This article is the third of three articles that address the questions and concerns patients have around private health insurance extras cover in relation to dental care. As a Gold Coast dentist who owns the longest operating dental clinic in the Gold Coast region – and who has chosen not to put the private health funds before my patients – I feel qualified to address these concerns. If you would like to know more, we recommend you contact the Australian Dental Association (ADA), hop onto the time2switch or fairhealthcare websites.
Dental extras or ancillary cover for dental: Is it worth it?
In this blog we tackle the perennial question of ancillary or extras cover for dental treatment and if it’s really worth it.
As a Gold Coast dentist who owns the longest operating dental clinic in the Gold Coast region – and who’s chosen deliberately to put our patients before the private health funds – I feel qualified to answer this question.
Interested and confused about whether dental extras or ancillary cover for dental is worth it?
Read on for some surprising answers.
Does your private health fund discriminate if YOU choose your dentist?
I’ve already touched on the fact that building a trusted relationship with your dentist – or any health care provider – requires an investment by you and your dentist.
If that’s the case, then let’s consider why you have private health cover. If you’re like most people, it means being able to choose the health care providers you want. People you know, like and trust!
Does your health fund give you the freedom to choose your own dentist or dental practice without prejudice, that is, without paying a gap in fees?
If not, this can be interpreted as discrimination. Why? Because you are penalised for choosing the dentist you want to see. By contrast, people who see the fund’s “preferred” dentists are rebated more, yet they pay the same premium as those who choose their own clinicians and are rebated less.
Doesn’t it make sense that all members of a fund who are paying identical premiums receive the same rebates? I think so.
Is your health fund serving you?
Some patients ask me what I do about private health cover.
With a large family, it’s my personal philosophy that hospital cover is important, but I don’t maintain extras or ancillary cover. Why? Because I don’t believe health funds provide me with any value in that area.
While the private health fund model for ancillary or extras cover works for the funds and their shareholders, it doesn’t necessarily work that well for all members.
Just think about the following.
It’s argued by some that the private health fund model is flawed on the basis that there’s a conflict of interest.
They could be right. If the same company that insures you for dental expenses also owns and operates the dental practices, contracts the dentists who treat you, and charges you fees they rebate you on, then there might just be something in the logic from critics.
Loyalty also seems to be in short supply when it comes to health funds.
The private health fund model, with its annual reset does not reward you for years of membership, or whether you didn’t use specific services during your membership.
Instead, they cap services, for example, one crown each year. Even though you may have been with them for 20 years and never made a claim for a crown, while you remain eligible for this treatment, should you need more than just one, you’ll have to cover the costs of the additional treatment yourself.
Add to that frustration, the fact that private health funds are notorious for raising their premium fees each year. Their price hikes are typically in line with, or in excess of inflation. However, published evidence indicates that where dental fees for certain services or item codes have remained stable or increased in line with CPI, the amounts some health funds’ rebate for those same services have declined.
Paying more and getting less doesn’t seem like the foundation of a trusted relationship, doesn’t it?
Is it time to switch funds or cancel your ‘extras’ cover?
So it may be time to switch private health funds or cancel your extras cover altogether. The recommendation here is to save the amount you didn’t pay on your extras cover in a separate bank account for all your future dental needs.
We tend to resist change, even when it’s for our benefit, and that’s certainly the case when people face the prospect of changing health care providers.
Before you go ahead and make that call, consider the following questions put together by the Australian Dental Association.
- Does the health fund have the same rebate for dental services regardless of which dentist you choose? Any dentist who values your health and wellbeing will tell you that continuing treatment with the same dental practice is important.
- What is the average percentage of rebates for dental services? Is the rebate you receive worth the premium you pay?
- Are you covered for the procedures/treatments you want/need?
- By what percentage has your health fund increased its premiums? Have your rebates kept pace with your premiums?
- Is the gap between premiums and rebates increasing? (The “gap” is the dollar amount between what you pay to your dentist and the rebate you receive from your private health insurer. If this gap increases from year to year then maybe your current health fund is unsuitable).
You might also want to think about whether you maintain “extras” cover at all. This is a simple maths equation that adds up the extra premium you pay relative to the benefits you receive. You’ll very quickly see whether it’s worth the expense.
A final word about whether private health insurance for dental is worth it.
Ultimately the way you approach the management of your private health insurance is a personal choice. As Define Dental patients know, the quality of our relationship with them and the care we provide is our highest priority. We also provide the assurance that regardless of the position taken by private health funds, that our relationship with our patients will always be our priority.
If you’d like to explore this topic further, you can refer to the following useful resources for more information, or ask us when you next visit.
www.time2switch.com.au – Information on this site can assist with your decision about the suitability of your health fund. A little time invested in this research may benefit your health and your budget.
www.fairhealthcare.com.au/partners – Fair Health Care Alliance offers a personalised comparison service.
You can also visit the Australian Dental Association for more detailed information about choosing a private health fund.
Define Dental is the longest operating Gold Coast dentist. Located in Benowa on the Gold Coast, Define Dental has a team of dentists, led by Dr Les Jabbour, all of whom are committed to helping you achieve your best oral health. With a focus on education and raising awareness about common dental questions like whether private health insurance for dental is worth it, the Define Dental team is committed to putting the health of all patients where it should be – first and foremost, over and above provider contracts with private health funds. Learn more about our approach to care for our patients when you book an appointment today on 5597 2100