Major Dental Private Health Insurance

nasesco72 on 26/05/2025 - 10:02
Last edited 26/05/2025 - 10:22 by 1 other user

Hi all, some major dental work due soon which is potentially tooth implant.

I am currently with Frank bronze extras which has $800 yearly claim limit - the procedure may cost around $5k so is it worth changing to another insurer or going to higher extras? Have already served the waiting period.

Are there issues with going to higher plan then dropping back later on? etc

If anyone can recommend a good private health insurance would be a great too - for family cover mainly use dental and optical not much else

Health & Beauty Dental Health Insurance Insurance

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Comments

  • Ocker on 26/05/2025 - 10:05
    +9

    If you upgrade to a higher plan you will be subject to a waiting period

    • Duckie2hh on 26/05/2025 - 11:44
      +1

      Do this and wait out the waiting period. Nothing like being in daily pain for 12 months to save a buck.

      • modsec802 on 29/05/2025 - 14:04

        that is the ozbargain way

  • Fredfloresjr on 26/05/2025 - 10:09
    +1

    Book your ticket to ASIA asap.

    • Duckie2hh on 26/05/2025 - 11:43

      I hear Turkey does some good dental work too.

  • holdenmg on 26/05/2025 - 10:18
    +2

    Hi,

    Probably best you contact Frank as there seems to be a sub-limit cap on implants. I think that caps out at 50% of your yearly claim limit.
    The waiting period you have served pertains to the Extras Level you currently have, so your would need to re-serve a waiting period on an increased or higher level.

    Get some quotes.

  • coffeeinmyveins on 26/05/2025 - 10:35
    +1

    Hi all, some major dental work due soon which is potentially tooth implant.

    So you're trying to game the system by going to a new provider, serving the waiting period (which may be longer than you can wait) in order to be covered?

    WOuldn't this be counted as something like a 'pre-existing condition' and you wouldn't be covered?

    Insurers are very smart, and have a lot of data, don't think you can outsmart them.

    • eltito on 26/05/2025 - 12:40
      +1

      pre-existing applies to hospital not extras, so the major dental wouldn't be a factor in terms of pre-existing, unless it was done in a hospital.

      TO OP: Upgrading your cover to another provider to cover additional funding is not worth it, as major dental has a 12-month waiting period. So, if your current fund only has a $800 max major dental, that will carry over to new providers and anything additional will be in a waiting period for 12 months. This will not be waived.

      Furthermore, items in major dental (and general dental, and basically other services like physio), carry sub-limits, and sub-limits go by item numbers.

      As an (fictional) example, item 114 in dental is related to a scale and clean. If your limit in general dental is for example $2000, and the dentist you are going to, is charging item 114 - $500. This doesn't mean it'll all be covered, as there may be a sub limit of $200 for item 114 in your insurer.

      The most accurate of knowing your actual out of pocket costs, is by obtaining a quote from your dentist, which will have a breakdown of item numbers/treatment sessions.

      Then either call your insurer OR (some insurers) allow you to do online quotes.

      Also, to add, OP you asked: Are there issues with going to higher plan then dropping back later on? etc The answer (generally speaking) is no. If you decide to upgrade, use the higher allowance (after waiting periods have been served), and then downgrade - there are no issues.

  • Serathis on 26/05/2025 - 11:23

    Yeah it wouldnt work mate, went through the same thing and if you upgrade, you have to serve another 12 months waiting period

  • AustriaBargain on 26/05/2025 - 11:44
    +1

    5k for an implant in Australia sounds cheap.

  • donbot on 26/05/2025 - 13:20

    every crook dentist that I've seen since having a rear lower molar removed has said I need to get an implant or the tooth above will start to come down after a year or two of not having an opposing tooth to keep it from coming out.

    Yet here it is, 19 years later, and the molar they are all 'concerned' about hasnt moved a bit.

    It is this reason alone that my trust with dentists is incredibly low. Unless its visible, I'd be questioning the benefit of an implant vs not.

    • Sweet3st on 26/05/2025 - 20:12

      This. They are very keen to push you into expensive treatments whether you need them or not. I asked a dentist once what foods I should avoid to prevent cracking my (overfilled) teeth. He said none, it was important to continue to eat normally. Then saw a specialist who gave me a long list. Repairing cracked teeth obviously an attractive source of income.
      I too have a missing molar, no problems whatsoever with surrounding teeth.
      No wonder they don't want to be added to Medicare, too much oversight.

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