Private Health Funds

What is Private Health Insurance Cover?

Two basic types of health insurance exist; HOSPITAL and ANCILLARY (name varies between funds).

Hospital covers some or all of the extra costs of being in a private hospital. This may be useful in dentistry when surgery such as wisdom teeth removal is carried out in hospital.

Ancillary may cover some of the cost of dentistry. The fund typically pays a portion of the cost of treatment, leaving a gap paid by the patient. Each fund has limits on the type, number of treatments, amount of payment, yearly limit and eligibility limits. These are best discussed with your health fund.

Can I use my health fund at Port Kennedy Dental Group?

Yes, to our knowledge you can use a health fund with any registered dentist in Australia. The exact services that a fund will allow vary widely.

How do I use my health fund?

If your health fund is part of the HICAPS network, then instant rebates are possible. You must have a valid functioning health fund card with you. The patient only has to pay the difference between the rebate and the total fee (the Gap). The Port Kennedy Dental Group has a HICAPS Terminal making transactions easier. Funds not in the HICAPS network require full payment and then patients claim the rebate back from their health fund. The method varies between funds.

Is the Port Kennedy Dental Group a preferred provider (choice provider, health fund practice)?

The Port Kennedy Dental Group is a Members First Provider with the BUPA Health Fund. We routinely provide treatment for members of other health funds. The rebates and benefits that your fund provides vary and again this is best discussed with your health fund. Port Kennedy Dental Group is owned by our dentist.

Does my health fund cover all my dental expenses?

No, Health Fund routinely provides complete unlimited total cover of all treatments. It is common to expect a reasonable health fund to cover half the cost of treatment. Again this widely varies. Some funds provide very high levels of benefit while other funds are very poor. Once you have an itemised list of treatment required, most funds can give you an estimate of out of pocket expenses.

Are there any limits on treatments?

A period of time is waited after joining a health fund before it is active and claims can be made. Funds divide dentistry into minor or major dentistry, with different waiting times. Total value, frequency and number of treatments are usually controlled as well.