By: Dr. Lahiru Chandraweera
January 01, 2023
Health Fund Coverage for Dental Implants Explained
Do you need dental implants as a tooth replacement but are put off by the cost? It can be a significant financial outlay. If you’re wondering whether health funds will help ease the financial burden, we’ve got some answers for you.
In this blog post, we’ll tell you everything you need to know about how health funds work with regard to dental implants. We’ll also discuss your options if your health fund doesn’t cover them.
Keep reading, and let us help you find a way to make dental implants more affordable.
How Much Does a Dental Implant Cost?
Dental implants are a safe and long-lasting dental treatment option. They are used to fill in the gaps of missing teeth. It includes a titanium implant post placed in the jaw bone and an artificial tooth (or crown) attached to the post. They are designed to look and feel like your natural teeth.
The cost of dental implants varies widely depending on the type of implant used. Here are the different types of dental implants with their corresponding average prices:
- Single-tooth Implants:
Single-tooth implants replace one missing or damaged tooth. A single artificial tooth root is surgically implanted into the jawbone. A dental crown is then placed at the top of the implant. The average cost is between $4,000-6,000 per single implant. - Implant-Supported Bridge:
These are used to replace multiple missing teeth. They involve placing two or more implants that support a bridge of several artificial teeth. Implant-supported bridges range from $6,300-$20,500. - Implant-Supported Dentures:
Implant-supported dentures are designed to be attached to the implants. They provide a much more secure fit than traditional dentures. Depending on the number of implants needed, the price of this treatment can range from $15,000-$30,000. - All-on-Four Dental Implants:
All-on-4 dental implants are a treatment option that utilises four strategically placed implants. This treatment option is recommended for patients who have had bone loss and can be used for either upper or lower teeth. Depending on the case’s complexity, they can cost from $16,000 to $42,000 per arch.
As you can see, the total cost of tooth replacement with dental implants is several thousand dollars. These prices vary based on several factors, such as:
- How complex the case is:
The cost of a dental implant can vary significantly based on the complexity of the procedure. More complex cases require more time and expertise. Therefore, they come with a higher price tag. - The number of implants needed:
The cost increases with the number of implants needed to replace missing teeth. - Geographical location:
The cost may be higher in busy urban areas than in more rural areas. - Your health fund coverage:
Not all health funds will cover the cost of a dental implant. Some may offer partial coverage. It is important to check before treatment to know what fees they will cover. - Dentist’s experience:
Highly experienced dentists are likely to charge a higher fee than those with less experience. - The need for additional procedures:
Additional procedures to prepare the area for the dental implant could increase the cost of treatment. Examples are bone grafting, gum grafts, or sinus lifts. - The type of restoration:
Dental implants can be fitted with crowns, bridges, and dentures. Different types of restoration can affect treatment costs. More complex restorations are more expensive.
Before committing to tooth replacement via implant, get a quote from your dentist and weigh the costs against your budget and lifestyle.
Are Dental Implants Covered by Health Funds?
Dental implants are a reliable and effective way of replacing missing teeth, allowing the patient to smile with confidence once again. However, whether or not health funds cover them varies significantly. Some health funds may cover all or part of the cost of treatment, while others may cover none.
Some major health funds may cover a portion of the cost of dental implants but only in specific circumstances. This is often part of their major dental category in extras policies. However, there is usually an annual limit on what you can claim through the major dental section of the policy. Additionally, a 12-month waiting period may still apply. As a result, you may still have an out-of-pocket expense to foot.
Ultimately, it all depends on your policy and coverage level. It is helpful to check, as you can claim a rebate on a procedure depending on your level of coverage. Consulting with your dentist can greatly assist with understanding any upfront costs associated with dental implants.
In Which Cases Can I Use My Health Funds for Dental Implants?
Dental implants are generally viewed as a cosmetic treatment by health insurers, which is why they’re rarely covered. However, if the dental implant procedure is deemed medically necessary by your dentist, you can use it to partially or fully pay for it.
If you’ve experienced tooth loss due to medical conditions, such as oral cancer, your health fund may provide coverage for dental implants. Additionally, many health funds offer coverage for cosmetic dental implants if the procedure is necessary to address a physical problem that causes difficulty with eating or speaking. Other implant-related cases that health funds would cover include congenital defects and trauma.
The exact amount of coverage you receive will depend on which health fund you are with and which hospital you have your procedure done in. Another important factor to check is whether the health fund claim is limited to certain dentists. Always make sure that your dentist is registered with the Australian Dental Association and has accreditation from your health fund before proceeding.
If you’re considering using your health fund for dental implant treatment, check with the provider regarding their specific policies.
Can I Get Coverage for Both the Surgical and Restorative Parts of the Dental Implant Procedure From My Health Fund?
Dental implant procedures are incredibly beneficial in restoring your teeth. Sadly, the price of this treatment may discourage some patients from getting them. The good news is that some health funds can be used for dental implants, depending on your health fund and coverage.
In most cases, coverage can be broken down among the following:
- Pre-surgical assessments and procedures, such as tooth extraction
- Surgical procedure
- Post-operative care to keep track of the recovery time and healing period
- The restoration placed over the dental implant, such as the crown, bridge, or denture
Many funds will offer rebates on most oral care, such as check-ups and maintenance procedures, but not all procedures may be covered for dental implants. Find out if your health fund covers dental implants and what specific procedures are included, so you know what to anticipate concerning any additional costs you have to pay. It’s a complex situation as this coverage tends to differ between various providers.
