Major Dental Insurance

How we calculate Health Insurance Extras Finder Scores

Read full methodology

What different scores mean

9+

Excellent

Competitive pricing coupled with highly ranked extras.

7+

Great

Balanced pricing and features, offering overall good value.

5+

Standard

These products offer a balance between price and features.

0+

Basic

These products usually offer fewer extras or above average pricing.

*Prices are based on a single person living in Sydney earning less than $97,000 a year.

Finder Score - Health Insurance Extras

Each month we analyse over 10,000 extras insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare extras cover a bit faster.

We want to compare apples to apples, not apples to apple pie. It doesn't make sense to compare a top extras policy with coverage for hearing aids and braces against a policy designed only for dental. So we've separated all the extras policies on the market into pools and categories. Once in their pools and categories, each product gets a price score and a features score, which are then combined to give the Final Score.

Read the full Finder Score methodology

What does major dental insurance cover?

• Complex oral surgery. For example, some wisdom tooth extractions are classed as major dental.
• Dentures. Dentures are removable prosthetic teeth that can be fitted to replace any number of missing teeth.
• Dental crowns and bridges. These are two different but very closely related types of dental implant you may need. They act like partial fake teeth permanently installed on top of damaged existing teeth.
• Root canals. For example, if a tooth has fissured or cracked and the interior pulpy tissue becomes infected and inflamed, you may need root canal.
• Periodontics. This encompasses a variety of non-tooth related treatments such as treatment of gingivitis and other oral tissue problems.
• Veneers. A cover of porcelain or resin that are fixed into the front of the teeth. This procedure is mainly done for changes in shape and colour of the teeth.

How does private health insurance cover major dental?

Health insurance for dental is split into general and major dental, which are explained below. Orthodontic cover and endodontic cover is also available in some higher tier extras policies.

Major dental

Major dental is covered by most mid-range extras policies which let you claim up to around $800 per year. They generally cover more complex procedures such as root canal therapy (endodontics), root planing, more complex fillings and non-tooth related surgery (periodontics). Major dental usually doesn't include orthodontics – you'll need to pay extra for that – and most treatments come with a 12-month waiting period.

General dental

General dental is available in most extras mid-tier policies, including every policy that also includes major dental. This can cover you for the basics like your 6 month exam, scale and clean, fluoride treatments, X-rays, some fillings and simple extractions.

