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Last Updated on 24 February 2019

Dental Cover: Save Your Face and Finances

All too often, consumers avoid the dentist’s chair in an effort to economize. A nationwide study conducted in 2004 and 2005 revealed that nearly half of all Australian adults have no dental insurance. This is unfortunate, as statistics indicate that dental insurance decreases overall costs in the long term. This occurs mainly due to more frequent preventative dental visits allowed by such policies. Receiving routine checkups drastically reduces the incidence of subsequent oral health deterioration.

Photo by Dr Parveen Chopra

Currently, Australia’s national Medicare system omits dental providers from its list of covered facilities. Thus, consumers typically utilize private dental insurance as a matter of course. Australian dental cover insurance provides varying levels of protection against the high costs of routine and emergency dental treatment.

Last year alone, private insurers paid 49 percent of all dental charges billed by Australian dental practitioners. General dentistry reimbursements constituted the largest share of all services within its class: A whopping 52 percent of insurer payouts. Optical services were a distant second with a mere 18 percent industry share.

Who should consider a dental cover insurance policy?

Anyone wanting to maintain optimal dental health and hygiene should have dental insurance. Most covered services entail out-of-pocket copayment costs. Nonetheless, such expenditures are relatively minimal. Those with excellent dental health who rarely require dental visits may find premiums to be an imprudent expenditure.

What services do Australian dental policies cover?

Australian dental cover differs significantly by premium levels and insurance carrier. Basic policies typically cover routine fillings, root canal surgery, and periodic checkups. More expensive contracts might also cover elaborate orthodontic services such as bridgework, tooth implants, and oral surgery.

How are premium rates established?

Most Australian dental cover policies feature pre-set maximum benefit levels that are based upon specific policy premium. Basic dental insurance premiums have the lowest cost, as the scope of coverage is limited. Other than longevity with a particular insurance provider, the overall condition of one’s teeth determine premium levels. The worse one’s overall dental health is, the higher will be the insurance premium.

What is comprehensive dental cover?

Because it is usually cost-prohibitive, full dental cover is a rarity in Australia. Many major comprehensive coverage plans are available for an annual cost of several hundred dollars. Policy benefits offer large returns relative to invested premiums, however.

Is it possible to be denied coverage?

Due to the current practice of “grading” patients’ relative dental health, those with pre-existing dental disorders will be denied insurance coverage.

How do I find a qualified dental practitioner?

The best source is referrals from family, friends, co-workers, or neighbours. Be sure to ask those with excellent teeth for the recommendations. Also, consult local Yellow Pages listings for “Dental Surgeons” or similar classifications. Mobile dental units serve the Australian Outback and other isolated locales. The Flying Doctor Service provides emergency care in such outlying areas.

How to cut dental treatment costs

Dental treatment costs have risen substantially during recent times. Fees vary among geographical areas and specific dentists. An excellent way to reap significant savings is by visiting one of the dental teaching hospitals located within major urban areas.

Although Medicare does not cover general dentistry services, it does reimburse 75 percent of in-patient hospital procedures performed by registered practitioners.

The national health insurance program provides basic dental insurance, as does ancillary provisions of most general health insurance policies.

In addition, the Australian government extends considerable tax incentives to induce private dental insurance purchases.

The Commonwealth Dental Health Program offers no-cost emergency and general dental coverage to retirees and the unemployed. Wait times to obtain treatment may be up to two years, however.

In some areas, schoolchildren may receive government funded dental care. For further information about these programs and overall dental costs, contact the Australian Dental Association at Their telephone number is 02-9906 4412. Alternatively, you may write to them at P.O. Box 520, St. Leonards, NSW 1590.

How much is the average co-payment and total cost of dental treatment?

Here’s a detailed chart of dental charges that features a list of 21 common services available through the Australian Dental Association. Also displayed are detailed breakdowns by geographical areas of residence.

This data is a great frame of reference for estimating your likely costs for various dental services. You may use the percentages set forth in your specific policy to calculate probable co pay amounts. Consult your insurer for more detailed listings of covered dental services.

What is the Medicare Teen Dental Plan (“MTDP“)?

The MTDP was implemented as of July 1, 2008. The program provides cost assistance for annual preventative dental care. To be eligible to participate in the program, a teen must:

– Be between the ages of 12 and 17;
– Be Medicare eligible;
– Be currently receive Part A Family Tax Benefits, Career Payments, ABSTUDY, disability support pensions, parenting payments, special benefits, or a youthallowance
– Be the child or ward of a recipient of any of the above benefits.

Letters advising of preventive dental service eligibility are posted each year. If you have not received a letter by November of a given year, contact your local Medicare outlet to request an entitlement voucher.

What services do MTDP entitlement vouchers include?

MTDP vouchers encompass basic oral exams in addition to:

– Routine x-rays;
– Dental scale and clean;
– Fluoride treatment;
– Oral hygiene instruction;
– Nutritional and dietary advisement; and,
– Fissure sealing of cracked tooth enamel.

What is the voucher redemption procedure?

In order to receive covered services, teens must:

1. Make a dental appointment;

When setting the appointment, you should verify whether the dentist participates in MTDP and whether advance payment is required. If so, determine if charges will exceed the maximum MTDP benefit of $159.85†.

2. Have all necessary preventive dental work performed; and,

3. Submit a preventative dental claim.

Disclaimer: The above information is correct and current at the time of publication

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