#9: Health Insurance & Dentists

HEALTH INSURANCE and DENTISTRY!! … talk about one of the most confusing conversations to have these days.

Every day, we get phone calls from people asking which preferred provider network we are associated with.  These questions and many more can result in very long and detailed replies.

Firstly, we have a lot of information regarding Private Health Insurance at www.diamond-dental.com.au/privatehealthinsurance, but we will give you an overview of how it works from a clinic perspective – Diamond Dental Wantirna South.

Health Insurance Overview

If you have Private Health Insurance, we ask you to bring your health fund card with you to your appointment so we can process your health fund claim on site. This helps process your health fund rebate to us on the day of service and you are only responsible for your Gap amount on the day.  We find this system the most convenient for our patients, as it saves both time and paperwork.

Every health fund is different and most health funds have different levels of cover – for example; you can opt to get hospital only cover, basic extras with or without hospital cover etc.  Depending on the premium you pay to your health fund, you may get a little or a lot back at your dental visit.

This makes it extremely difficult for us to be able to tell you over the phone how much you will be out of pocket for your visit with us.  We can quote most health funds if you come to the clinic and allow us to swipe your card through our HICAPS machine to give you a printed quote.   Or we can give you the item treatment codes for you to call up your insurance provider to ask them for a quote.  Most of the time you will get around a third to just over half of your total bill back, depending on your level of cover.

Beware of the Fine Print:

Private Health Insurer’s have started to become a little tricky with their marketing.  They lure you into signing up with them with promises of “Gap Free Dental” or “Unlimited Dental” BUT beware the fine print!

They only honour those ‘deals’ if you see their dentists.  Diamond Dental is incredibly fussy on the Private Health Funds with which we align ourselves.  Most health funds don’t screen a dentist before signing them onto their preferred provider network.  That being the case, you don’t know if you are seeing a good quality dentist, or just another dentist who needs to sign up with a health insurer to fill their appointment book.

Trust Your Dentist:

It has been our experience that some health funds lead patients down a path that may be more financially beneficial for them, but not necessarily best for their dental health.  For example, if the health fund will give you back 75% of one treatment but only 10% for another, most people need to save the money and go with the 75% option, even if that option is not necessarily the best decision for you.

With that in mind, Diamond Dental Wantirna South has steered clear of aligning ourselves with funds that work in that way. We are always keeping our patients health as our number one priority.  Sure, we could have become a preferred provider with these companies and become crazy busy, but patient care is what we are about.

Referral Website:

What is smile.com.au?

At Diamond Dental Wantirna South, we are aligned with smile.com.au.  To be transparent – smile.com.au benefit us by referring new patients to us.  They handle all of the marketing that makes it successful.  We then offer anyone referred to us by smile.com.au a discounted price at a minimum of 15% but up to 25% off some procedures.

smile.com.au is NOT a private health fund.  We really do love this concept as they don’t set different rebates for different procedures, which means cost won’t guide a patient down a path that may not be the ideal treatment for them.  It is simply good quality dentistry suited to you.

smile.com.au is partnered with Defence Health, Australian Unity, Frank, GMHBA, Budget Health, PeopleCare and health.com.au – so if you already have cover with these companies, then Diamond Dental Wantirna South would be a great place for you to benefit from good quality dentistry and make the most out of your health insurance.

We are also part of HCF’s More for Teeth program. This is an excellent program where your six monthly check up, standard teeth clean and x-rays (and other preventative dentistry) are covered by HCF 100%.  We love this because it encourages our patients to visit us six monthly and stay on top of their dental treatment.  We love recommending HCF as a health insurance company for your dental needs.

What is Self Insurance?

This is fast becoming a growing trend within our patient community.  The costs of Private Health Insurance are going up and rebates aren’t keeping up.  Meaning you are paying more and getting less back.  To be self insured means you save the money from paying premiums to the Insurance companies, but you pay the full amount at the dentist. If you don’t have a need for a lot of dental work, this could be a beneficial option for you.  The Australian Dental Association released an article “Why are my rebates so low?”, in it, they discovered that between March 2012-March 2017, average dental fees only increased by 3%, while Health Insurance Premiums increased by 38%!!

We can certainly understand why people are opting out of dental extras with Private Health Insurers and choosing to become self insured.

If you have any questions feel free to contact us at [email protected]

Yours in good dental health,

The Diamond Dental Team.