• Full list of providers who offer cover for major dental

  Health fund	Policies that cover major dental services and the annual benefit limits	Find out more
  	Super Extras. Benefit limit of $1,100 per person. Family Extras. Benefit limit of $750 per person. Lifestyle Extras. Benefit limit of $750 per person and $1,500 per family. Black 60. Shared benefit limit of $600 per person and $1,200 per family.	More info
  	Advanced 80% Extras. Benefit limit of $2,400 per person (includes orthodontics). Comprehensive Extras. Benefit limit of $2,400 per person (includes orthodontics). Intermediate Extras. Benefit limit of $300 per person. Standard Extras. Shared benefit limit of $600 per person with a sub-limit of $300 for crowns, bridges and dentures.	More info
  	Top Extras 90. Benefit limit of $1,200 per person. Top Extras 75. Benefit limit of $1,100 per person. Top Extras 60. Benefit limit of $1,000 per person. Your Choice Extras. Initial benefit of $500 after 2 years of retaining cover, increasing by $100 for each additional year until it caps at $1,000 after 7 years.	More info
  	Total Extras. Shared benefit limit of $1,600 per person. 75% Extras. Shared benefit limit of $800 per person.	More info
  	GMHBA allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table. Top Extras 75% Top Extras Set Benefits	More info
  	Lots Extras Cover. Shared benefit limit of $2,000 per person and $4,000 per couple/family. Some Extras Cover. Shared benefit limit of $500 per person and $1,000 per couple/family.	More info
  	Top 70. Benefit limit of $1,000 per person. Complete 60. Benefit limit of $800 per person. Flex 60. Combined limit of $1,000 per person. Flex 50. Combined limit of $800 per person.	More info
  	HCF Platinum and Gold Extras benefit limits for major dental increase each year you retain your policy. The increase caps at year six. HCF Top Extras. Benefit limit of $1,000 per person. HCF Vital Extras. Benefit limit of $800 per person. HCF Mid Extras. Benefit limit of $650 per person.	More info
  	Health Care Insurance allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table. Premier Active Life	More info
  	Freedom Max Extras. Benefit limit of $1,000 per person. Freedom Extras. Benefit limit of $900 per person.	More info
  	The HIF major dental benefit will increase each year you retain your policy. The increase caps at year five. Premium Options. Initially $1,500 per person, capping at $3,000 per person. Super Options. Initially $1,300 per person, capping at $2,500 per person. Special Options. Initially $1,000 per person, capping at $2,000 per person. Saver Options. Initially $750 per person, capping at $1,250 per person.	More info
  	All of Latrobe Health Services' extras policies, except for Premier Silver, increase their major dental benefit limits for each year you retain cover. Premier Extras. Benefit limit of $1,500 per person. Core Extras. Benefit limit of $1,000 per person. Basic Extras. Benefit limit of $500 per person. Premier Singles & Couples Extras. Benefit limit of $875. Premier Families Extras. Benefit limit of $300 per person.	More info
  	Top Extras. Benefit limit of $500 per person. Growing Family Extras Only. Initially $400 per person, increases by $50 each year until it caps at $600 after four years of continuous cover.	More info
  	Five Star Extras. Shared benefit limit of $390 per person during the first year of cover, increases to $1,400 per person from year two onwards. Dental Cover. Shared benefit limit of $350 per person during the first year of cover, increases to $1,000 per person from year two onwards.	More info
  	onemedifund allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table. Gold Hospital - $250 Excess & Comprehensive Extras	More info
  	Top Extras. Benefit limit of $1,300 per person. Core Extras. Benefit limit of $600 per person.	More info
  	Premium Extras. Benefit limit of $1,500 per person. High Extras. Benefit limit of $1,000 per person. Mid Extras. Benefit limit of $500 per person.	More info
  	Complete Extras 70. Benefit limit of $1,000 per person. Everyday Extras 60. Shared* benefit limit of $800 per person.	More info
  	Super Extras. Benefit limit of $1,200 per person.	More info
  	Top Extras. Initial benefit limit of $800 per person, increasing to $1,000 per person after three years and $1,200 per person after five years. Healthy Choice Extras. Benefit limit of $500 per person and $1,000 per policy.	More info
  	Ultimate Extras. Benefit limit of $1500 per person. Advantage Pro Extras. Benefit limit of $1400 per person.	More info
  Restricted fund*	CBHS allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table. Top Extras Intermediate Extras	More info
  Restricted fund*	Premier Extras. Benefit limit of $1,100 per person. Value Extras. Benefit limit of $900 per person.	More info
  Restricted fund*	Premium Extras. Benefit limit of $2,000 per person. Healthy Living Extras. Benefit limit of $1,500 per person. Budget Extras. Shared benefit limit of $500 per person.	More info
  Restricted fund*	Total Extras. Benefit limits vary depending on the service. You can find the amounts for each treatment below this table. Essential Extras. Shared benefit limit of $1600 per person.	More info
  Restricted fund*	Rolling Extras. Benefit limit of $1,500 per person.	More info
  Restricted fund*	Premium Extras Cover. Benefit limit of $1500 per person Smart Extras Cover. Benefit limit of $1200 per person	More info
  Restricted fund*	RBHS allocates varying sub-limits to each service that falls under major dental. You can find the details on each one below this table. Premium Extras	More info
  Restricted fund*	Top Extras. Initial benefit limit of $1,300 per person. Increases for each year you hold cover until it caps at $2,800 on year six. Essential Extras. Benefit limit of $300 per person.	More info
  Restricted fund*	Comprehensive Extras. Overall benefit limit of $3,400 per person. Family Extras. Overall benefit limit of $2,000 per person. Everyday Extras. Overall benefit limit of $2,000 per person. Healthy Options Extras. Shared benefit limit of $1,000 per person. Mid Range Extras. Overall benefit limit of $1,000 per person.	More info

