Dental Insurance Australia Policies + Advice with GMHBA

One of the most claimed private health insurance areas in Australia relates to dental services. Dental insurance exists within a policyholder’s extra cover (not hospital cover). Below provides answers to the most frequently asked questions in relation to dental cover.

What Are The Two Dental Cover Areas?

  1. General Dental
    These are services you may receive during periodic visits to your dentist to maximise your dental health. Standard dental treatment such as a regular diagnostic service, preventative and restorative services are considered general. To maximise policyholder’s dental health, GMHBA extras polices all include general dental cover.
  2. Major Dental
    These are procedures for non-periodic dental services such as orthotics, dentures and implants. While this dental work for most individuals will be claimed less frequently than general dental, the costs associated with them may be significantly higher.

What Dental Insurance Plans does GMHBA Offer?

As highlighted earlier, dental insurance plans are part of an extras insurance policy. GMHBA has Bronze, Silver & Gold extras policies which can be purchased as a stand-alone or combined with a hospital policy.

Bronze Extras

This is GMHBA’s most affordable dental insurance providing preventative & general dental coverage. The benefit level can be set at 55% back or at set benefits.

Silver Extras

This is the medium tier level dental cover with general, preventative and major dental services included. The benefit level can be set at 65% or at set benefits.

Gold Extras

The highest dental coverage available through GMHBA with the flexibility to choose from set benefits or 75% back option. General, preventive and major dental are included with the highest annual limits and dental coverage available.

Making A Claim At Your Dentist

GMHBA uses HICAPS which means that you can receive a rebate on work done on some dental treatments (such as general dental) at your dentist. Simply scan your GMHBA members card and the amount you can claim will be removed from the total bill.

The rebate you will receive on work will depend on which of the dental insurance plans you hold. It’s always recommended prior to having major dental work to first get a quote from your dentist to understand the total bill. If you have the item numbers, you can also call GMHBA prior to treatment to understand the rebate amount payable from the total bill.

How Annual Limits Work

There are two sets of annual limits that apply to dental. The first set applies to the entire amount you can claim in total per person each calendar year (for example general dental).

The second set is the amount you can claim per dental service with further sub limits applying within some. For example, orthodontics by a registered specialist. This second set can be either annual limits or set for every two years depending on the procedure.

The key to annual limits is they are set by calendar year which is worth keeping in mind at the end of the year when considering dental care services.

What If I Don’t Have Extras Policy And Have Dental Problems?

There are two options for those who don’t have dental cover and require dental work.

  1. Pay 100% Of The Dental Costs
    A patient can visit a dentist or specialist dental clinic and be treated as a private patient. The full bill will then be charged to the patient with some dentists providing payment plans. For major dental work bills can be significant leaving patients out-of-pocket thousands of dollars.
  2. Try To Use The Public System
    Each state or territory has a public dental scheme which can be limited to only certain groups and have long waiting lists. These state or territory schemes can be supplemented by Medicare but coverage again is limited.

Due to the limitations of the public system and significant out-of-pocket costs of dental procedures extras cover with dental insurance is recommended for Australians.

What If I’m an Overseas Visitor Working In Australia?

Overseas visitors who come to Australia on a professional working visa are required to have “adequate health insurance” during their stay. The Department Of Immigration and Boarder Protection requirements are not met by GMHBA health insurance policies and extra’s cover. You can learn about these on the Border Protection website.

Instead, overseas visitors should look for specialist cover such as Frank Australia. Such overseas visitor health policies can be supplemented by GMHBA’s extra’s cover with dental coverage included.

Is GMHBA Right For Me?

GMHBA is a not-for-profit health fund. This means that unlike some other funds they don’t have shareholders to pay dividends to. This helps GMHBA provide affordable dental insurance with great dental benefits. There is also the opportunity top-up fund with a dental plan such as smile to maximise dental coverage in Australia.

Overall, for great value private health insurance with easy to claim dental coverage, GMHBA is a great option for Australian residents.