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A common question asked by our patients when are told they need significant dental work done is, should they get insurance for it? The answer is almost always no, because they would be paying more in premiums overtime than just paying for the treatment.
Many people buy health insurance and don't have an understanding of what they are buying. You may have taken out a policy too. But do you really understand what you are getting for your monthly premiums and is it worth it?
When you take out health insurance?
You have the option of adding on 'extras cover'. This is an additional premium to your hospitals cover that gives you an annual benefit to health services such as dental, physio and optical. Your annual benefits reset every calendar or financial year depending on your health fund.
For dental, this annual benefit is divided into general and major dental. Major dental may also have sub-limits that apply, meaning you only have a certain amount available to claim for specific procedures.
You also need to pay your premiums for 2 months before you can claim for general dental, 12 months for major dental (called the waiting period).
So for example, a typical basic extras cover policy might cost you $250/year, but gives you $500 worth of general dental, $150 optical and $300 physio. Sounds like an awesome deal right? Pay $250 for $950 worth of value!
Well you see, the issue is that you can only claim 40-60% of the total cost of a procedure (depends on the policy), up to your annual limits, meaning you will still have to pay a 'gap' per service. So if you have great oral health and attend the dentist twice yearly for a scale and clean only, you may never fully use the $500 worth. Unless you are making an effort to max out your annual limits just for the sake of it, the cost of taking out an extras policy might not be as much of a bargain as you would think.
At the end of the day, most health funds need to generate a profit and can't be paying out more in claims than they receive in premiums.
However, occasionally it may be worth it to take out cover for a year or two when a health fund have deals (such as waiving the waiting period) and you are expecting to need some dental work done.
So it might be worthwhile for you to review your health insurance policy to see if you are paying more in premiums than what you get back in benefits while also factoring in your future needs for these services.
We offer payment plans and HICAPs for your convenience when claiming benefits for dental treatment. See you payments page for more information or give us a call on (03) 8351 5466.
