Dental – Health Insurance, How Does it Work?

Dental health is an important aspect of overall health and well-being, yet many people struggle to afford necessary dental care due to the cost of the treatment. Having dental as part of your private health insurance can help alleviate the financial burden you may incur from a trip to the dentist but trying to understand how it works can be confusing. In this blog post, we will discuss the basics of dental inclusions with your private health policy and how it can assist you pay for the proper dental care you need.

What is dental health?

⦁ Brushing your teeth twice a day with a fluoride toothpaste to remove plaque and prevent tooth decay.
⦁ Flossing at least once a day to remove food particles from between your teeth.
⦁ Visiting your dentist regularly for check-ups and professional cleanings.
⦁ Limiting your consumption of sugary and acidic foods and drinks to prevent tooth decay.
⦁ Don’t use tobacco products, which can cause tooth staining and gum disease.
⦁ Consider using an antiseptic mouthwash to kill bacteria and freshen your breath.
⦁ Wearing a mouthguard if you play sports to protect your teeth from injury.
⦁ Keeping your gums healthy by maintaining good oral hygiene, quitting smoking, and managing any chronic health conditions that can affect your gums.
⦁ Good nutrition is important for your overall oral health, eat a balanced diet with enough of key nutrients.

What is dental health cover?

First, it’s important to understand that dental health insurance is not the same as regular private health insurance. Dental health insurance, also known as dental coverage or dental benefits, is a separate extras policy that is designed specifically to cover the cost of dental care and makes up part of your private health insurance.

There are two main types of dental cover available: private dental insurance and public dental cover. Private dental insurance is purchased by individuals or families as part of your private health insurance policy, while public dental insurance is offered through state-funded programs and is available to certain groups of people or low-income individuals. Typically, Medicare does not cover most dental procedures such as teeth cleaning, dentures, wisdom teeth extraction, filling, or other routine procedures.

Your private health insurance extras cover typically includes a range of services which can be categorised into four main groups:

⦁ General Dental – oral exams, scale and clean, simple fillings, mouthguards, x-rays, and tooth extractions.
⦁ Major Dental – Tooth extraction, wisdom teeth removal, complex fillings, crowns and bridges, veneers, and dentures.
⦁ Endodontic – root canal therapy and periodontics which includes treatment of gum tissue diseases, infection, and inflammation.
⦁ Orthodontic – correction of teeth and jaws into the right position with braces or Invisalign.

How to Claim?

Claiming is simple, if your dentist is set up digitally and offer HICAPS – you can claim on the spot. Before booking any dental work and making a claim make sure that:

⦁ You’ve served the relevant waiting periods on your private health insurance policy to be able to claim.
⦁ The dental provider is a recognised provider with the health fund and has a provider number.
⦁ You have an itemised invoice that shows the provider ID and item number for the service/s, the charges and how much you’ve paid, and is dated within the last two years.

In conclusion, dental health insurance can help alleviate the financial burden of paying for dental care, but it’s important to understand how it works and what is covered. By comparing different plans and understanding the terms and limits of your private health insurance policy, you can make informed decisions about your dental health and ensure that you are getting the coverage you need. It’s also important to keep in mind that a good oral hygiene, healthy diet, and regular visits to a dentist can help prevent costly dental procedures in the future.

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Other private health funds in Australia

In Australia, there are more than 30 insurers offering a wide variety of distinct private health products.#These health funds can be broadly categorised into three main types: for-profit, mutual and not-for-profit.

For-profit health funds

are owned by shareholders and are operated to make a profit. They are required to pay dividends to their shareholders and must also meet the same regulatory requirements as other types of health funds.

Not-for-profit health funds

are not operated to make a profit and instead, any surplus is used to improve the services and benefits provided to members. They are also subject to the same regulatory requirements as other types of health funds.

Mutual health funds

are owned and controlled by their members. They are operated on a not-for-profit basis, with any surplus being used to improve the services and benefits provided to members. Mutual health funds must also comply with the same regulatory requirements as other types of health funds.

In addition to these three types of health funds, there are also the government-funded health optionsincluding Medicare and the Pharmaceutical Benefits Scheme (PBS) which provide coverage for certain medical expenses.

Top 10 Private Health insurance companies in Australia by Market Share*

Insurer NameMarket Share
Medibank27.3%
Bupa24.8%
HCF11.9%
nib9.3%
HBF7.3%
Australian Unity2.5%
Teachers Health2.5%
GMHBA2.1%
Defence Health0.4%
CBHS0.1%

When choosing a private health fund, it’s important to consider the type of coverage you need, and the benefits offered by each fund. It’s also important to compare the costs and benefits of different funds, as the cost of premiums can vary significantly between policies.

In conclusion, with over 30 registered health funds in Australia+ as of January 2023, each health fund offers a different set of coverage options and benefits, so it’s important to compare the costs and benefits of different funds to find one that best suits your needs.

To explore your health fund options visit us to compare health insurance in Australia

speak to one of our friendly team members on 1300 861 413 hello@health.compare

References:

#ACCC

* Ombudsman.gov.au

+ PrivateHealth.gov.au

What would the waiting period look like?

