Private health insurance can save you a significant amount of money on dental care, but many Australians are not using their entitlements to their full potential. If you have extras cover and you live in Newcastle, Cardiff, Fletcher, or Mayfield, here is everything you need to know to get the most out of your policy at MS Dental.
Understanding Your Dental Cover
Most private health insurance policies in Australia include two tiers of dental cover under extras: general dental and major dental.
General dental typically covers routine treatments such as check-ups, cleans, X-rays, fluoride treatments, and basic fillings. Major dental covers more complex treatments including crowns, bridges, root canal treatment, dentures, and sometimes orthodontics and implants depending on your level of cover.
It is worth calling your insurer or logging into your health fund app to check exactly what your policy covers, what your annual limits are, and how much of those limits you have already used this calendar year. Many people are surprised to find they have unclaimed benefits sitting unused.
Know Your Annual Limits and Benefit Year
Most health funds operate on a calendar year basis, meaning your annual dental limits reset on 1 January each year. Some funds, however, operate on a policy anniversary basis, so your reset date may differ.
This matters because unused benefits do not roll over. If you have not had a check-up and clean this year and you have general dental cover, you are likely leaving money on the table. Booking before your benefit year ends ensures you get the value you are paying for every month in premiums.
At MS Dental, we process all health fund claims on the spot through HICAPS, so you only pay the gap on the day rather than paying upfront and waiting for reimbursement.
Use Your Benefits Twice a Year
Most general dental policies allow for two check-ups and cleans per calendar year. This aligns perfectly with the Australian Dental Association’s recommendation that patients attend for a professional clean and examination every six months.
If you have only attended once this year, booking your second appointment before your benefit year resets means you are getting full value from your policy while also keeping your oral health on track.
At MS Dental, a general check-up and clean includes a comprehensive examination, professional clean, and fluoride treatment. For patients without private cover, we offer a New Patient Special of $295 which includes the same services plus two X-rays.
Check Your Waiting Periods
If you have recently upgraded your health insurance policy or switched funds, you may be subject to waiting periods before you can claim certain benefits. General dental waiting periods are typically two months, while major dental waiting periods can be up to 12 months.
If you are unsure whether your waiting period has been served, contact your insurer before booking a treatment that requires major dental cover. Our reception team is also happy to help you check your entitlements before your appointment.
Preferred Provider Status and What It Means
Some health funds have preferred provider agreements with dental practices. Being treated at a preferred provider clinic can mean lower out-of-pocket costs or higher benefit levels for certain treatments.
MS Dental is a preferred provider for HCF, Westfund, and CBHS at our Cardiff clinic. If you are a member of one of these funds, you may be entitled to additional benefits when you visit us. Contact your fund to confirm what additional advantages apply to you as a member.
Understand the Gap
The gap is the difference between what your health fund pays and the total cost of the treatment. Even with a good level of cover, there is almost always a gap for dental treatment. The size of the gap depends on your fund, your level of cover, and the specific item numbers billed for the treatment.
At MS Dental, we will always provide you with a treatment plan and cost estimate before proceeding with any work so you know exactly what your out-of-pocket costs will be. We process claims through HICAPS on the day, so you can see exactly what your fund covers in real time before you finalise payment.
Make Use of Major Dental Benefits Before They Expire
If you have major dental cover and you have been putting off a crown, bridge, or other significant treatment, it is worth checking how much of your major dental limit remains this year. Major dental annual limits are often higher than general dental limits, and unused major dental benefits do not carry over.
If you need a crown, dental implants, veneers, or root canal treatment, booking a consultation before your benefit year resets could save you a meaningful amount out of pocket.
What If You Do Not Have Private Health Insurance?
If you do not have private health insurance, MS Dental has several options to make dental care accessible and affordable.
For new patients without cover, our New Patient Special of $295 includes a comprehensive examination, professional clean, fluoride treatment, and two X-rays. For children aged 2 to 17, we offer bulk billed dental services through the Child Dental Benefit Schedule at no out-of-pocket cost for eligible families.
For more significant treatment, we offer flexible payment plans through Denticare, Afterpay, and the National Dental Plan, allowing you to spread the cost of treatment over time.
Book Your Appointment at MS Dental Newcastle Today
Whether you have private health insurance or not, MS Dental is committed to making quality dental care accessible for every patient across Cardiff, Fletcher, and Mayfield. Our team is happy to help you understand your entitlements and make the most of your cover at every visit.
New patients are always welcome across all three of our clinics.
📅 Book your appointment today:
🌐 www.msdental.com.au
📞 Cardiff: (02) 4954 7722 | Fletcher: (02) 4953 8614 | Mayfield: (02) 4023 3885
Your health fund is working for you. Make sure your dental care is too.