Can I Upgrade My Health Fund to Get Coverage for Dental Implants?
Upgrading your health fund can be a great way to access funds for dental implants. If you require restorative dental treatment and want to upgrade your existing coverage plan, it is important to carefully read the policy’s terms and conditions. There are circumstances under which an upgrade could help get coverage for your implants.
Different levels of upgrade likely offer various types of dental covers. They will come with other conditions that may affect the ability to get full coverage. Take the time to do some research ahead of time. Look into what type of coverage conditions the upgrade entails to know if it fits with the procedure. Make sure you are not paying for something that does not benefit you.
Speak with your dentist, who might have helpful advice on obtaining coverage.
Are There Financing Options Available for Dental Implants if My Health Fund Does Not Cover Them?
For those without health fund coverage, payment plans or financing options are available for dental implants.
Afterpay
Afterpay helps you avoid high upfront costs with four equal payments and zero interest fees. Simply book your treatment, and settle all instalments on time before the end of each period to keep it risk-free.
Humm
Humm offers two products for any sized purchase.
- Buy Big Things:
This provides approval up to a maximum of $5,000 and flexible repayment plans – 6, 12 or 24 months plus an optional 60-month extended period. - Buy Little Things:
This product allows you to pay off purchases up to $2,000 in either five fortnightly or ten weekly instalments.
In-House Financing
Many dentists offer payment plans to help spread the cost over multiple months, so you can enjoy a healthy smile without breaking the bank. Be sure to ask what payments are expected each month and make arrangements that suit both parties.
Supercare
You can take advantage of the benefits of accessing your superannuation funds early without penalties. It’s an ideal way to build financial flexibility. It can cover anything from doctor visits to surgeries or even dental care. There are no limits on how much money can be withdrawn from your superannuation fund.
ZipPay
Zip Pay and Zip Money offer a range of payment options for dental treatments. These allow patients to spread the cost over time. From small services to larger-ticket procedures, you can choose from weekly, fortnightly, or monthly payments with an agreed minimum repayment fee starting at $40 per month.
Final Thoughts
Many health funds may not cover or fully cover the cost of dental implants because they are considered cosmetic procedures. However, certain circumstances may make you eligible for at least partial cover. It’s always wise to speak with your health fund provider about the scope of coverage available to you.
There’s no one-size-fits-all answer when it comes to dental implant coverage. It’s important to explore all of your options so you can make an informed decision regarding your dental and oral health that is also financially viable.
We hope this post has given you a better understanding of dental implant coverage and alternative payment options. If you have any questions about implant coverage or other dental procedures, don’t hesitate to contact us at Hills Family Dental Centre. Our team of experienced dental professionals provides personalised dental services tailored to your unique needs.
Take charge of your oral health today. Please book an appointment through our website or call Hills Family Dental Centre to find out how we can help improve your life with dental implants.
Frequently Asked Questions
How do dental implants work?
Dental implants are a popular choice for replacing one or more missing teeth. During the procedure, a dentist inserts titanium posts into the jawbone, acting as an artificial replacement for a natural tooth root. These posts provide a stable anchor to secure artificial teeth, like crowns, bridges, and dentures.
The success of teeth implants depends largely on how successfully they integrate with the surrounding bone tissue—a process called osseointegration. This treatment requires several months of healing before the implant-supported restoration is complete. When finished, dental implants look and perform just like natural teeth.
What are the benefits of dental implants?
Dental implants can provide many benefits that can help restore oral and overall health.
- Aesthetics and Function:
Dental implants look, feel, and function like natural teeth and can be customised to match your remaining teeth for a comfortable fit. - Improved self-confidence:
People who are missing teeth often feel embarrassed or uncomfortable when smiling or speaking in public. Dental implants can restore their confidence by providing a natural-looking and long-lasting smile. - Longevity:
Dental implants are a long-lasting solution to tooth loss as they are made from titanium. They are durable and may last for several decades with proper care. - Jawbone preservation:
Dental implants help maintain bone structure. Because it is implanted within the jawbone, it can encourage bone growth. Due to this, it can prevent bones from shrinking, which is a common occurrence after a tooth has been extracted. - Easier eating:
Dental implants allow for better chewing and biting pressure, making it easier to eat. This means that people with dental implants can enjoy their favourite foods without worrying about discomfort or slipping dentures. - Improved oral hygiene:
People who have lost teeth often struggle to keep their mouth clean, as the spaces left by missing teeth can be difficult to reach and clean properly. Dental implants help improve oral hygiene by filling in the gaps between teeth, making it easier to brush and floss.
How long do dental implants last?
In most cases, patients will find that dental implants can last between 15 and 30 years when properly cared for. This makes them a preferred option for those looking for a long-term replacement for missing or damaged teeth.
Are dental implants suitable for everyone?
Dental implant suitability varies from person to person. Everyone has different dental health needs and goals, so dental implant placement needs to be determined on a case-by-case basis. A dental professional can help determine if dental implants are appropriate for you.
Patients who are most likely to be successful with dental implants are those with the following:
- Healthy gums
- Enough jawbone structure
- Commitment to follow through with the treatment plan
Careful consideration of the patient’s oral health and needs will ultimately determine whether dental implants are suitable and beneficial for the patient.
