Does Medicare Cover Dental?
Taking care of your pearly whites is more than just about making sure you have a great smile. Keeping your teeth and gums healthy goes a long, long way when it comes to maintaining your overall well-being and quality of life.
* The price shown is per week and applies to a Single, aged 30, living in VIC. It excludes LHC loading and includes a Base Tier Government Rebate
|Extras services (when included on cover)|
|All extras benefits except as specified below.
Waiting Period: 2 Months
|Optical, home and domestic aids and medical aids.
Waiting Period: 6 months
|Major dental services (including full & partial dentures, orthodontics, crown & bridgework, endodontic services such as root canal, gold fillings, indirect restorations, surgical extractions of a tooth/teeth including wisdom teeth).
Waiting Period: 12 Months
|Health appliances including nebuliser pump, blood glucose monitor, pressure garments, sleep apnoea monitor, extremity pump, hearing aids, orthopaedic appliances (GMHBA approved), prostheses (GMHBA approved non-surgical), tens monitor, podiatry surgical procedures and orthotic appliances (foot).
Waiting Period: 12 Months
|Hospital services (when included on cover)|
|Accidents - bodily injuries resulting from accidents which occur after the date of joining GMHBA or upgrading to a higher cover.
Waiting Period: No
|Obstetrics and maternity.
Waiting Period: 12 months
|Pre-existing ailment, illness or condition (other than psychiatric, rehabilitation and palliative care).
Waiting Period: 12 months
|Any other benefit for hospital (or hospital substitution) treatment.
Waiting Period: 2 months
A pre-existing condition is one where signs or symptoms of your ailment, illness or condition, in the opinion of a medical practitioner appointed by GMHBA (not your own doctor), existed at any time during the six months preceding the day on which you purchased your hospital insurance or upgraded to a higher level of hospital cover and/or benefit entitlement.
A special waiting period applies to obtain benefits for hospital treatment for new members who have pre-existing conditions. The waiting period also applies to existing members who have recently upgraded their level of hospital cover. If the ailment, illness or condition is considered pre-existing:
New members must wait 12 months for any hospital benefits (other than psychiatric, rehabilitation and palliative care).
Existing members (transferring or upgrading)
Members transferring/upgrading to a higher hospital cover must wait 12 months to get the higher hospital benefits (other than psychiatric, rehabilitation and palliative care).
Existing members (with at least 12 months membership)
Existing members with at least 12 months membership in total across their old and new cover are entitled to the lower benefits on their old cover.
Silver Hospital cover provides the same single room coverage as Gold Hospital, but co-payments of $100 per day up to a maximum of $700 per admission apply. Co-payments are not the same as hospital excess. Please note: Some private hospitals only have single rooms and co-payments will apply.
Co-payments do not apply.
Proper oral hygiene and regular visits to the dentist are an absolute must if you wish to keep your teeth healthy and problem free well into your golden years. And while most people, young and old alike, have no trouble sticking to a daily habit of brushing, flossing and gargling with mouthwash, among other things, dental check-ups are often overlooked or put off until the last minute. With Frank’s cheap dental insurance you can make sure you maintain that beautiful smile and a healthy mouth.
Typical Dental Costs
Growing up, we may have been afraid of going to the dentist. And as we grow older, the cost of dental care becomes one of the more compelling reasons people typically delay or avoid visiting the dentist altogether. Frank has various cheap dental insurance plans you can choose from which will cover you for some of your out-of-pocket expenses.
The average prices for common dental work such as check-ups, teeth cleanings and x-rays can vary greatly but typically start at around $50 and can reach up to $100 or more per procedure, depending on which dental practice you ask. Small fillings and extractions are more expensive and will cost you at least $100 to $150 per tooth.
People with healthy teeth can get away with yearly visits, but it is generally recommended that you go to the dentist every six months especially if you have a high risk of developing dental issues due to lifestyle or genetics.
If you need to get several procedures done all at once, your out of pocket costs will likely be quite significant, even if it’s only for general dental procedures. Just imagine how much dental care would cost annually if you have to pay for the rest of your family as well. That is why Frank’s cheap dental insurance plans are perfect for you.
More complicated procedures such as wisdom tooth removals, root canals, dentures, crowns, bridgework, veneers and orthodontic work such as braces can easily cost you thousands of dollars. In most cases, you can’t simply just delay getting many of these complex treatments as you’ll be in significant pain and discomfort if it is left unattended.
Will Medicare Cover Any Dental Costs?