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New year, New you, have you got the right health cover this year ?

It’s a question on everyone’s mind as we kick off 2023.

The start of a new year is a time for many people to reflect on their health and well-being and make changes that will improve their overall quality of life. One of the most important aspects of maintaining good health is having the right private health cover in place. In Australia, there are several different health cover options available, and it can be difficult to know which one is best for you. Once you have worked out what your health goals are for the new year you can tailor your private health insurance policy to meet those objectives.

Setting goals for good health is helpful, such as:

  • Losing weight
  • Getting in shape
  • Reducing inflammation
  • Improving overall health

Another thing that can help you maintain good health is to have regular check-ups with your doctor. This can help you identify and address any health issues early on before they become more serious. In addition to this, there are also several other things you can do to improve your overall health and well-being.

Some of these include:

  • Eating a healthy and balanced diet
  • Exercising regularly
  • Getting enough sleep
  • Managing stress
  • Not smoking or drinking alcohol excessively

Now is the time, the new year is a great time to take stock of your health and well-being and make positive changes to improve your quality of life. Knowing you have the right private health cover in place, with the correct extras and options that best meets your needs will give you peace of mind. And remember that taking care of yourself is a continuous journey, and it’s never too late to start!

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I’ve never had Private Health, what should I look for?

If you’ve never had private health insurance before, it can be overwhelming to know what to look for and what you should consider when choosing a policy. In this blog post, we’ll go over some of the key things you should consider when looking for private health insurance in Australia.

Some points to consider:

1. What is covered by the policy?

One of the most important things to consider when choosing a private health insurance policy is what is covered. Most policies will cover a range of hospital treatments, such as wisdom teeth removal or joint reconstructions, as well as some extra services like dental check-upsand cleaning or physiotherapy consultations. It’s important to check exactly what is covered by the policy you are considering, as well as any exclusions or limitations.

2. Are there any excesses or co-payments?

An excess is the amount you need to pay towards the cost of your treatment before your admitted into the hospital. Co-payments are fees that some policies apply to help reduce the cost of the premium. It’s important to consider whether you are comfortable with any excesses or co-payment option on your policy, as these can add up over time.

3. What if I’m a single parent?

Feel comfort that you and your child or children are covered for healthcare needs by taking out a private health insurance policy to cover them and yourself as a single parent. This will make it easier for you to stay on top of your kid’s healthcare needs by giving you the option to avoid public hospital waiting lists, save on dental check-ups and more.

4. What is the premium?

The premium is the amount you need to pay each month for your private health insurance. Premiums can vary significantly between policies and providers, so it’s important to compare the premiums of different policies to ensure you are getting the best value for money. Keep in mind that lower premiums may come with higher excesses or co-payments, so you’ll need to weigh up the costs and benefits of different policies.

5. Are there any waiting periods?

Waiting periods are the length of time you need to wait before you can access certain benefits under your policy. For example, there may be a waiting period for pre-existing conditions, or for certain types of treatment. It’s important to check what waiting periods apply to the policy you are considering, as you may need to pay for treatment out-of-pocket during this time.

6. What are the policy limits?

Policy limits refer to the maximum amount that your health insurance policy will cover for certain treatments or services. It’s important to check what the policy limits are for the treatments and services that are important to you, as you may need to pay any costs above the policy limit out-of-pocket.

7. What are the policy’s exclusions and restrictions?

Exclusions and restrictions refer to the treatments or services that are not covered by your policy. It’s important to check what exclusions and restrictions apply to the health insurance policy you are considering, as you may need to pay for these treatments or services out-of-pocket.

8. Do I need to restructure my health insurance policy as a senior?

As the population ages health funds have had to refine their private health insurance offerings for seniors as the risk of falling ill or getting injured increases. Always check your policy in detail to make sure you are covered for certain types of treatments and surgeries. These include surgeries such as heart and vascular surgery, hip surgery, joint replacements, and cataracts.

With so much to consider before going ahead with a private health policy, jump on to compare health insurance policies and work out which cover is best for youor speak to one of our friendly team members on 1300 861 413 hello@health.compare

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Health Fund – Extra’s Benefits

Tips to get more value from your extra’s cover

Here we are in 2023, at the beginning of the new calendar year and it marks the point at which most private health insurance policy extras reset. This means that any benefits you have accumulated over the course of the year, such as those for physiotherapy or dental work, will be reset back to zero. Understanding why this happens, and how to make the most of your benefits, can help ensure that you get the most value out of your private health policy.

Following are some tips to help you make the most of your private health insurance policy extras:

  • Know your policy: The first step to understanding your private health insurance policy is to know what it covers. Review your policy carefully and make note of any extras that are included, such as physiotherapy, natural therapies, chiropractic care, or dental work. Knowing what your policy covers will help you plan how to best use your benefits before they reset.
  • Keep track of your benefits: Keep track of your policy extras throughout the year by checking your policy statements. It’s important to know how much you have left in each category, which will help you plan when to schedule appointments or procedures.
  • Use your benefits before they reset: Because most extras reset on January 1st, it’s important to use as much of your benefits as possible before the end of the year. This means scheduling appointments for physiotherapy, optical or dental work before December 31st or making sure to use any outstanding benefits for things like glasses or contact lenses.

