Private Health Insurance Dental Cover
Do you accept my Private Health Insurance?
No one likes standing in queues or going online and claiming a bill later, so to save you time, we can process all items from all medical insurance companies with HICAPS at the completion of every visit.
How much will I be out of pocket for my treatment?
Even though we can process your claim on the spot, the decision of how much an item of treatment is rebated lies with the medical insurance company as determined by your level of cover and its business rules. This is not determined by your dental practitioner. Our primary duty is to our clients and our objective is to provide our clients with the best possible care that suits them. Hence, we are proudly not affiliated with any particular medical insurance company.
Do you offer no-gap Dentistry?
Some medical insurance companies try to influence their member’s choice of dentist in a bid to reduce their costs (while increasing premiums). Medical insurance companies may seek to subtly influence your choice of provider with schemes such as “members select” or “preferred provider” or by setting up their own clinics and recommending them to you. However, can you be sure you’re getting the best quality care when your Dentist may be more worried about what the medical insurance companies say, than what you do?
Being affiliated in schemes such as preferred provider or ‘Member’s Select’ requires the Dentist to sign an agreement with the medical insurance company which then refers patients to that Dentist. In exchange the Dentist agrees to a set of fees for performing certain procedures. This creates incentives for the Dentist to carry out certain treatments and not others.
By not signing a contract with them, we keep the primary relationship with our clients and have no other influence in clinical decision making other than what is best for you. Therefore, we always offer all the options to you and suggest what is in your interest (rather than what is in our best interest or the interest of the medical insurance company).
Is it worth getting Private Health Insurance to cover my dental treatment?
Private Medical Insurance is split up into hospital and extras cover. Tax benefits are only applicable for hospital cover so in most cases the question is “Is it worth getting extras cover?”
When considering this question, it’s a good idea to get a medical insurance quote for hospital only, and extras only cover or (work out the difference between the hospital/extras and hospital only to determine how much you are paying for extras cover).
The next step is to work out how much the insurance company would give you back for all your health-related claims in a year- this includes not only dental but all allied health insurance like physio, optical, massage etc.
The most common dental item numbers that people claim twice a year are:
- 012- Periodic examination
- 114- Removal of calculus (cleaning)
- 121- Topical application of fluoride
- 022- x-rays
Each company will rebate a portion of the invoiced fee, leaving you with an out-of-pocket payment often known as a gap.
If the total rebate you are going to claim each year is more than the amount you pay on extras cover then it’s worth getting extras insurance.
Please note, health insurance companies are very smart and will place restrictions like waiting periods and annual limits to prevent you from claiming too much otherwise they will not make a profit.
Many people find that unless you claim a lot on other allied healthcare it’s generally not worth getting extras cover just to help cover your dental treatment alone as by the time you factor in your annual premium and the gap you’ll likely be better off without extras and just paying out of pocket for what you need.
Ultimately the choice to have extras cover is one that each individual and family will make. Some decide that they won’t take on extras cover, but it’s important to remember that your teeth need looking after whether you have cover or not.
In some ways looking after your teeth is a bit like looking after your car. Cars that are well maintained run better and seldom need expensive work done. The same is true of your teeth, a regular six monthly check up coupled with a good oral hygiene routine is very inexpensive, costing only a few hundred dollars a year.
However, just like when you hear a grinding noise under the bonnet that you ignore and hope will go away (resulting in breaking down in the middle of an intersection during peak hour), ignoring problems with your teeth can lead to a bad toothache at the worst possible time (during an exam, or a job interview, a wedding or an overseas trip).
When that delayed visit is finally undertaken, people are often surprised at just how little they get back from the medical insurance companies. If you’ve had medical insurance for a while, see if you can remember what your limits for dental were when you first got it. We wouldn’t be surprised to hear you say they haven’t changed in years, yet the cost of staff, materials, equipment and premises have been increasing every year. That means you’re paying a bigger gap every year on top of your ever-increasing premiums
So, whether you have insurance or not is up to you, but don’t let a medical insurance company decide what happens to your teeth, they’re far too important for that.