Are Dental Implants Covered By Health Insurance?
Find out whether dental implants are covered by private health insurance right here with Savvy.
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Dental implants are becoming an increasingly popular option for individuals who are missing one or more teeth. They’re a permanent and durable solution that can restore a person's ability to bite, chew, and smile with confidence. However, the cost of dental implants can be a concern for many people.
Are you considering dental implants and wondering if they are covered by your private health insurance? Find out detailed information about the benefits, coverage and potential out-of-pocket costs you may encounter with dental implants with Savvy. Learn about the ins and outs of dental implant cover in our informative guide.
Are dental implants covered by private health insurance?
Yes, dental implants come under the ‘major dental’ category of private health insurance and are covered by extras (also known as general or auxiliary) health insurance policies. However, it’s usually only the more expensive and comprehensive extras policies which will provide coverage for this type of dental treatment.
The ‘major dental’ category of health insurance coverage includes more complex and expensive treatments such as:
- wisdom teeth removal
- root canal work
- braces and aligners and other orthodontic treatments
- crowns and bridges
- implants
The amount of coverage available for dental implants will vary from policy to policy and will be subject to annual benefit limits, and sometimes lifetime policy limits. These limits are the total amount of benefit that can be claimed on that policy either in one financial year or across the life of the policy. If the cost of your implants exceeds the policy annual or lifetime limit, you’ll have to pay the remainder of the cost out of pocket.
Are dental implants free under Medicare?
No – dental implants aren’t free and, in most cases, aren’t covered by Medicare in Australia. Generally, Medicare doesn’t cover any dental services except limited coverage for children and pensioners. However, even this limited coverage doesn't extend to dental implants, as they're considered elective or cosmetic procedures.
Dental work which may be covered by Medicare for children and pensioners is usually limited to routine care and basic cleaning, plus necessary fillings and extractions. Therefore, if you are considering dental implants, you’ll have to rely on private health insurance to assist with some of the cost.
Medicare does provide some coverage for dental implant surgery in very specific circumstances, such as emergency oral surgery in a hospital following an accident or severe injury, or dental services related to a Medicare-eligible medical condition. If the condition of your teeth is impacting your overall health you may be able to get a referral from your GP which will enable you to be seen by a public hospital dentist.
For example, if a dental implant is required due to an accident or injury that is covered by Medicare, some portion of the cost may be eligible for coverage. However, this would be assessed on a case-by-case basis and would require prior approval from Medicare.
How much do dental implants cost in Australia?
The cost of dental implants will vary depending on several factors, including:
- the number of implants being done
- the complexity of the implant surgery
- the type of dental implant and crowns used
- the location (state) of the dental clinic
- the fees charged by the dental clinic, dentist or oral surgeon
On average, a single-tooth dental implant in Australia can cost between $3,000 and $6,000. A full arch of dental implants for one complete set of teeth can cost upwards of $20,000 or more per jawbone.
What out-of-pocket expenses can I expect if I do have a dental implant?
The out-of-pocket expenses that you may have to pay will depend on the level of extras cover you’ve decided to buy and the policy allocation and benefit limits for the major dental category.
As an example, here are the costs of some comprehensive extras policies and the benefit limits they provide for major dental:
| Cost of extras policy per month | Amount allocated per year for major dental |
|---|---|
|
$104.76 |
$2,000 |
|
$100.59 |
$1,500 |
|
$88.66 |
$1,100 |
|
$79.16 |
$1,000 |
|
$66.96 |
$750 |
|
$56.69 |
$700 |
As you can see from the above examples (figures current as of April 2023), the amount allocated to the major dental category is in direct proportion to the cost of the policy. Higher-priced extras policies will generally offer a higher benefit limit for the major dental category.
If your dental implant costs an average $5,000, the amount of out-of-pocket expenses you may be up for can be quite extensive, even with the highest level of health insurance available in Australia.
More frequently asked questions about health insurance and dental implants
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