Dental Only Cover: Is It Worth It?
What Is Dental Only Cover?
Dental only cover is a type of extras policy that exclusively covers dental services — check-ups, cleans, X-rays, fillings, and sometimes major dental work. It does not include hospital cover or any other extras (optical, physio, etc.). It's the cheapest way to get dental benefits through private health insurance.
What Does Dental Only Cover Typically Include?
- General dental — Check-ups, scale and clean, fluoride treatment, X-rays, fillings, and extractions.
- Major dental — Crowns, bridges, inlays, root canals, dentures, and gum treatment (often with a 6–12 month waiting period).
- Orthodontics — Braces and aligners (only on higher-tier dental policies, with high waiting periods).
Annual limits typically range from $500 to $1,500 per person. Per-service limits (e.g. $50 for a check-up) also apply.
How Much Does Dental Only Cost?
Standalone dental cover typically costs $15–$35 per month for an individual, depending on the level of cover. Family dental cover is around $30–$60 per month.
Is It Worth It? The Numbers
Let's compare:
- Without insurance: One check-up + clean costs around $150–$250 out-of-pocket. Two visits per year = $300–$500.
- With basic dental cover ($20/month): $240 per year in premiums. You get 2 free check-ups (100% back up to ~$100 each). Net cost: $240/year plus any gap for major work.
- With comprehensive dental cover ($30/month): $360 per year. Higher annual limits ($800–$1,200). Good if you need major work like crowns ($1,000+ each).
If you visit the dentist twice a year for basic check-ups, dental only cover is approximately break-even to slightly cheaper than paying out-of-pocket. If you need major dental work, it easily pays for itself.
Dental Only vs Full Extras
Full extras cover (dental + optical + physio + etc.) costs $25–$50 per month. If you only use dental services, dental only is cheaper. But if you also need glasses, physio, or other services, full extras may be better value — the extra $10–$20 per month often pays for itself.
Who Should Get Dental Only Cover?
- Good for: People who only need dental, have good oral health but want regular check-ups covered, and don't need hospital cover (already have it or don't need it).
- Not great for: People who need multiple types of extras (dental + optical + physio), families with kids (kids often need dental + optical), or those needing hospital cover to avoid MLS/LHC.
Dental Only and Hospital Cover
Remember: dental only cover does not count toward the Medicare Levy Surcharge or Lifetime Health Cover. If you need hospital cover for those reasons, you'll still need a separate hospital policy. Some people combine a Basic or Bronze hospital policy with dental only extras for a low-cost total package.
Final Verdict
Dental only cover is a good option if you rarely need other health services and just want predictable dental costs. It's even better if you need major dental work. However, if you also need glasses or physio, a combined extras policy is usually better value.
Orthodontics: The Big-Ticket Item
If anyone in your household needs braces or aligners, dental-only cover deserves a close look. Orthodontic treatment in Australia typically costs $5,000–$9,000 (often more for complex cases), and funds cap orthodontic benefits at an annual limit — commonly $700–$2,000 per person — with a 12-month waiting period before you can claim. Because the benefit is capped, the strategy is to hold the cover for the full waiting period before treatment starts, then claim across the treatment years. Check whether the fund pays per year or per lifetime for orthodontics, as the two structures change the maths completely.
Claim Timelines and the HICAPS Flow
Dental claims run on fixed waiting periods: typically 2 months for general dental, 6–12 months for major dental (crowns, bridges, root canals), and 12 months for orthodontics. At most practices you will claim instantly through HICAPS, with the benefit deducted from your bill on the spot. One timing trick: if your annual limits reset on 1 January, a late-year check-up plus an early-year check-up lets two years of limits fund back-to-back treatment. And remember — dental-only cover never counts toward MLS or LHC obligations, so it is a supplement to hospital cover, not a substitute.