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Should You Get Private Dental Insurance In Australia?

dentist showing patient results of all on 4 dental implant treatment

The question of whether private health insurance is worth it is a matter of concern to many people, particularly in the current economic situation. If you are concerned about whether or not to get private health insurance to cover your dental needs, you should speak to your dentist regarding your current dental health and your future needs based on any potential problems envisaged.

Private insurance is designed to step in when things go wrong in order to avoid being liable for large out-of-benefit expenses that your health insurance fund does not cover or that have capped benefits at a fixed dollar or percentage amount. Private health insurance basically offers two distinct products: Hospital cover and Extras insurance.

Hospital insurance covers private treatment in-hospital but does not cover any out-of-hospital treatments such as GP visits, dental check-ups, or specialist appointments. The level of cover is based on tiered categories ranging from Basic through to Bronze, Silver, and Gold, each category covering a broader range of services with Gold offering the most comprehensive cover. Some health insurance providers cover services beyond each category limit which is given a ‘+’ symbol to denote that extra cover is provided.

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The most important benefits of private health insurance include the personal choice of hospital and doctor; the option to have your own private room; and, most importantly, avoiding long waiting lists for important procedures.

Extras insurance covers out-of-hospital treatment costs not covered by Medicare such as dental care, physiotherapy, prescription glasses, and other specialist services. Once again, different levels of cover are available, from a basic cover that offers procedures like general dental check-ups, cleaning, and scaling to more comprehensive cover for procedures such as wisdom teeth extractions, bridges, crowns, and braces.


So should you get private dental insurance?

The ADA  has been quoted as saying that the dental care needs of many families are not being met by dental care funding arrangements in Australia and that consumers may be better off putting money aside to cover out-of-pocket expenses for potential dental work. But before you cancel your private dental insurance, first do some calculations to decide whether private dental insurance will be of benefit to you:

  • Find out how much Extras cover is for dental and which benefits are capped.
  • Review your claims history over the past 12 months to determine how much you have paid for cover and how much you have claimed back related to dental care.
  • Assess your future dental needs with the help of your dentist based on the knowledge of your current dental health and potential dental work that may be needed in the future.
  • Are you allowed to pick your own dentist and the services you require?

It’s important to remember that Private Health insurance companies are businesses also trying to make a profit.  Statistics show that 51% of ‘Extras’ cover is used for dental services in Australia and as such insurance companies cap their limits accordingly.

The best way to avoid costly dental work in the future is to have regular dental health and hygiene check-ups and to maintain the health of your teeth and gums. If you have a large family private dental insurance may be of benefit to cover potential dental work such as braces for kids.

If you have any questions, feel free to contact Rockingham Dental Centre where we offer quality, patient-centred dental services for Rockingham residents. Ask us for advice on which health fund may be best for you and/or where to find the best information before joining any health fund.

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