What does dental insurance cover?

Maintaining a healthy, bright smile is important – and private health insurance can help you do just that! Here’s all about dental insurance, including what procedures it includes and what the waiting periods might be.

You’ve probably heard, over and over again, how important it is to have regular dental check-ups. This is because a check-up can help catch problems early. Cavities and gum disease are generally easier and cheaper to treat sooner rather than later. Cleanings also remove plaque and tartar buildup that brushing alone can't manage, reducing the risk of dental issues. It is generally recommended that everyone, including children, visit the dentist twice a year.1

Does Medicare cover dental?

Medicare generally doesn’t cover dental services. However, there are exceptions to this, such as the Child Dental Benefits Schedule (CDBS) for children aged 0 to 17 with a parent or carer who is already receiving certain government concessions.

Does private health insurance cover dental?

Dental insurance is often a part of private health cover and can be very useful in managing the cost of your dental bills. In fact, dental is one of the main reasons people take out Extras cover in the first place.

Knowing how important it is to our members, you can get 100% back on up to two dental check-up and cleans every year, including x-rays at any Members’ Choice Advantage (MCA) dentist.#

Rest assured, our Members’ Choice Advantage network meets strict quality standards for safety, comfort and care for our members. So, you know you’re in trusted hands at an MCA dentist.

What is general dental?

General Dental provides benefits towards less complex dental services including:

  • Examinations - When the dentist checks your teeth for cavities and gum disease.
  • Preventative treatments - Such as a dental check-up, clean and polish.
  • Scale and clean - The removal of plaque and calculus, followed by a clean and polish to leave teeth smooth and help prevent bacteria sticking. Hello, fresh breath!
  • Extraction - Also known as having a tooth pulled out, this is the removal of a tooth form the jawbone.
  • Fillings - A minor procedure to help restore a damaged tooth to its normal function and shape.
  • X-rays - To help detect mouth abnormalities invisible to the human eye, like those pesky wisdom teeth causing trouble.
  • Surgical removal of wisdom teeth - A procedure to remove one or more of the four adult wisdom teeth, either in the chair under a local anaesthetic or in hospital under a general anaesthetic. 

What is major dental?

Major dental procedures refer to more complex treatments, you may be able to claim for services including:

  • Endodontic services - Which include procedures relating to the soft tissue of teeth, such as root canal.
  • Periodontics - A category of dentistry that deals with the treatment of periodontitis, also known as gum disease. 
  • Crowns, bridges and dentures - Crowns and bridges are fixed prosthetics cemented onto existing teeth, and unlike dentures can only be removed by a dentist. Dentures can be taken out daily and are shaped by the dentist from an impression of your teeth and gums. 
  • Major restorative fillings - Such as veneers, which are thin bits of porcelain stuck to the front of teeth often used as an alternative to crowns. 

Looking for other dental services and procedures?

Any more dental questions? Let us fill you in!

We hope this article helped you brush up on your dental insurance lingo. As always, we’re here to answer any questions you may have about any treatment on your horizon. And if you know any of the item numbers for your upcoming procedure, we can help work out any out-of-pocket costs you may have. (You can usually find the item numbers in a quote from your treating dentist.)

If you’re not sure about your limits or restrictions, get in touch. We can check these for you and make sure you’re on the right cover for your needs.

 

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Things you need to know

1 Better Health Channel, Dental treatment; retrieved November 2024.

# Two month waiting period applies. Eligible members on Medibank extras (excluding Healthy Living Extras and Gold Ultra Health) can claim a maximum of two 100% back dental check-ups per member, per year at a Members’ Choice Advantage provider (including bitewing x-rays where clinically required). For members on eligible extras, the first two check-ups do not count towards your annual limit.

Members with Healthy Living Extras can get 100% back on one dental check-up each year at a Members’ Choice Advantage provider (including up to two bitewing x-rays, where clinically required) or at a Members’ Choice provider (excluding x-rays).

Members with Gold Ultra Health can get 100% back on up to three dental check-ups at a Members’ Choice or Members’ Choice Advantage provider.

Members’ Choice and Members’ Choice Advantage providers are not available in all areas. Some products may have other dental inclusions, check your cover summary for details.

While we hope you find this information helpful, please note that it is general in nature. It is not health advice and is not tailored to meet your individual health needs. You should always consult a trusted health professional before making decisions about your health care. While we have prepared the information carefully, we can’t guarantee that it is accurate, complete or up-to-date. And while we may mention goods or services provided by others, we aren’t specifically endorsing them and can’t accept responsibility for them. For these reasons we are unable to accept responsibility for any loss that may be sustained from acting on this information (subject to applicable consumer guarantees).