How to manage your dental costs

An out-of-pocket cost, or gap, is money you pay over and above what you get back from your private health insurer for dentist charges. This means you won’t be reimbursed for these costs.

Get a quote

The first way to manage your out of pockets is to get a quote, including a list of the item numbers and the cost per item from your treatment. You can then use our handy Out of pocket estimator to get an idea of what your total costs will be so you can make an informed choice. It’s simple to use – just tap on “Out of pocket estimator” on the main menu of the My Medibank app and follow the prompts.

We also recommend that you contact us before you have any treatment outside routine maintenance so that you can understand your options.

You may also be able to ask your dentist for a HICAPS quotation. This will give you an estimate of your health insurance benefit on the spot, before you receive treatment.

Members' Choice and Members' Choice Advantage

If you want to receive the maximum benefit available for your level of cover, you may want to consider Members’ Choice, or Members’ Choice Advantage. We have negotiated Maximum Agreed Prices (MAPs) and discounts with Members' Choice and Members’ Choice Advantage providers, and for many services this generally results in lower out of pockets. 

Members’ Choice Advantage is a network of dental providers that deliver even better value, including 100% back on two check-up and cleans a year, including up to four bitewing X-rays.

You can find Members’ Choice and Members’ Choice Advantage providers in our Find a provider tool or in the My Medibank app. To find Members’ Choice providers on the app, simply tap on “Find” in the bottom menu.

GapCover

Tooth extractions aren’t claimable under Medicare, but if you have extras cover you may claim the dental items of the procedure. And for related costs of your tooth extraction, you may want to consider Medibank GapCover. GapCover is a scheme designed to help eliminate or reduce your out-of-pocket expenses for in-hospital charges. If you have hospital cover that includes dental and need to go to hospital to have dental surgery, GapCover may help with additional services you might need, like an anaesthetist or assistant surgeon. Chat with the specialists to find out if they participate in GapCover. 

If you need dental surgery, our procedure cost estimator will give you an approximate total cost, including what Medibank and Medicare pay.

Get in touch

It’s important to contact us before you commit to your dental treatment – it’s never too early for you to get in touch. We can check that the treatment is included in your cover and help you understand what out-of-pocket costs to expect. We can also help you understand your waiting periods and annual limits, and check whether your current cover meets your needs. Just be sure to ask your dentist for the specific item numbers related to your treatment so that we can give you the most accurate information.