Dental Insurance minefield

When it comes to dental care, private dental health insurance is the best way to deal with unexpected costs. But like many things in life, dental insurance isn’t a ‘one size fits all’ solution, meaning you need to pick the right plan for your circumstances.

If you don’t, you could end up paying much more than you need to or risk being improperly covered when you need it. There are a huge number of dental insurance plans to choose from, each with their own options and mountain of fine print.

Below we’ll look at some general facts and features of dental insurance in Australia to help you better understand dental insurance and make an informed decision.

Dental Coverage is Part of a Health Insurance Plan

In Australia, you can’t specifically get dental insurance. Instead, dental coverage falls under your private health insurance plan. Basic or general dental treatments are covered by default with the option to add on extras to cover you for larger dental procedures.

There Are Two Types of Coverage

Dental insurance comes in two forms of coverage in Australia – general (covered by default) and major (extras). How they’re classified varies from each health insurance provider, but in most cases:

  • General dental coverage – refers to regular checkups, cleaning, minor fillings and other preventative dental work.
  • Major dental coverage – refers to more complex procedures like tooth extractions, orthodontics, crowns and bridges.

Extras Expire Every Year

Many people who have private health insurance and extras cover unknowingly waste their benefits. The vast majority of private health funds calculate your limits for services over a year. Any benefits that aren’t used don’t roll over to the following year, meaning you lose them.

For example, your plan might offer you and your family general dental services up to $400 per person, per year. But because of annual contracts, if you don’t use these benefits each year, you’ll lose them. Keep this in mind when picking an insurance plan to ensure you don’t end up throwing your money away.

The exact amounts of benefits and cover you receive depend on your circumstances and what’s outlined in your Product Disclosure Statement (PDS). Depending on your plan, you’ll be allocated different maximums for different treatments. As you move up in the value of your policy, so too will the benefits and treatments that are covered.

Understanding the Gap

The Gap is the difference between the price of a dental treatment and what your insurer will pay. You pay the gap out-of-pocket. For example, when a dental procedure costs $300 and the insurer pays $200, you’re left to pay the remaining $100.

This can get complicated because each insurer pays different amounts for different treatments. But on average, Australians pay a gap of $45 for every trip to the dentist. Some dentists, like City Central Dental, offer gap-free checkups for children. The best approach to making the most of the gap is to coordinate your choice of insurer with your regular dentist.

Consult Your Dentist

If you are still confused about your options, it may be best to consult your dentist about the ideal dental insurance plan. At City Central Dental, we are passionate about providing quality dental care that is as affordable and accessible as possible for singles, couples, and families.

Our dental clinic helps by partnering with high-quality dental insurance providers and processing claims at the counter. This way, we can help facilitate a stress-free process for patients in need of dental care.

For more information or for family dental services in Adelaide, call 08 8231 9922 or contact us online.