A guide to selecting health insurance with dental cover

When it comes to protecting your smile, dental care is important but can quickly become expensive. That’s why Australians often turn to health insurance policies with dental cover to make these costs more manageable.

Whether you’re looking for dental cover for routine check-ups, wisdom teeth removal, or braces, choosing the right health insurance policy can make all the difference.

In this guide, we’ve consulted Associate Professor Khaled E Ahmed to break down what dental cover is, the different types of dental cover available in Australia, and what to consider when reviewing waiting periods.

What is dental cover insurance?

Dental cover insurance refers to health insurance policies that include coverage for dental treatments.

In Australia, this type of cover is generally available as part of an extras policy rather than being bundled with a hospital cover. Extras policies can help to cover the costs of services not typically included in Medicare, such as physiotherapy, optical, and dental care.

For dental treatments, your policy may offer coverage for:

• General dental care, such as routine check-ups, cleans, fluoride treatments, and fillings
• Major dental care, including more complex procedures, such as wisdom teeth removal, root canals, crowns, and bridges
• Orthodontics, such as treatments like braces or aligners to straighten teeth

Why dental cover matters in Australia

According to Associate Professor Khaled E Ahmed, "Major dental procedures represent the highest costs in dental care, including veneers, crowns, bridges, implants, dentures, and root canal treatment. The prevalence of these treatments is significant – over 10% of Australians have lost a significant number of teeth, while 4% have no remaining teeth. This impact is particularly severe among older patients, those who are socioeconomically disadvantaged, and those without insurance."

Without the right level of health insurance with dental cover, even a simple filling or cleaning appointment can set you back hundreds of dollars. Plus, major dental procedures like root canals or crowns can cost thousands. Health insurance with dental cover may bridge the gap, helping you access regular care without the stress of hefty, unexpected bills.

Comparing the different types of dental cover

When selecting a policy, it’s important to understand the types of dental treatments covered under extras insurance. The level of cover you need depends on your circumstances, including your age, dental health history, and family needs. To help you explore your options, let’s breakdown the key categories of dental cover.

General dental

General dental insurance includes routine preventative treatments such as check-ups, teeth cleaning, fluoride application, and minor fillings. General dental cover can be a good starting point for most people, particularly those who visit the dentist regularly for preventative care. Keep in mind that these policies typically have lower annual benefit limits.

Major dental

For more complex treatments, such as wisdom teeth removal, crowns, bridges, and root canals, major dental cover can offer more extensive coverage.

Policies that include this level of cover often have higher annual limits and may require longer waiting periods before you can claim. To cover more complex dental treatments, particularly those that require hospital admission, you might find a level of hospital cover is also required.

"The demand for these [major dental] procedures is substantial, with over 200,000 dental implants placed annually in Australia to address missing or severely damaged teeth" explains Associate Professor Ahmed.

Endodontics

Endodontics is a specialised area of dentistry that focuses on the treatment of tooth pulp and surrounding tissues, such as root canal therapy. Some insurers classify endodontics under major dental, while others list it separately.

Orthodontics

If you or your child need braces, aligners, or other orthodontic treatment, it’s important to check whether orthodontics is covered by your health insurance with a dental cover policy.

Associate Professor Ahmed explains, "Orthodontic care often comes with the highest out-of-pocket costs".

No-gap dental policies

Some health insurers offer "no-gap dental" policies, which cover 100% of the cost (up to a certain amount) of basic preventative treatments when you visit a dentist in their preferred provider network. This can significantly reduce your out-of-pocket costs for regular check-ups and cleans.

Choosi tip: Always check your policy’s annual benefit limits and sub-limits for each type of dental treatment. If you anticipate needing major procedures, it’s important to find a level of cover that aligns with your healthcare needs.

Dental cover waiting periods: what you need to know

A waiting period is the time you must wait after taking out a policy before you can claim certain benefits. Understanding these waiting periods is crucial when selecting a health insurance plan, especially if you need timely treatment.

Associate Professor Ahmed emphasises, "Patients who only visit the dentist for pain or serious problems are twice as likely to report that cost prevented them from seeking recommended treatment compared to those who maintain regular dental check-ups. Regular check-ups are crucial for prevention and early detection. Without proper attention, simple issues can escalate significantly."

Standard waiting periods for dental cover

• General dental: Typically ranges from two to six months. Some policies offer shorter waiting periods or waive them altogether during promotions.
• Major dental: Waiting periods are usually 12 months or longer. If you’re planning significant procedures, it’s important to account for this in your timing.
• Orthodontics: Often comes with the longest waiting periods, ranging from 12–24 months, depending on the insurer.

No-wait dental insurance

Some insurers provide options for no-wait dental health insurance, particularly for general dental services. These policies can be helpful if you need immediate access to basic treatments. However, waiting periods still typically apply for major dental and orthodontics, so it's always best to check.

Emergency dental care

In the case of dental emergencies, such as a cracked tooth or sudden pain, health insurance may not always provide immediate relief due to waiting periods. It’s worth exploring whether your policy offers any exceptions or faster access to urgent care.

How to choose the right level of cover for your needs

When selecting a health insurance policy with dental benefits, it’s important to consider your individual or family healthcare requirements. Here are a few factors to weigh up:

1. Your dental history: If you’ve maintained regular check-ups and have healthy teeth, general dental cover may be sufficient. However, if you’ve experienced recurring issues or require specialised treatments, you’ll likely benefit from a policy that includes major dental or orthodontics.
2. Family considerations: For families with children, orthodontic cover may be a priority as braces and other treatments often arise during adolescence. Additionally, consider annual benefit limits for general dental, as families typically require more frequent visits.
3. Budget: It can be helpful to balance your budget with your likely dental needs. Policies with higher annual benefit limits and more comprehensive coverage tend to cost more in premiums but can also provide greater financial protection for major procedures.
4. Preferred dentists: Check if your chosen dentist is part of your insurer’s preferred provider network. Visiting a network provider can lower costs, especially for no-gap dental treatments.

Associate Professor Ahmed notes, "Cost is indeed a major barrier to accessing dental care in Australia. According to the Australian Institute of Health and Welfare, patients spent $6.7 billion on dental services in 2021-22".

Keep Reading: Learn more about family health insurance and how it can protect your loved ones.

Choosing the right health insurance policy with dental cover is an investment in your oral health and financial peace of mind. By understanding the types of dental cover available, factoring in waiting periods and dental fees, and evaluating your specific needs, you’ll be in the best position to make an informed decision.

To get started, compare your health insurance options with Choosi, so you can find a policy that aligns with your budget and lifestyle. If you’re uncertain about which level of cover is right for you, don’t hesitate to seek personalised advice from a professional financial adviser.