To help you navigate the private health fund market, we have put together 5 important things to consider before signing up for dental extra's cover:
1. RESEARCH AND COMPARE
Research and compare health funds online, or call funds directly to ask for information on their policies. Remember extra’s cover is not limited to just Dental – will you be using your extra’s cover for other treatments? massage, chiropractor e.t.c. You do need to consider your overall policy’s needs before signing up. Also when comparing funds online – the website you are using may only be drawing policies to compare from a limited pool of health funds(often sponsored). We recommend researching potential funds individual websites as well. If you have an existing policy, the Australia Dental Association(ADA) has a helpful website that lets you compare dental health fund policies. For more information, click the link below:
2. VALUE FOR MONEY
PREMIUMS vs REBATE. You’ve had a look around for dental extra’s cover and found a fund that will save you $120.00 a month for your premiums – great news!......or is it?
What you really need to consider is what your rebate will be for specific treatments and procedures that you want. Your premium cost may be lower, but your rebate could be lower too. You are able to check this with any prospective insurer prior to taking out a policy.
3. WAITING PERIODS
Remember every policy has pre-existing illness clauses and exclusions that determine when and if you can make a claim. Some health funds have a waiting period for certain treatments, meaning you aren’t able to start claiming immediately. If you are transferring your existing cover from one fund to another, you can ask that they waive the waiting periods for certain treatments, this is something that needs to be discussed prior to signing up.
4. GENERAL vs MAJOR DENTAL COVER
There is a difference, check up’s and cleans are covered under General dental and treatments such as crowns and root canal therapy, are covered under Major dental.
If the information is not readily available on the health funds website, another way to find out what is covered and what your potential rebate might be – is to simply ask for the information. Each health fund is required to have a Standard Information Statement(SIS), which will provide you with details such as benefit limits, services covered e.t.c. Most dental practices will be happy to provide you with the specific item codes for any proposed treatment, so that you can query directly with your current or prospective health fund.
5. PREFERRED PROVIDERS
Does your health fund let you choose your own Dentist, without restrictions? Some Insurers are referring to contracted Dentists as “preferred providers”. It doesn’t mean they are more or less skilled than your current Dentist, it just means that the particular Dentist has a contract with their health fund, or they are employed by that funds own dental clinic.
Which poses the question: How much influence does that health fund have over your dental treatment? If the health fund governing that Dentist has a vested financial interest in their work output, are they really putting your needs as a patient first?
With the introduction of “preferred providers” you could find yourself paying the same premiums as other members, but not getting the same benefits back. You should not be penalised for wanting to remain with your own Dentist, whom in many cases you have built up a long-term relationship, rapport and trust with. Look for a fund that will let you choose who provides you with your oral health care.