HEALTH INSURANCE …is it worth the money?

One of the most popular questions I am asked by my patients undergoing All-On-4 or other Dental Implants procedures is “should I get private health insurance to cover this treatment?”

I have a simple but not so straightforward answer.

I always advise people who can afford private health cover to definitely take out ‘Private Hospital Cover’ and ‘Ambulance Cover’ as these are covered well, up to 100% (less the excess) in some cases.  But when it comes to ‘Extras Cover’ for dental treatment, its simply NOT worth it, this is why …

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Extras for dental and other ancillary services typically only cover a SMALL PORTION of the treatment. This means that you will still likely be quite substantially out of pocket;

There are many limits, and especially when it comes to expensive treatments such as Crowns, Bridges and Dental Implants, which fall under the category of “Major Dental”. The cap for Major Dental is typically sufficient for one or two crowns only, and once reached, you will not receive any more by way of a rebate;

The premium costs that you will pay for maintaining Dental Cover will end up being far more costly than the capped benefits that you will receive from the insurer in the one time that you need to do something more major on your teeth.

In some cases, the insurance company may entice patients to go to a “preferred provider” and receive FREE check ups and scale and clean per year.  But these services collectively would not cost more that $250, whereas your annual premiums will be far more than this amount.

To be clear, a dental practitioner who is classified as a “Preferred Provider” by the insurer is typically NOT someone who has been selected by the insurer for any accolades or superlative care but rather someone who themselves ELECTS to enter into an agreement with the insurer to adhere to certain fees and charges when it comes to certain treatments, for the purpose of getting patients referred under the preferred provider scheme.  This can becomes a problem when the dentist finds the need to compromise on quality or standards of care in order to maintain to the insurer’s recipe. But even then, for dental services other than check-ups and cleans, there is still a substantial out-of-pocket cost to the patient, and there are still the limits or “Caps” in place on Major Dental.

The Federal Government has just approved another premium increase for health cover, in some cases up to 10%, the average increase being above 6%.

“So that means that what I get back by way of rebates would also go up, right?”

No Way!!!  How do I know? Because in the past 5 years there have been numerous premium increases approved (> 30% for some of the Private Health Insurers), the 30% government rebate has been eliminated and yet rebates have NOT increased by more than 5% in the same period of time, and in some instances, rebates have been reduced.

NOW THIS IS THE REAL KICKER!!!!!!!!!!!!!!

In Australia over the past 13 years, Private health Insurers have returned profits of over $8 BILLION!!

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So whether it’s “All on 4” treatment, a single tooth implant or a porcelain crown, don’t expect a significant rebate from your Private Health Insurer…… they are working for their shareholders and NOT for you.

Finally, the standard recommendation I give all my patients is, that if they have a big family in which everyone sees the dentist regularly, each child gets a new pair of optical glasses EVERY year, everyone sees a physiotherapist multiple times per year as well as the osteopath, chiropractor etc, then ancillary cover may be justified. Otherwise take out hospital and ambulance cover, don’t take out Extras Cover and with your yearly savings you can buy me a bottle of Penfolds Grange for Christmas, and still be way ahead!