What Health Cover Is Required to Get Dental Implant Surgery?

Morphio25 on 12/06/2024 - 12:22
Last edited 25/06/2024 - 18:12 by 1 other user

As per the title…

I am missing the tooth to the immediate right of my right front tooth. I currently have a bridge, which is essentially a plastic tooth cemented to the tooth to the right of it with a small rest on the back of my right front tooth. Just over a week ago it came out. This is the third time this has happened and the dentist who was able to cement it back in for me said that I really ought to consider getting a dental implant. The bridge has to be around about 16-17 years old now and replacing it has been on my mind for a while now.

I am currently without health insurance, given I don't make enough to the point I need the tax break, so it felt like I was just wasting that money and hence I cancelled it.

Due to my wimpish nature, a local anaesthetic in a dentist's chair somewhere is not going to work for me, I'm going to need to go under general anaesthetic in hospital to have this done.

Should I look at getting some health cover to help cover the cost? If so, what provider is recommended?

Update June 25

I had a CT scan done today and that has confirmed that if I want to go down the path of a dental implant I first require braces for a short period. I also have some ball park figures of what said treatment might cost me. I'm looking at ~$5-5.5K for the implant and another $1-1.5K for the orthodontic treatment (braces). So $6-7K all in. The specialist is confident he can do my implant in the chair knowing that I don't have a particularly good gag reflex and struggle a lot with having things in my mouth.

I'm currently wondering whether extras cover through a PHI is worth it? As I don't have a current policy I have to wait 12 months to get treatment covered.

I've looked through a few providers. Let's take HFI for example and their 'Essential Extras' product which is $23.71/ft. That equates to $616 per year. From what I can tell that policy offers $1,250 per year for general and major dental, endodontic and orthodontic as a group. Am I right in saying that benefits me to the tune of $634?

Would I be better off looking for an extras only policy that pays as much as possible, say GMHBA which offers a $2,000 limit (which would cost me $988 for the year)? It seems to be that within the yearly limit there are also sub limits that apply to certain items so I might not get the full amount of the annual limit back anyway?

What provider do people recommend.

Health & Beauty Health Insurance Insurance

Comments

  • mrkorrupt on 12/06/2024 - 12:42
    +3

    Welcome to OzHealthInsure,
    Your call is important to us, please wait while we direct your call to the next available agent. Any information provided to you will be of a general nature and may not apply to you, please consult your PDS for coverage questions and your GP or specialist to confirm on whether any medical advise provided is suitable for you. Please hold….

    • pharkurnell on 12/06/2024 - 13:01
      +3

      you forgot this old cherub

      We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work.

      • payless69 on 12/06/2024 - 13:55
        -2

        Wait there is more: ICJ just made a ruling against all invading governments……
        Curtesy of South Africa!

    • Bignudge on 12/06/2024 - 13:56

      This call is may be recordered for quality and training purposes. If you do not want to be recorded, hang up now.

  • Shoocat on 12/06/2024 - 13:00

    This will probably count as a pre-existing condition so you'll likely have to wait 12 months to draw on your health fund, even if you do get coverage that fully paid for this.

    You should see an orthodontist to understand what your options are. It might be overall cheaper to pay upfront than via private health cover. You might be able to work out a payment plan if you can't afford the whole thing up front.

    • mskeggs on 12/06/2024 - 13:51

      I don't think there is any cover that goes very far towards covering implants.
      Prices are $4k+, even the best plans have limits much lower.
      I'd love to be corrected!

      • DashCam AKA Rolts on 12/06/2024 - 16:45

        Even with extras and top level cover with Bupa, implants were mostly out of pocket Despite the expense, well worth while.

      • BOGOF on 12/06/2024 - 16:59

        No one will correct you.

        Around 4-6k for 1 tooth.
        Medicare wont contribute unless it's a medical necessity.
        private insurance will only cover with 'Extras' as major dental, and will be a very small contribution.
        There will be a a waiting period of 12 months.
        So pay $5,000 in premiums for 12 months to get back $1,000 for a $5,000 procedure?

  • payless69 on 12/06/2024 - 13:53

    Complex issue, some need a bone-graft, worse if you have sensitive nerves right in the bone below, the opinions between implantologists may vary to the point of you no longer want to sign disclaimers.
    Dentures are a painful alternative to save money.
    Insurance cover is like finding life insurance for suicidal persons. They are in business to make money and do not care how you lost the tooth.

  • Duckie2hh on 12/06/2024 - 14:00
    +2

    Just go to Vietnam and get the implants done for 1/10th the price.

    • BoltThrower on 12/06/2024 - 15:38

      Have you had yours done? I'm looking for recommendations.