The short answer is no. If you’re relying on Medicare to cover your medical needs, you can’t simply go to a public hospital and get your teeth cleaned every year or have a cavity filled. You can get treated for pain if you have a toothache and get a prescription for antibiotics to treat infections and reduce swelling, but you’ll still have to go to a private practice for any kind of standard dental work and pay full price if you do not have Frank’s cheap dental insurance.
Difficult wisdom tooth removals may be performed by an oral surgeon at a public hospital if general anaesthesia is required, though waiting periods for such procedures tend to last months if not years. Other special medical procedures that require dental work may also be covered by Medicare, but these tend to be few and are assessed on a case to case basis.
Some states and territories provide free or subsidised dental care for certain demographics such as children, adolescents and healthcare card holders (not the same as a Medicare card). However, these types of services are not part of the nationwide public healthcare system and access to them can be limited.
Cheap Health Insurance for Dental
If you want to avoid getting hit with astronomical dental care costs, you should definitely look into joining a private health fund. In Australia, dental treatments fall under the category of extras cover or ancillary cover. Extras cover allows you to reimburse up to 80% of the cost of various general treatments such as dental, optical, chiropractic, physiotherapy or homeopathy, which are not covered under hospital cover.
Getting cheap dental insurance also allows you to pick the dentists or specialists you are most comfortable with.
Picking the Right Cheap Health Insurance Extras Cover for Dental
There are several factors you need to consider before signing up for any kind of private health cover. Much like choosing hospital cover, which ranges from basic to top level cover, the right extras package for you is the one that fits your needs the best.
Frank’s extras range makes it easy to choose between getting the same amount back or a set percentage back per visit, up to your annual limits.
Some Extras lets you claim benefits for dental, optical, physiotherapy, chiropractic and acupuncture therapy, as well as avail of ambulance services and remedial massages.
Lots Extras includes everything that Some Extras covers and adds even more services such as podiatry, psychology, travel vaccinations and antenatal/postnatal classes.
Simple Extras gives you basic extras cover for our most popular general dental services.
Everyday Extras covers you for all services in Simple Extras plus common services like major dental, psychology and exercise classes.
More Extras covers you for all services covered by Everyday Extras, with even more services such as podiatry, occupational therapy, speech therapy, eye therapy and orthodontics.
You can also pick how much of the bill Frank has to cough up. Whether you go with Some Extras or Lots Extras, Frank can split the bill straight down the middle with a 50% benefit or pay a good chunk of it with an 80% benefit.
If you’re looking for the lowest premiums, you can sign up for Simple Extras amd get the same amount back each time you visit, up to your annual limits.
It’s important to note that even with private dental insurance, not all types of procedures will be covered. So if you already have a specific treatment you want to have done, make sure that your health fund will cover it before signing up.
Frank’s cheap health insurance policies offer different annual limits for certain dental procedures and services.
It’s very important to determine how much you or a loved one will be using your cheap health insurance benefits before signing up. You might think that you’re saving money by picking the lowest premiums, only to find out a few months later that you’re paying out of pocket for the majority of your dental needs. If you have dental insurance you want to make sure the majority of your dental costs covered.
When you sign up with Frank extras cover, you can get a checkup, cleaning or other general dental work done after a period of two months. Waiting periods for major dental are a bit longer at 12 months, but this is usually the same across different insurance companies. Make sure all your waiting period are complete before using and trying to claim any services to guarantee you get your dental costs covered.
On some occasions, some health funds may waive waiting periods for certain procedures during their special promotions. This can be especially useful if it’s your first time getting health insurance and want to start claiming benefits right away, or if you’re thinking of switching to a different insurer.
If you’re already part of a health fund you’re happy with, waived waiting periods don’t really provide any benefit. However, special offers for a free month of cover may be worth considering with Frank’s cheap health insurance policies.
Other Things to Remember
Some health funds allow you to sign up for extras only cover while others offer extras packaged with hospital cover. You don’t always need top level hospital cover with extras cover, especially if you’re budget is limited. Some households may get a lot more use out of our Entry Hospital (Basic+) Cover with Lots Extras rather than Top Hospital with no extras.
No matter which private health cover you choose, make sure to read the fine print and compare all the relevant details such as benefits, premiums, limits and exclusions. Shopping around and doing a bit of research will make sure you are able to get most of your dental costs covered and get the most out of your insurance premiums, while having the peace of mind that you and your loved ones will be properly taken care of no matter what happens.