  _{*Restricted funds only provide cover to members of specific industries, groups and organisations. In some cases family members may also be eligible to join.}

Major dental waiting periods and claim limits

• Major dental waiting periods. Most extras policies will come with a 12-month waiting period. This means you need to hold cover for a year before you can start claiming on treatments like endodontics, root planing and periodontics. Basic dental usually comes with a two-month waiting period.
• Claim limits. A benefit limit is the most the insurer will pay per year, per person. Most mid-range major dental insurance policies come with a $500 to $800 limit. In some cases, sub-limits may apply for specific treatments, such as periodontics.

Frequently asked questions

• Can I get major dental with no waiting periods?

  No, all major dental cover policies come with a 12-month waiting period. However, you don't have to serve waiting periods for chiro, general dental and optical with some extras policies, such as ahm Lifestyle Extras.

• What is classed as major dental?

  Root canal, periodontics, crowns, bridges, veneers and dentures all generally come under major dental, though this can vary slightly between insurers.

• Does major dental cover periodontics?

  Yes, major dental usually covers periodontics. This can include a wide range of gum-related treatments.

• What does major dental not cover?

  Exclusions may vary between health funds, but some you may encounter include:

  • No payout for claims made more than one or two years after a procedure
  • No benefits payable for pre-existing conditions
  • No cover for treatments or procedures that an independent medical professional deems unreasonable or inappropriate
  • No benefits for services not provided face to face, such as phone or online consultation, unless stated otherwise
  • No cover for cosmetic procedures without a specific condition being treated or the presence of symptoms, illness or injury
  • No cover if you are visiting a dentist or specialist who is not registered with or approved by your private health fund

• Does Medicare cover major dental?

  No, Medicare doesn't cover major dental, which is why many Australians take out extras cover. However, you might be eligible for free major dental if you can't afford to pay and are a concession card holder or you have children.

• How do I make a claim for major dental?

  The claims process can vary depending on your fund and practitioner. However, here are some general guidelines to claiming:

  • If your dentist or specialist is associated with your health fund then they may be able to liaise directly with the insurer and arrange payment.
  • Most funds will provide you with a membership card, which can be swiped at your treatment facility.
  • You may be able to download a health insurance app to your phone which lets you claim and pay benefits on the spot.
  • In some cases you will be required to fill out a claims form and send it to your insurer.

• How do the benefit limits work?

  Here are the benefit limits you'll commonly see with extras insurance:

  • Sub-limit. A sub-limit is the largest possible amount you can claim for a specific service, which is then deducted from a larger overall benefit limit. For example, your dental cover might include an overall benefit limit of $900 with sub-limits of $300 being applied to bridgework, endodontics and dentures. In this case, the maximum you could claim for any one of those services is $300.
  • Shared or combined benefit limit. This means that the benefit limit is shared amongst multiple services, rather than applying a limit to each one individually. While you are not restricted to claiming a capped amount like you are with sub-limits, your total overall benefit amount is spread over a wider range of treatments, so be sure not to claim excessively on one service and leave yourself without cover for others.
  • Lifetime benefit limit. This is the maximum amount you can claim for a service throughout your lifetime. Be aware that if you've reached your lifetime benefit limit with one insurer and switch to a new one, they may deduct that amount from your new policy. It is recommended that you check with your new provider to find out if these penalties apply.

Written by

Gary Ross Hunter

Editor, Insurance

Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio

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