100% BACK On dental check ups
100% BACK
on two dental check ups every year
Love your smile with Hunter and Premium extras.
There are many great benefits to having dental health insurance. With our Hunter and Premium extras policies, you can keep your teeth healthy while keeping your bank account happy.
Not sure what terms like ‘no-gap dental’ or ‘no annual limits’ really mean? Or how to claim 100% back on your dental check up? Keep reading below to learn more or get in touch with our friendly team if you have any questions!
Learn about 100% back on check upsLearn about no annual limitsJump to FAQs
How do I claim my dental benefits?
Claiming your dental benefits with Hunter Health Insurance is easy!
Visit your dentist
Choose any dentist. Your teeth, your choice. You’re not restricted to a provider network, giving you complete freedom to choose which dentist treats you.
Scan your HHI card
Simply scan your HHI card at the dentist, as we’re part of the HICAPS network, your extras benefits apply instantly.
Pay the difference
If there’s a gap, you’ll just pay the difference – but for no-gap services such as the 100% back on dental check ups, there’s nothing extra to pay.
Learn more about what is covered under our 100% back on dental check ups.
How do I get 100% back on my dental check ups?
Our 100% back on general dental check ups is also referred to as gap-free dental or a no gap for selected dental services. This benefit is designed for your peace of mind in knowing that we cover the full cost of treatment for bi-annual dental check ups.
Under our Hunter and Premium extras policies, each member is entitled to two preventative dental visits each year which covers the periodical oral examination and scale and clean treatment.
At Hunter Health Insurance, you are not limited to a preferred provider network. This means you can redeem this benefit from any dentist across Australia, allowing you to choose the dentist that best suits your circumstances.
What services are included in the 100% back dental?
The following services are included within the no-gap dental insurance benefit for active Hunter and Premium extras policies:
Scale and clean
Periodical oral examination
What services are not included in the 100% back dental?
The following services are not covered under the 100% back benefit and depending on your level of cover, would incur a gap fee:
Fillings
Root canal
Surgical tooth extraction
Fluoride treatment
Major dental (such as crowns and bridges, dentures or orthodontics)
Does this mean I’ll have to pay the full amount for other dental services like fillings or root canal?
Not at all, it simply means that you cannot claim 100% back for services not included in your bi-annual check up. Our extras policies cover a portion of the expenses for other services such as fillings, root canal or tooth extraction for example. Depending on your chosen dentist, their fees, your Hunter Health Insurance policy and remaining limits, we will cover a fixed amount for each treatment and anything above this is considered the ‘gap’ which you pay directly to your dentist.
Learn more about what no annual limits means in relation to our extras health insurance and how this benefits you.
What does no annual limit mean?
With no annual limits, members can claim a fixed rebate an unlimited number of times on selected dental item numbers from any dentist within Australia.
If your preferred dentist charges above the fixed rebate amount, this incurs what is called a ‘gap expense’ which you are then required to pay the difference of.
For example, if you needed to have a tooth surgically extracted (ADA 311), our Hunter and Premium extras policies will pay a fixed amount of $110 towards this service. If your dentist charges $130 per tooth extraction, you would pay the difference of $20 per claim known as the ‘gap payment’.
What services are included in no annual limits?
The following dental services have no annual claim limit for active Hunter and Premium extras policies:
Fillings
Root canal
Surgical tooth extraction
Fluoride treatment
What services are not included in no annual limits?
Scale and clean
Periodical oral examination
Major dental (such as crowns and bridges, dentures or orthodontics)
What if I need to have other dental work done?
If you need dental work beyond preventative care such as fillings, extractions, or more complex treatments like crowns, root canals, bridges, or orthodontics (e.g. braces), we pay a fixed benefit amount towards both general and major dental services. This means there may be a gap fee depending on your treatment and your dentist’s fees.
Want to know exactly what’s included in your dental cover? Reach out to our team and we’ll be happy to help provide the exact rebate for each service before your appointment.
Other Frequently Asked Questions
A gap fee or our of pocket payment is the difference in cost between what your medical provider charges for a service and what you are eligible to claim on your health insurance.
Example 1.
Dentist A charges $150 for a tooth filling.
Your benefit in your policy is $85 per tooth filling.
This means we would pay $85 towards the cost.
The difference between what dentist A charges and what we cover is $65. This is known as the gap fee or out-of-pocket payment.
You would cover the remaining gap fee of $65 to your dentist for the tooth filling.
How to calculate the gap fee
( How much the service costs ) – [ How much we cover for that service ] = { Gap fee }
( $150 ) – [ $85 ] = { $65 }
Please note the above pricing is using placeholder figures for demonstrative purposes only. You can find the actual benefit amounts in your policy document or by contacting member support.
Yes, if you held an eligible level of cover at the time of treatment and had served the required waiting periods but missed claiming on the spot with your HHI member card, you can still claim your benefit.
You can submit a claim online, via our mobile app or even by visiting us in our branch and once processed by our team, you will be paid the benefit amount to your nominated bank account.
At Hunter Health Insurance, we do not have a preferred provider network. This means that you have complete freedom to choose your dentist without being penalised.
We will pay the same benefit amount per service to any accredited Australian dentist performing the services within Australia.
Yes, the waiting periods for dental services range from 2 months to 12 months.
If you are transitioning from another health fund, we will honour the waiting periods already served for the same level of cover. If you are increasing your cover, you will have to serve a wait period for the additional level of cover.
If you do not currently have cover, you will need to serve the appropriate waiting period before you can claim a benefit.
The waiting limits for dental services range from 2 to 12 months. You can view the waiting limits for specific services e.g. fillings or root canal when getting a quote on our website.
You don’t need to provide any personal information to access a quote which will provide the cost for insurance, waiting periods, benefit limits and more.
As a general rule of thumb, general dental care is not covered by Medicare. There are government initiatives where Medicare will help subsidise dental care for children and teens under the Child Dental Benefits Schedule (CDBS), conditions medically required where performed in a hospital setting and other special circumstances however for most Australians, general dental care is only covered by holding eligible private health insurance.