Dental insurance | What is included in dental insurance?


Taking care of our teeth has been around since childhood, but it can be expensive and it is a big problem for many of us.

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Many of us may not like going to the dentist, but for some, it’s also the cost that keeps us from making regular appointments.

Data from the Australian Institute of Health and Welfare (AIHW) shows that a fifth of adults avoid or delay dental treatment because of the cost.

But experts warn that while it may alleviate pressure on hip pockets in the short term, it could also mean that thousands of Australians risk paying the price for pain and expensive dental care in the long term.

“Regular dental check-ups give your dentist the opportunity to check your mouth for any possible signs of oral health problems such as tooth decay, gum disease and chipped teeth which can escalate into more serious problems if they are not monitored, ”says Dr Cathryn Madden, Chief Dentist at Bupa Dental.

You do not believe it ? According to the figures of the AIHW, Australian adults have an average of 11.2 decayed, missing and filled teeth, and there are approximately 72,000 annual hospitalizations for dental problems that could have been prevented with earlier treatment.

You could get money on dental care

“Some of the more expensive procedures that can often be avoided with effective preventive dental care such as regular checkups include crowns, root canals and dentures which often cost well over $ 1,000 per crown,” explains the Dr Madden.

“Sometimes these procedures are unavoidable, but you give yourself the best chance of preventing them by taking care of your teeth year round.”

If paying for regular dental check-ups is a concern, Dr. Madden recommends both looking for the best price and taking advantage of private health insurance.

“When making an appointment, you can ask how much a standard exam will cost so that you can compare providers. However, it’s important to note that private health insurance reimbursements will vary depending on your provider and level of coverage, ”she says.

“There is no specific guideline for the ideal frequency of dental exams, your dentist will make a recommendation based on your situation and your risk factors. Health benefits aside, one or two routine checkups per year will likely cost you a lot less than a potential emergency or complicated dental care in the future.

Could you save on your dental care?

Private health insurance dental coverage is usually a form of supplemental coverage that can be added to your private health insurance policy. As part of the “extras” of your insurance plan, you may have coverage for preventative dental care such as cleaning, plaque removal, exams, and small fillings.

Dental coverage generally falls into two categories, although the exact coverage will depend on your health insurance policy and provider:

General dental – this includes the basics like routine cleanings, fluoride treatments, x-rays and small fillings.

Major dental – This is designed to cover more complex treatments such as tooth extractions, crowns, bridges and dentures. This coverage can also cover orthodontics (orthodontic appliances) and endodontics (root canal surgery).

With a few exceptions, your private health insurance fund will only cover part of the cost of the most common dental procedures. The remainder, which you have to pay, is often referred to as the “spread”.

Find a better adapted extras policy

“Some health insurers and dentists offer you the option of having exams at no cost,” says Dr. Madden.

“A great way to minimize out-of-pocket expenses is to take advantage of your health insurance provider’s network coverage. Bupa customers with eligible extras coverage, for example, can take advantage of Bupa’s Members First Extras network and receive up to two regular non-stop exams per year at Members First Platinum dental clinics, within the annual limits. .

FAQ: Major dental insurance

Why do i need dental insurance?

Dental insurance benefits people who plan to visit the dentist regularly. It helps you make routine dental visits as well as pay for any major dental procedures such as root canal and dental crowns.

Why do you need private health insurance for major dental procedures?

Major dental procedures can be expensive. Having a health insurance policy that covers major dental care can help by helping you with some of the payments – so you don’t have to worry about paying for your treatment in full upfront.

What are the waiting times for major dental coverage?

The private health insurance ombudsperson says major dental procedures such as crowns, bridges or orthodontics typically result in waiting periods of up to 12 months.

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