What does my dental cover pay for?

April 2023 | 3 min read
Expert contributor Gabriel Hajjar, HCF Dental Centre Network clinical manager
Words by Angela Tufvesson

Need some help understanding exactly how dental cover works? We explain what can and can’t be covered, and how you can get the best value from your cover.

Regular visits to the dentist can reduce the risk of tooth decay and gum disease, and keep your smile looking bright. It’s recommended to make an appointment with your dentist regularly, depending on your dental needs. Most people should see a dentist once or twice a year, with some of us needing more frequent trips. If you have extras cover that includes dental, some or all of the cost of those visits may be covered.

Here, we explain the ins and outs of dental cover – what it pays for, what it doesn’t and how to make the most of it.

Does Medicare cover dental care?

Medicare doesn’t cover the cost of most dental care in the same way it does some other health services.

“The vast majority of dentistry is delivered by private dental clinics in Australia and not covered by Medicare,” explains HCF Dental Centre Network clinical manager Gabriel Hajjar.

There are some exceptions. The Child Dental Benefits Schedule covers children aged two to 17 for basic dental services. Depending on your state or territory, you may also be eligible for public dental services if you have a healthcare or pensioner concession card.

Does private health insurance cover dental care?

If you have extras cover that includes dental, some or all of the cost of your dental appointments may be covered. Gabriel explains that dental cover includes both ‘general’ dentistry – check-ups, scaling and cleaning, basic fillings, extractions, fluoride treatments and X-rays – as well as ‘major’ dentistry like root canal therapy, crown and bridgework, and orthodontics. Not all health cover products cover all types of services. It’s also worth remembering the amount you get back varies depending on your level of cover. Annual limits and waiting periods apply.

How can I get more back with dental cover?

You could get 100% back^* on check-ups and cleans at our nationwide network of 7,000 dentists in our More for Teeth program.

If you have dental cover, are on the east coast of Australia and visit an HCF Dental Centre, you can claim one or two check-ups per calendar year and get a scale and clean, fluoride treatments and any required X-rays with no gap to pay^*. You can find your nearest Dental Centre here.

Our Dental Centre services also include teeth whitening and with advancements in orthodontic treatments, we can provide efficient orthodontic care for children and adults to help you achieve the smile you want^{^}.

How can I make the most of my dental cover?

Understanding what you’re covered for is one of the easiest ways to make the most of your dental cover – and one of the most overlooked, Gabriel says.

“Know what level of cover you have, understand the limits and know how much you can claim,” he says. “From a preventive point of view, issues can be identified from an earlier stage and resolved.”

If you're unsure about your cover or any plans for your dental treatment, ask your dentist to explain the options available and their recommendations, as well as the costs involved before you have any work done.

Ultimately, understanding your dental cover puts you in a better position to use it. “A lot of treatments tend to have annual limits that reset every calendar year,” says Gabriel. So make the most of your extras cover and keep your smile as healthy as possible.

You can check your level of cover online through online member services or in the My Membership app.

The dental care you need at a price you can afford

We have Dental Centres across NSW, Qld, Vic and ACT. Our experienced teams provide the highest level of professionalism and knowledge. If you’re anxious about visiting the dentist, let us know when you book your appointment and we’ll do everything we can to help you feel comfortable on the day.

Find an HCF Dental Centre. To find other dentists in our More for You network, browse our Find a Provider tool, or call 13 68 42.