Dental Insurance and Choice
As an independent and Australian privately owned dental practice, we believe that your choice of dentist is important and as such we have chosen not to align ourselves with any one health insurance provider. This way the service that we deliver to you has no constraints and cannot be influenced by a third party, as at times we are aware that health funds tend to dictate what treatment they want you to have each year and we both know that the reality of this can be very different and at times, a number of dental issues can occur all at once.
Imagine a world where you are entitled to great rebates for which ever health care provider you like and are not restricted to the ones that the health fund tells you to go to. Have the freedom to choose any dental practice you like. The benefits of choosing your own dentist that you can warm to, learn to trust and is convenient for you to visit regularly.
Our position is supported by the Australian Dental Association (ADA). Dr Terry Pitsikas AM, chair of the ADA’s Schedule and Third Party Committee, says that in the past 10 years private health insurers have begun aggressively targeting an increase in the numbers of contracted dentists and that health funds actually owning dental surgeries raises serious ethical issues: “One of the problems we have philosophically is whether a health insurer should actually be providing the service for which they are charging a fee, providing a rebate and then charging the contributor a fee to actually join the insurer,” he says, describing a clear conflict of interest that is not visible to the patient. (Bite Magazine The Problem with Preferred Providers, February 2015).
“Preferred Providers” are NOT preferred because of their dental ability, but because they make a financial agreement with the health fund. Health funds are not concerned with the quality of treatment, only concerned with securing shareholder profits through an increased number of patients. There is no assurance about the quality of the work provided in a “Preferred Provider” contract. Health funds impose annual limits on the amount you can claim. If you receive higher rebates back at a “Preferred Provider” practice, you will reach the limit of what you can claim sooner and then be out-of-pocket. Unfortunately, the health funds focus is to encourage you to go to practices that they have financial arrangements with because it benefits them to do so, particularly once your limit is used up.
Many people that visit us say, “I’ve finally found a dentist that understands me, listens to what I say and talks to me honestly about my teeth. I want to keep visiting Smile Central, but my healthfund won’t rebate me the full amounts unless I go to one of their clinics”.
What to do?
Reports in the media about consumers being dissatisfied with health funds are consistent with what we see everyday. ACC is currently investigating largest health fund insurers due to allegations of deliberately misleading consumers.
Many forward thinking people are now opting to “self insure” for dental extras. Indeed the benefits of private health insurance for hospital cover are essential – though extras for things like dental, chiro, physio, optical can now be covered in a variety of different ways with new emerging organisations addressing the issues of the monopolising health fund giants we pay high premiums to. Some years you may not claim any dental benefits from your health insurer – because your mouth is healthy; and at other times, there may be a lot of care required and you are out of pocket anyway.
Get savy, choose an independent dentist who understands what you want for your healthcare.
Here are a few other clever ways you can still be covered for dental and not have to pay the full amount each time you visit.
- select a health fund that doesn’t restrict you to only visiting their affiliated providers like HIF, Defence Health
- for annual prevention; self insure and become a member of a practices own membership program and pay a small portion monthly payment to pay for your preventative dental treatment in advance (such as check-ups, cleans & x-rays)
- if or when you actually need dental treatment; simply utilise financing arrangements with a monthly payment plan programs like our Take-Home-Layby or Medipay systems.
- Stay with your current health fund insurance provider for essential hospital cover, opt out of extras, and find a better solution in other companies now offering competitive deals for extras only.
- This way you are actually paying for the dental treatment that you need, when you need it. Not having to wait years until your health fund allows another tooth to get treated.
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