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If you're considering wisdom teeth removal, you may be wondering if your private health insurance can help cover the cost. Wisdom teeth extraction is a common dental procedure, but it can be expensive, especially if you don't have dental cover. That's where buying health insurance can help reduce your out-of-pocket expenses.
You can quickly compare quotes for private health insurance which includes cover for wisdom teeth removal through Savvy. By answering a few simple questions about the health insurance you’re after, you could have multiple policies to consider side-by-side instantly from our panel of insurers which includes some of Australia’s leading health funds. Get the process started through Savvy today.
Does private health insurance cover wisdom teeth removal?
There are two types of health insurance that can assist with the cost of wisdom teeth removal. Which type of cover will benefit you most will depend on whether you have your extraction done as an out-patient by a dentist, or in hospital under a general anaesthetic.
Extras cover is a type of health insurance plan which covers a range of non-hospital treatments, including dental procedures. If you're going to have your wisdom teeth removed in a dental surgery, having extras cover may help cover a portion of the cost. The amount you can claim back will depend on the level of cover you have.
More expensive extras policies may allow you to claim back a higher percentage of the cost. For example, with a cheaper policy, you may be able to claim back 50% of the cost, but with a more expensive extras policy you may be able to claim 85% or more. However, in the terms and conditions of your health insurance plan, there may be an annual limit which puts a cap on how much you can claim on your policy per year.
If your wisdom tooth extraction is more complex and needs to be performed under a general anaesthetic in hospital, hospital cover may cover some of its cost if you choose to be treated as a private patient. This could either be in a private hospital, a public hospital or a private dental clinic which has the facilities to perform extractions under general anaesthetic. However, if you’re admitted to hospital for the procedure, you may have to pay an excess (if your policy has one) and possibly a co-payment.
How do I compare the best health insurance policies to cover wisdom teeth removal?
When choosing a health insurance policy for wisdom teeth removal, consider the following factors:
- Cost: look for a policy with a premium which fits within your budget. With hospital insurance, you can choose between silver or gold cover, as both these types of insurance cover dental surgery. Some bronze plus hospital policies may cover major dental procedures, but this is less common. You may also need a more comprehensive extras policy to ensure you have coverage for a major dental procedure, as cheaper policies may only include basic dental costs such as cleaning and general check-ups.
- Benefit limits: extras policies often come with policy benefit limits, so compare these limits and check whether they’ll cover the cost of your extraction. Wisdom teeth removal falls under the ‘major dental’ area of extras cover.
- Waiting periods: check the waiting periods for wisdom teeth removal cover, as they may vary between extras policies.
- Exclusions: be aware of any exclusions or limitations in the policy which may affect how much you can claim back when you have your extraction done.
- Special offers: health funds will sometimes try to attract new clients with special offers, such as offering no waiting periods for dental treatments with a new extras policy. You can compare special offers through Savvy.
Is wisdom teeth removal covered by Medicare?
Medicare doesn’t routinely cover dental treatment. Whether your wisdom tooth removal will be covered by Medicare is not a simple question, as it'll depend on a variety of factors, including:
- Urgency – whether the extraction is medically urgent; for instance, if it’s due to a severe gum infection or injury resulting in serious pain
- Medical necessity – whether the extraction is medically necessary, or if it’s being done to avoid future cosmetic issues, such as mouth overcrowding or teeth misalignment. If the extraction is medically necessary but not urgent and you choose to be treated as a public patient, waiting lists can be up to two years
- Complexity – whether the extraction can be done by a regular dentist or if an oral surgeon or maxillofacial surgeon is required to complete the procedure. How complicated the extraction will be will depend on the way your teeth have developed within the jaw
If the extraction of a wisdom tooth is medically urgent (due to a serious jaw infection, for example), you may be able to have the procedure done as a priority public patient in a public hospital and Medicare will cover the full cost.
In most other circumstances, however, you'll have to pay for the cost of the procedure yourself. Having private health insurance can assist you with the cost of the extraction, either at a dental surgery or as an inpatient in hospital if you require a general anaesthetic.
You can find and compare health insurance policies which include cover for the cost of wisdom teeth removal through Savvy. Start comparing policies through us today.
Types of health insurance
This can help you pay for medical treatment if you need to be admitted to hospital. It can help cover the cost of your admission or accommodation and the fees charged by doctors, surgeons and anaesthetists. It can also cover other costs associated with a stay in a private hospital.
This helps cover the costs of health care treatments outside a hospital setting which aren’t covered by Medicare. This can include major and minor dental treatment, orthodontics, hearing aids, physiotherapy, glasses, contact lenses and podiatry (in most cases with annual limits).
This is a standard health insurance policy designed for a single person, rather than being tailored to cater to the needs of a couple or family. It may include hospital cover plus extras, or either of these types of insurance on their own, depending on what you're after for your health cover.
A family health insurance policy is designed for a family unit including dependent children who may reach up to 31 years of age with some insurers. It offers private health insurance suitable for the whole family and may include shared limits for all members included in your policy.
A health insurance policy aimed at seniors is designed to appeal to people who are in the second half of their life. These are often specific Silver Plus policies that offer the same cover as other health insurance policies, with the exception that pregnancy and childbirth cover may not be included.
Visitors who are in Australia on a temporary basis for travel, work or study may be able to take out Overseas Visitors Health Cover (OVHC). Many visas issued in Australia come with a requirement to take out this type of insurance, which covers visitors who may not be covered by Medicare.
Ambulance cover is generally available either packaged into your private health insurance or on its own as a separate policy or subscription. By having this protection, you could be covered for all eligible ambulance travel in Australia (subject to your insurer's terms and conditions).
The cheapest and most barebones form of private hospital insurance, this can include cover for rehab, in-hospital psychiatric services and palliative care. Having this policy will enable you to avoid paying the Medicare Levy Surcharge (MLS) and Lifetime Health Cover (LHC) loading.
Bronze hospital cover is a step up from basic insurance, including 18 further clinical categories such as ear, nose and throat, bone, joint and muscle, digestive system, joint reconstructions, gynaecology and chemotherapy, radiotherapy and immunotherapy for cancer.
Silver hospital cover is the second-most expensive type of policy and offers the second-most clinical categories. On top of what's offered by basic and bronze cover, it also includes heart and vascular system, lung and chest, blood, hearing device implantation and dental surgery.
The highest level of private hospital insurance available in Australia, gold policies can offer cover for pregnancy and birth, weight loss surgery, assisted reproductive services and insulin pumps on top of all the categories provided by silver, bronze and basic hospital insurance.
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Frequently asked questions about health insurance for wisdom teeth removal
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