Private health insurance
Dental rebates are available to people with private health insurance extras policies. This can reduce out-of-pocket costs for dental treatment; however dentists and patients often report some issues.
These issues include the following:
- Some major health funds have preferred providers, where patients are offered higher rebates for treatment at a preferred provider dentist, which limits their choice or financially penalises them if they continue seeing their regular dentist
- Health funds may not pay rebates for all dental treatments or restrict how often treatments can be carried out, which doesn’t take each individual person’s oral health care needs in to account
- Health funds may offer advice that is incorrect, for example they may comment on treatment options when they are not qualified to do so.
The Australian Dental Association (ADA) believes that people with extras cover should all receive the same dental rebates regardless of which dentist they see, as everyone pays the same premium.
Report an incident
To receive specific advice on issues with health funds and provide us with valuable evidence for advocacy work, ADAVB members are invited to complete this form: Health Fund Complaint Form.
Useful resources
Resources for patients are available at:
www.ada.org.au/Professional-Information/Private-Health-Insurance
www.ada.org.au/time2switch/Home
What to do if you are contacted by a health fund
ADAVB members that are audited by a health fund or concerned about any other issues relating to health fund behaviour such as item code queries, recognition status or any other matters, please contact the ADAVB’s Community Relations Officers on 8825 4600.
ADA action
The ADA has made various submissions to regulators regarding the behaviour of health funds, their impact on the dental profession and patient care.
Leaving health fund preferred provider schemes
The ADA’s preferred provider exit strategy resources are available to members who wish to leave preferred provider schemes. Note: You must be logged in to the ADA website to access.
