund pays in benefit.
To get an idea of how much an out-of-pocket dental bill could cost with health insurance, we’ve put together an example:
Let’s say that you go to the dentist for a checkup (that costs $225 without insurance) and find that you need a filling (which could cost up to $380 without insurance). If your dentist offers gap-free checkups and covers 60% of your filling, you would pay $152 rather than $605 for your checkup and filling combined.
Which level of dental cover should I get: general or major?
Generally, the older you are, the more likely you’ll need dental work. According to Australia’s Adult Oral Health Tracker 2020, less than half of adults (48.8%) have had a dental check-up in the last 12 months, despite more adults experiencing tooth aches. It is for this reason that dental cover can be beneficial, as even a simple check-up can end up costing hundreds of dollars.
According to Dental Guide Australia, young people with relatively good dental health may be better suited to general coverage. Alternatively, families and elderly people may choose to opt for a plan with major dental coverage.
However, if you think you may need an expensive procedure at some point in the future (dental implants, braces, or veneers), a higher level of coverage may cost more in the short term but save more money in the long run.
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Written by Rachel Horan
Rachel Horan is a Content Writer for Jacaranda Finance. Rachel has previously produced content for Brisbane City Council, Black & White Cabs, and Clubs Queensland. She has a Bachelor of Mass Communication with Distinction from the Queensland University of Technology.