Are you in need of some dental or oral surgery? Do you need a wisdom tooth removed, perhaps? According to the Australian government's Private Health Insurance Ombudsman (PHIO), wisdom tooth extraction is one of the most commonly claimed oral surgery services under private health policies.
There are a few things you need to bear in mind if you do require such a procedure. The following is by no means an exhaustive list; if you are concerned or have any questions about insurance as it pertains to dental health, get in touch with HICA today.
Make sure you know what you're covered for
The Australian Dental Association cautions that every health insurer has different "business rules" regarding which dental treatments they will and will not cover.
It is therefore vital that you ask your health insurance consultant or provider which procedures they cover, so that you don't find yourself in a situation where you require care that you are not insured to receive.
If you need to have dental or oral surgery, you also need to make sure you've got the correct private health insurance policy to cover it.
For example, a General Treatment Policy will cover any dental surgery fees you accrue from a general dentist or oral surgery specialist, but will not cover your hospital accommodation, theatre, anaesthetist or other medical fees.
A Hospital Policy, on the other hand, will cover everything except for general dentist or oral surgery specialist fees.
And even when insurance plans do claim "cover" certain services, the percentage of the service they cover can vary.
PHIO explains that, for instance, 75 per cent of the fees charged by an anaesthetist will generally be taken care of by Medicare (through the Medicare Schedule Fee) and the other 25 per cent will be covered by your insurance provider.
It is definitely worthwhile comparing health insurance policies, just so you know exactly what you're getting.
Make sure you know the conditions of your cover
Being prepared is also important. Coverage is not necessarily guaranteed the moment you sign up with an insurance company, so it is best to organise your policy before you need it. You may be required to wait for up to twelve months before you can claim a rebate on any dental or oral procedures you undergo after choosing an insurance provider.
Be wary of going ahead with a dental or oral procedure until you are certain that it falls under your insurance policy.
When you have determined that treatment is required, it is a good idea to ask your dentist or an oral surgery specialist for a written quote detailing the overall cost of their services. Then you should get in touch with your insurance provider and see if they will cover this.
You also may not be allowed to go to the dentist of your choice. Some policies may allow this, but others may have existing partnerships with specific dental practices.
If, on the occasion that you do require oral surgery, sticking with your tried-and-true dentist is important to you, make sure you find a health insurance provider that will allow you to do so.
Dental cover for travellers
Interestingly, a study conducted by the School of Public Health and Tropical Medicine at James Cook University in Queensland revealed that dental treatment and procedures represent "a noteworthy proportion" of health insurance claims by those travelling Down Under.
So, if you're planning a trip to Australia, health insurance for visitors is another important commodity to look into.
Your dental and oral health is important, and getting the treatment you need when you need should be a priority.