Most Australians with private health insurance have Extras cover that includes dental benefits — yet a surprising proportion don’t fully utilise these entitlements every year. Understanding how your dental cover works, and how to make the most of it, can save you significant money and keep your oral health in excellent condition.
How Does Dental Extras Cover Work?
Private health Extras policies typically include two categories of dental cover:
- General dental: Covers routine check-ups, cleans, X-rays and simple restorations (fillings). Most policies cover 60–100% of the scheduled fee for these items, up to an annual limit.
- Major dental: Covers more complex work including crowns, bridges, root canal treatment and orthodontics. Usually covered at a lower percentage and with a waiting period of 12 months before claiming.
The specific items covered, percentages, annual limits and waiting periods vary significantly between insurers and policy types. Contact your health fund or log in to your member portal to see exactly what you’re entitled to.
HICAPS — The Fastest Way to Claim
At Peninsula Dental Clinic in Mornington, we have HICAPS on-site. This means you simply swipe your health fund card at reception, your rebate is calculated and deducted automatically, and you pay only the gap fee on the day. No forms, no waiting for reimbursement, no paperwork.
What About Cosmetic Dental Treatments?
Most private health policies do not cover purely cosmetic treatments such as teeth whitening, cosmetic bonding for aesthetic purposes, or orthodontics solely for cosmetic alignment. However, some restorative work — such as tooth-coloured composite restorations — may attract a partial rebate. Your dentist can advise you on which items are likely to be covered at your consultation.
Payment Plans for Larger Dental Work
For larger dental treatments — such as crowns, bridges or implants — costs can be significant even after health fund rebates. At Peninsula Dental Clinic, we offer flexible payment plans through humm for eligible dental treatments, allowing you to spread the cost over fortnightly or monthly repayments. Speak with our reception team for details.
Children and the CDBS
If your children are eligible for the Medicare Child Dental Benefits Schedule (CDBS), you can use their $1,095 entitlement for check-ups, cleans, X-rays, fillings and fissure sealants — and use their private health Extras on top of this for any remaining gap or items not covered by CDBS. Our team can advise you on how to maximise both entitlements at your child’s dental appointment.