Comparing Dental Insurance in Australia: Extras Cover, Benefits and Costs

What dental insurance is (and how it works in Australia)

Dental insurance is designed to help cover the cost of dental treatments such as check-ups, cleanings, fillings and other services. The main purpose is to reduce out-of-pocket expenses so dental care can be more affordable over time.

In Australia, dental insurance is most commonly included as part of an Extras health insurance policy. Extras cover can include a range of services, with dental benefits varying depending on the level of cover you choose. Policies typically have annual limits (how much you can claim each year), and many services are only partially covered. For example, an Extras policy may cover general dental, but you might only get 60% back or have an annual claim limit such as $750.

While most dental benefits sit under Extras, some dental procedures performed in a hospital may be claimable under Hospital cover. This can include hospital-related costs such as accommodation and operating theatre fees for certain procedures, including dental surgery for implants or wisdom teeth removal.

Common dental categories covered under Extras

Extras policies that include dental are often structured around three broad categories: general (or preventative) dental, major dental, and orthodontics. The availability of each category and the level of benefits can change significantly between basic and top-level policies.

• General and preventative dental: Typically includes exams to check for cavities and gum disease, plus preventative treatments like check-ups, cleanings and polishes. It may also cover plaque removal, some tooth extractions, fillings and x-rays. Most Extras policies include general dental, but Basic and Bronze levels may have more limited benefits. A waiting period of around two months normally applies.
• Major dental: Covers more complex procedures such as endodontics (root fillings) and treatment for periodontitis (gum disease). It may also include crowns, bridges, dentures, major restorative fillings and oral appliances for sleep apnoea. Major dental is typically found on higher-level Extras policies and may be particularly beneficial for seniors. A 12-month waiting period usually applies.
• Orthodontics: Specialist care to correct teeth alignment using bands, braces or clear aligners. Like major dental, orthodontics is generally available only with higher levels of Extras cover and may be relevant for family or single-parent policies. Orthodontic treatment typically has a 12-month waiting period, and benefits are often capped over multiple years (or over the lifetime of the policy), not just annually.

Preferred provider networks and why they matter

Many health insurers have agreements with specific dental practices and other care providers. If you use a provider outside your insurer’s network, you may receive lower benefits and pay more out-of-pocket. You can still attend a dentist who is not in the network, but it’s worth checking whether your preferred dentist is partnered with the insurer before you book.

Why people take out Extras cover for dental

Dental cover can support routine oral health by making regular check-ups and cleanings easier to budget for. Regular preventative visits can also help identify problems earlier, potentially reducing the need for more expensive treatments later.

Survey results referenced in the extracted content indicate that dental is a leading reason Australians choose Extras cover. In that survey, 52% of Australians selected Extras for dental check-ups and cleans, compared with 26% for optical care and 14% for physiotherapy and chiropractic services. By generation, 59% of baby boomers chose Extras for dental, followed by 53% of Gen X, 50% of Millennials, and 45% of Gen Z.

Broader utilisation data cited in the extracted content also points to high demand for dental services. Private health insurance subsidised over 50 million dental services in 2022–23 (as reported by APRA). AIHW data referenced in the content also showed that 52% of Australians aged 15 and over visited a dental professional in 2022–23.

How much dental insurance can cost

The cost of dental insurance in Australia depends on factors such as the level of coverage, the health fund, and which services are included in your Extras policy. The extracted content states that, on average, Extras cover (which can include dental) may cost anywhere from $20 to $280 per month.

In general terms, a basic policy may cover just one dental check-up per year, while a top-level policy may offer a wider range of benefits, including major dental and orthodontics, along with higher annual limits and sublimits. However, having dental cover does not automatically mean you will avoid out-of-pocket costs.

Understanding out-of-pocket costs, limits and “no-gap” offers

Out-of-pocket costs can still apply because insurers generally pay only a portion of your dental bill. The difference between what your dentist charges and what your insurer pays is commonly referred to as the gap.

Dental benefits are typically paid in one of two ways:

• Percentage-based benefits: Your insurer covers a percentage of the bill (for example, 60%), up to your annual limit. You pay the remainder.
• Set benefits: Your insurer pays a fixed amount for eligible services (for example, $60 for a check-up or clean), regardless of the dentist’s fee.

Policies also set annual limits for general, major and orthodontic dental. Once you reach your limit, you generally pay the full cost until the new policy year begins. Depending on the policy, limits may apply per person or as an overall policy limit. In most cases, annual dental claim limits do not roll over—if you don’t use them, you lose them.

Some people consider switching dentists to access “no-gap” dental benefits, where treatment may be fully covered with no out-of-pocket costs when using eligible providers. These arrangements can depend on the insurer’s preferred provider network and the specific policy terms.

Waiting periods: what to expect

Waiting periods are a standard feature of many Extras policies. The extracted content notes typical waiting periods of two months for general and preventative dental, and 12 months for major dental and orthodontics.

In some cases, waiting periods may be waived. For example, some funds offer no waiting periods for general dental as an incentive for new customers. The extracted content also notes that waivers are often tied to taking out combined Hospital and Extras cover rather than a standalone Extras policy. If you are switching to the same or a lower level of cover and have already served waiting periods with a previous provider, the new fund may recognise those waiting periods.

What Medicare does (and doesn’t) cover

The extracted content states that Medicare does not cover dental costs as a standard rule. However, public dental services are available through state and territory health departments for eligible individuals, including children and adults. Adults typically need a Health Care Card or a Centrelink Pensioner Concession Card to access these services, and eligibility rules vary by location. Public dental care may include emergency treatments and specialist referrals such as orthodontics, but waiting times can be lengthy and may exceed a year.

How to compare dental insurance policies

When comparing dental insurance in Australia, the extracted content highlights several practical checkpoints:

• Match services to your needs: Review whether the policy includes general/preventative dental, major dental and orthodontics, and whether the level of cover fits your likely usage and budget.
• Check annual limits and sublimits: Compare how much you can claim each year, and whether limits apply per person or across the whole policy.
• Consider preferred providers: If you have a dentist you want to keep, confirm whether they are in the insurer’s network, as this can affect rebates and out-of-pocket costs.
• Review waiting periods: Understand standard waits (often two months for general dental and 12 months for major/orthodontics) and whether any waivers apply when switching.
• Look at sign-up deals and perks: Some funds offer incentives such as credits, cashback, waived waiting periods on Extras, or gift cards. Some also offer multi-policy discounts when bundling with other insurance types.

Where to check what your policy actually covers

To confirm what is included in your dental cover, review your policy’s Product Disclosure Statement (PDS). The PDS outlines covered treatments, limits, sublimits, exclusions and waiting periods. If anything is unclear, you can contact your insurer for clarification.

Is private dental insurance worth it?

Whether private dental cover is right for you depends on your needs and priorities. The extracted content suggests it may suit people who value regular check-ups and want to keep costs manageable. For families, cover that includes orthodontics may be particularly relevant because braces can be expensive and benefits can help reduce the burden, subject to waiting periods and caps. It’s also important to remember that most dental policies do not cover teeth whitening or other cosmetic treatments, although some of the highest-level Extras policies may include it.

Finally, how often you can claim depends on your policy’s dental limits, which are usually dollar-based rather than a set number of visits. Even with cover, you may not be able to claim 100% of the cost unless a no-gap arrangement applies with eligible providers.

The information in this article is general in nature and does not take into account your objectives, financial situation or needs. Consider whether a product is suitable for you and read the relevant disclosure documents before making a decision.