Information for the public - private health insurance

We advocate alongside the federal Australian Dental Association (ADA) to protect the community and the dental profession from discriminatory and inequitable private health insurance fund policies and behaviour.

Our action includes government lobbying, community education and highlighting concerning health fund issues in the media.

These issues include:

  • Lack of transparency: It is difficult for consumers to compare policies, restrictions and exemptions to make informed decisions about health insurance
  • Preferred providers: Patients are often offered higher benefits for treatment at preferred provider dentists, which limits choice and means that you’ll receive lower benefits if your regular dentist is not a preferred provider
  • Rebates: Some rebates have not increased for years, and health funds may not pay benefits for all dental treatments or restrict how often treatments can be carried out without understanding your individual oral healthcare needs
  • Advice: Health funds may offer the wrong advice, for example, they may comment on treatment options when they are not qualified to do so
  • Rising premiums: A review into the value and affordability of private health insurance and discussions around new affordable alternatives are needed.

Dentists and patients commonly report issues concerning the behaviour of health funds in particular around lack of transparency around rebates and discrimination due to preferred provider schemes. The ADA believes that people with extras cover should all receive the same dental rebates regardless which dentist they see, as everyone pays the same premium. The ADA has made detailed submissions to regulators regarding the behaviour of health funds, their impact on the dental profession and patient care.

Useful resources

Resources for patients are available at: