Health Insurance and Dental Fees

  • Unlike Medicare, dental fees are not subsidized by the Federal Government and there is no recognized fee schedule
  • Fees have to be set by the dentist to take account of individual costs of practice, which will vary in different practices
  • As a general rule, a dentist has to pay out approximately 70% of all fees received in the overhead costs of running a practice
  • If a practice tries to cut these costs to lower the fees you pay, there is a danger that the quality of your treatment may be compromised
  • The fees charged in this practice are kept to the standard of a ‘Paediatric Specialist’ and as low as possible whilst still providing care of the highest quality
  • There is no comfort in providing cheap dentistry if it means a lower quality of care for patients
  • The best way to lower your dental costs is to prevent dental decay and disease in the first place. Brushing and flossing your teeth and regular check-ups are a relatively inexpensive way to avoid higher costs

When taking out dental cover, you should be aware that:

  • Each health fund determines what level of rebates it will pay based on its own commercial requirements (no matter what information on Australian dental fees, fund representatives may communicate to a claimant)
  • An important aim of some health funds is, quite appropriately, to make profits for their shareholders as well as to provide rebates for their customers.
  • The rebates payable on dental fees are unlikely, in most cases, to cover more than 60% for common dental items and may cover less than half of the cost of more complex and thus more expensive procedures
  • For some people, these rebates may be of assistance in offsetting some of the costs of the more expensive procedures but some arrangements may not always represent value for money for routine dentistry for you and your family
  • If you have a problem with your private dental insurance, you should contact the fund directly. If you are unable to reach a satisfactory agreement with your fund, contact the Private Health Insurance Ombudsman, an independent body formed to help resolve complaints and provide advice and information. The Ombudsman can be reached on 1800 640 695 or by writing to

Suite 1201
Level 12
St Martins Tower
31 Market St
Sydney NSW 2000
Fax: 02 9261 5937
Email: info@phio.org.au