      • Ridiculous Panda on 12/06/2024 - 17:08
        +1

        I did one of the front teeth in Manila about 7 years and couldn’t be happier with the result.
        It cost around US$1000 but it was one of the top clinics in the country and I felt comfortable from the moment I walked thru the door.
        Issue is and depending in each, you might need more than one visit with a few months in between.
        The whole thing probably cost less than A$3000 and I had a couple of great holidays.
        Will probably much cost more now since cheap flights are almost impossible to find now.
        Let me know if you are considering and I will try to go thru my emails to find their contact for you.

        • Gdsamp on 12/06/2024 - 17:21
          +1

          are you awake for the procedure?

          • Ridiculous Panda on 12/06/2024 - 17:54
            +1

            @Gdsamp: Yeah.. it wasn’t bad at all. Only part I remember feeling was my head shaking during the drilling part. Besides that, they kept talking to me and I was relaxed.

        • BoltThrower on 12/06/2024 - 21:26
          +1

          OK, so now I'm considering Turkey, Thailand, Vietnam, and now….the Philippines!
          This is for an all-on-4 so multiple visits will be required as you said.
          I did find a good resource listing different clinics https://www.dentaldepartures.com/dentists/all-on-4
          I appreciate your offer though and glad to hear you had a good experience!

        • cinogirl on 13/06/2024 - 08:29
          +1

          Hi, I would love to know who you went through please. Thsnks

          • Ridiculous Panda on 13/06/2024 - 13:11
            +2

            @cinogirl: “Gerochi Dental & Implant Center”
            Took me 20 min of digging thru my emails to realise i contacted them thru facebook/whatsapp.
            Best of luck :)

  • sumyungguy on 12/06/2024 - 18:22
    +1

    I would select a competent implant specialist first, then consult them about how much cover may be possible. Implants are pricey so you can expect a considerable co-payment.

  • Toph Beifong on 18/06/2024 - 00:55

    I cracked the top right molar only a month ago. Dentist referred me to the Periodontist

    Normally, a single implant would cost around the $5-6k mark and you wouldn't get much back from PHI anyway. I didn't have enough bone in the upper jaw to accommodate the depth of the implant and therefore required sinus bone graft surgery. This is a procedure that is usually done in hospital and its where the costs begin to add up. $3k hospital theatre fee, $3.5k oral surgeon professional fees, $1k anaesthetist fee.In the end, I worked out that the single implant would cost over $13k. While I wouldn't be able to claim on oral surgeon professional fees and anaesthetist fees, I would be able to claim back the hospital theatre fees but would need to first pay an excess and wait 12months.

    The thing is…I don't have PHI or a spare $13k so I'm just going to leave it and learn to chew on the other side of my mouth.

  • Morphio25 on 25/06/2024 - 17:47
    Merged from Best Extras Provider for Major Dental and Orthodontics

    Hi all,

    I had a CT scan done today and that has confirmed that if I want to go down the path of a dental implant I first require braces for a short period. I also have some ball park figures of what said treatment might cost me. I'm looking at ~$5-5.5K for the implant and another $1-1.5K for the orthodontic treatment (braces). So $6-7K all in. The specialist is confident he can do my implant in the chair knowing that I don't have a particularly good gag reflex and struggle a lot with having things in my mouth.

    I'm currently wondering whether extras cover through a PHI is worth it? As I don't have a current policy I have to wait 12 months to get treatment covered.

    I've looked through a few providers. Let's take HFI for example and their 'Essential Extras' product which is $23.71/ft. That equates to $616 per year. From what I can tell that policy offers $1,250 per year for general and major dental, endodontic and orthodontic as a group. Am I right in saying that benefits me to the tune of $634?

    Would I be better off looking for an extras only policy that pays as much as possible, say GMHBA which offers a $2,000 limit (which would cost me $988 for the year)? It seems to be that within the yearly limit there are also sub limits that apply to certain items so I might not get the full amount of the annual limit back anyway?

    What provider do people recommend.

    • Muzeeb on 25/06/2024 - 18:06
      +3

      Do more research.

      Just because a limit is X doesn't mean you get all of X. There are so many conditions and item limits per claim that your maths isn't necessarily correct.

      • Jimothy Wongingtons on 25/06/2024 - 18:16

        Yeah in many instances you may actually be better off paying out of pocket straight without the level of 4d chess required to maximise and fully use all your allowances to make private cover worth. Eg ive been meaning to go back to get my eyes checked and new glasses (bit farsighted) - and I always say ah next Saturday… it’s been 4 years lmao. But I pretty much always maxed out my dental for last 3 years.

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