Understanding Extras cover for dental treatments

Good oral hygiene is incredibly important for reducing your risk of not just dental problems, but also other health conditions. 

Your oral health can have a major effect on your overall health and wellbeing. Poor oral health, including tooth decay, gum disease, infections and chronic inflammation, has been linked to major diseases such as cardiovascular disease. 

It’s also been proven that health plays a big role in your overall sense of wellbeing. 

Good oral health can have a tremendous effect on your overall health. 

Good oral health means regular brushing, flossing, being careful what we drink, and eating healthy foods,

Prevention is always better than cure, so take a little extra time to care for your teeth and make sure to book in for regular check-ups.

Australian Unity’s range of extras covers include many benefits to help you keep on top of your oral/dental health.  Here’s a rundown of what you can get and how it all works.

What does no-gap dental mean?

Australian Unity's No Gap Dental service offers members with eligible cover selected preventative dental treatments at no out-of-pocket cost. So if you have No Gap Dental on your cover, your dental check-up (including x-rays) will cost you $0 throughout our No-Gap Dental network (yearly limits may apply).

Members who visit the dentist regularly for preventative dental treatment will keep their teeth healthier, which saves you money in the long run.

Our No Gap Dental network is available in all States and Territories except Tasmania. To find a provider near you, visit our list of No-Gap Dental Services.

What preventative services does Australian Unity’s No Gap Dental cover? 

For preventative services, the following treatments are included as part of No Gap Dental (specific item numbers apply):

• Initial examination
• Scale and clean 
• X-rays 
• Topical fluoride treatment 
• Preventative examinations
• Custom mouthguards for protection during contact sports 

What other dental services are included in private health insurance? 

As well as a wide range of preventative services, we also cover the following dental treatments under our range of Extras products:

• General dental, includes most fillings and simple tooth extractions
• Root Canal, Gum Disease Treatments & Surgical Extractions including wisdom teeth
• Crowns, Bridges & Dentures 

Please refer to your product Fact Sheet to confirm your coverage for dental.

What are ‘out of pocket’ expenses and why do they vary between dental providers?

While our No Gap Dental Network provides preventative dental treatments with no out of pocket costs, if additional treatment is required (for example a filling or root canal) you may have ‘out of pocket’ or ‘gap’ costs associated with that treatment.  

The ‘gap’ or ‘out-of-pocket’ cost is the difference between what your dentist charges you and how much your health insurance will cover. The ‘gap’ will vary depending on what dental treatment you have, which dentist you see (as each dentist sets their own prices) and the dental benefits payable for each treatment under your cover. If you are still in a waiting period, you’ll need to ensure your treatment occurs after your waiting period finishes in order to claim a benefit from your extras cover. 

Nobody likes to get an unexpected bill, so prior to beginning any treatment, it’s really important to check with your dentist for a complete breakdown of the costs involved. 

Costs between dental providers can vary, so don’t be scared to get a second opinion and other quotes from different dentists.

To calculate your out- of- pocket expenses you can use our benefits calculator which you’ll find via Online Member Services, under ‘Your Cover’ menu. Or you can give us a call on 1300 021 209.  Don’t forget to have details of the item numbers provided by your dental provider.

What are waiting periods and yearly limits?

For some dental treatments there will be waiting periods, which means you have to wait a certain amount of time (e.g. 6 or 12 months) from the time of joining extras cover, before you become entitled to dental benefits or higher benefits if you upgraded your cover.  

There are no waiting periods for preventative dental treatments which means you can start using these dental benefits straight away. 

In addition, for some types of treatments there will be set yearly limits on the amount you can claim. Once you have used up your yearly limits you will need to wait until 1 January for your limits to ‘reset’ (i.e. you get the full amount to claim again). Lifetime limits and other conditions may apply. These will be set out in your product Fact Sheet.

Make the most of your yearly limits

To maximise the value of your health insurance it’s important you understand how much of your benefits you’ve used and how much you still have left. 

Our yearly extras limits (the benefits you can claim each year) are reset on 1 January every year. So when it’s getting close to the end of the year, check your limits to see how much you have left to use.

By knowing when your limits reset, you can plan any treatments and really maximise your cover.

You can also check your remaining limits in ‘Quick Links’ dashboard, via Online Member Services.

To get a clear understanding of your dental cover check out your extras product Fact Sheet via Online Member Services, under the ‘My Membership’ menu and then ‘My Details’.