Some policies may have annual or lifetime limits on extras cover, while others may have unlimited or no limits. It’s vital for policyholders to be aware of their specific limits on extras cover and to keep track of their claims throughout the year. Also keep in mind the cheapest health insurance isn’t always the best private health insurance especially when it comes to policy extras, these can vary dramatically.

Policyholders should also be aware that there are different types of extras cover, including general extras cover, which covers a wide range of health services such as dental care and physiotherapy, and specific extras cover, which covers more targeted health services such as psychology or acupuncture. The limits on extras cover may vary depending on the type of cover and the provider.

It’s worth noting that policyholders can sometimes increase their private health insurance limits on extras cover by paying a higher premium, but this will depend on the policy and the provider. Policyholders should carefully consider their needs and budget when deciding whether to increase their limits on extras cover.

Private health insurance extras can be a valuable option for individuals and families who want to have access to a wider range of health services or who want to reduce their out-of-pocket expenses for medical treatment. However, it’s important for policyholders to be aware of the limits on extras cover and to carefully consider their needs and budget when choosing a policy.

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To compare extras and work out which cover is best for you speak to one of our friendly team members about your health insurance policies today. Telephone 1300 861 413 or email us hello@health.compare

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Looking to Compare Health Insurance?

With so many health insurance policy options on the market today in Australia, it can be tricky to know which one is best for you. There are so many choices, not only the amount of health funds in the market but also different combinations of hospital, extra’s and excess cover. In this blog we will cover off why it’s so important to discuss with your provider your options and waiting periods on offer before you sign up.

For example, if you are planning to have a baby within the next 12-18 months , you’ll need to adjust your health insurance policy to ensure the birth of your child is covered under the policy.  Every private health insurance fund has a 12-month waiting period before your baby is due so you will need to consider when to take out cover for the first time or upgrade your cover to ensure this is covered.

Some other factors that may come into play and you should consider based on your situation are:

  • A sports or fitness-related injury
  • Knee surgery or full replacement
  • Needing a hip replacement or other procedure.

Why does it matter having the right health insurance plan?

There’s no all-encompassing product when it comes to private health insurance, so it’s important to find a policy that offers benefits you think you’ll use. As individuals we are never quite prepared for health issues that arrive out of the blue.  Being prepared with an insurance health policy for general cover is always a good idea. Some important points to consider when searching for insurance health polices in NSW are:

  • Who needs to be covered? Just yourself as a single, a couple, a family with 2 adults and children or even single-parent policy with kids. Nowadays, health funds have specific coverage for your individual life situation.
  • Pre-existing Conditions – A pre-existing condition is defined as any ailment, illness, or condition where, in the opinion of a medical adviser appointed by the health insurer, the signs or symptoms of that illness existed any time prior to the 6 months leading up to when the person became covered the health insurance policy.
  • Budget – if you have a particular budget in mind that is affordable to cover yourself or your family, we recommend talking us so we can search across a wide range of fund to find out the best insurance health plan to fit your financial circumstances.
  • Age – Some providers offer specific health policies and packages for those aged 50 and above. Other health care plans have policies more suitable for seniors and retirees aged 65 and up. Never has there been a better time to ensure your policy matches your needs.
  • Inclusions & Exclusions – Each health insurance policy has a range of inclusions and exclusions. These are a list of clinical categories that you can add or remove from your select health policy. It is important to know which of these services you need coverage for as it will be a determining factor in your premium.
  • Waiting Periods – as briefly covered off above, certain procedures and services have waiting periods. These can range from as little as 2 months to as much as 36 months – it’s recommended you check these before signing up for a health insurance policy.

Finding the cheapest health insurance in Australia isn’t always the best insurance for your family.

The cheapest health insurance isn’t necessarily the best insurance and the most expensive is not always the best coverage.  For example, a not-for-profit health insurance provider is one that invests its profits back into its members rather than shareholders. For-profit health funds pay stakeholders with their remaining surplus, while a not-for-profit fund uses that money to better improve and serve their policyholders.

It’s worth shopping around and comparing private health insurance to find the best deal for your individual needs. Nationally, there are more than 30 health plan insurers proposing a wide variety of benefits and health insurance products. There are several policies on the market that will differ depending on where you live and your circumstances. Comparing health fund offers can help you to decide and find a policy that suits your needs.

Whatever your insurance health plans needs are, be sure to arm yourself with the very best research and recommendations before making a final decision. It’s what works best for you or your family and your situation. Remember to review your policy regularly – don’t just set and forget. Visit our website for further resources to assist.

Chat to us Today

To compare health insurance funds and work out which cover is best for you, speak to one of our friendly team members about your health insurance policies today Telephone 1300 861 413 or email us hello@health.compare

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