Health.com.au policies are simple to understand, with a set percentage back (which varies depending on your specific cover) up to your annual limit. All dental services in Australia are classified by the Australian Dental Association (ADA) and assigned a corresponding three-digit item code. (It’s pretty easy to understand, once you get used to it.)
There’s a 2 month waiting period for General Dental services, which consists of things like:
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 and help with the longevity of healthy teeth.
General Dental services consist of the below item ranges:
There’s a 12 month waiting period for major dental services, which consist of the below item ranges:
411-458: Endodontic services like root canal therapy
800-899: Orthodontic services
Typically, major dental consists of things like:
Endodontic services – typically procedures such as root canal
Major restorative fillings – veneers and similar
Periodontics –treatment of periodontists (also known as gum disease)
Our Classic Bronze Plus & Basic Plus Stater products use a combination of set benefits and percentage back for extras. You can find the full set benefit list for General Dental here. Each cover has a distinct range of services that are covered. Benefits are paid up to an annual cap, which applies over a calendar year, for every person covered by a policy. The annual caps vary by policy.
You may choose to see any provider you wish, as long they’re in private practice and recognised as such by us.
Dental procedures are typically performed in the chair at the dentists, but when it comes to more complex dental services such as wisdom teeth, your dentist may want to either remove them in the dental chair, or in a private hospital. This will depend on a few things, such as the position of the wisdom teeth, the urgency, and number of teeth needing to be removed.
So what's the price difference between Dental Chair and Private Hospital?
Dental Chair for Dental Surgery (wisdom teeth)
i.e. Wisdom Tooth removal code 323 costing $500, on a cover that covers 65% back on major dental: we'll cover the $325, meaning your out of pocket would be $175. This is just using the extras part of your cover.
Private Hospital for Dental Surgery (wisdom teeth)
i.e Wisdom teeth done in a private hospital: you'll have to pay your excess of $500 for the hospital part of the admission. The actual removal of your wisdom teeth and anaesthetic (as it is still being done by a Dentist, and falls within the 3-digit codes) will be paid by your extras cover as explained above.