Understanding how much benefit your health insurer will pay towards your dental treatment gives you an idea of how much you may need to pay out-of-pocket.
To find out your remaining benefit limits, you can call your health fund and ask simply ask 'How much benefit do I have remaining?', or you may be able to find limited information via your health fund app on your smart phone. Depending on which level of cover you are on, and which health fund you are with, your limits may be split between:
- General Dental (check ups and cleans),
- Preventative Dental (fillings and fissure sealants) and
- Major Dental (includes extractions, gum treatment, crowns, root canal treatment, implants)
For a specific quote / estimate on the benefit your health insurer will pay towards your treatment, you will need to provide them with the following information:
- Your name and member number
- The Provider Number
- This is a 6 digit number that identifies the dentist
- Treatment ID / Item Number
- This is a 3 digit number, usually before the treatment description
- Tooth ID / Number
- This is required for treatment specific to a tooth such as a filling, crown, root canal treatment or extraction
- Treatment Price
The above information can be obtained from your treatment plan. Without a treatment plan or undertaking an examination, it is difficult to know what treatment you need, and the item numbers to provide to the health fund.
When obtaining a quote / estimate from your health insurer, please note that if anything changes in relation to your policy, claims you have made to date or when your benefits expire, your quote / estimate will also change.
Due to privacy reasons, our staff are not able to speak to your health insurer without your authorisation to do so first.