Using Your Health Fund for Dental in Perth

You can use your private health insurance for dental care in Perth by claiming on the spot through a HICAPS terminal. Bring your health fund card; we swipe it after your dental treatment, and you pay only the gap.

That part is easy. The part most people get wrong is knowing what their level of cover actually pays before they sit in the chair, which is where the unpleasant surprises come from.

At Perth City Dental, we accept all health insurance providers, and we are a preferred dental provider for HBF, Bupa, HCF and Fund My Dental.

How an On-the-Spot Claim Works

Most dental clinics in Perth are set up for electronic claiming, so there are no forms and no waiting for a reimbursement.

• Bring your card: Physical or digital, to every appointment. Without your health fund card, we cannot claim electronically, so you would pay the full fee and claim it back yourself later.
• We swipe it after treatment: HICAPS submits the claim to your fund and returns an answer in seconds.
• You pay the gap: That is the difference between our fee and the rebate your fund pays, settled there and then.

You can see which funds we work with on our health funds page.

What Your Extras Cover Actually Includes

Dental sits under extras cover, not hospital cover. This trips up more people than anything else we see, so it is worth stating plainly: a hospital-only policy pays nothing towards a routine dental check-up.

Hospital and extras cover are separate products, and you need the second one for the dentist.

Extras dental is then usually split into two tiers.

General Dental

This is the routine, preventative end: a dental check-up, a scale and clean, X-rays, fillings, fluoride treatments and fissure sealants for children.

These preventative treatments are the ones most policies cover best, and they usually carry the shortest waiting periods.

Some funds pay 100% back on two check-ups a year for eligible members, which makes regular dental care effectively free.

If you want to know what a clean actually costs before you claim, our guide to teeth cleaning cost in Perth sets it out, and our checkups and cleans page explains what the appointment involves.

Major Dental

This covers the more complex treatments: crowns, bridges, root canals, dental implants, partial dentures, wisdom teeth removal and surgical extractions.

Major dental procedures typically attract a lower percentage rebate than general work, longer waiting periods, and sometimes their own separate sub-limit.

Some policies bundle general and major dental into a single combined limit, which means two crowns can swallow the whole year’s allowance, including the check-ups you were counting on. Check which structure yours uses before you plan a course of treatment.

Two more exclusions worth knowing. Teeth whitening and other purely cosmetic work are usually excluded outright.

Orthodontics, where it is covered at all, often carries a lifetime limit rather than an annual one, so the amount you are given is all you will ever get.

Preferred Providers, and What They Actually Change

A preferred provider has an agreement with a fund on set fees.

Eligible members get a higher rebate or a smaller gap at that clinic than they would somewhere with no arrangement in place. Visiting a preferred provider can genuinely increase your rebate or reduce your out-of-pocket expenses, and on routine work the difference is often the whole gap.

Perth City Dental is a preferred dental provider for HBF, Bupa and HCF, as well as Fund My Dental. We also accept every other fund, so you are not turned away or penalised for being with someone else.

What Medicare Covers, and Help for Children

Medicare does not cover out-of-hospital dental treatment for adults, so routine dentistry is either paid privately or claimed through extras cover. That is why the right cover matters so much for your dental health.

The exception is the Child Dental Benefits Schedule, and it is underused. It provides up to $1,000 in dental benefits over two calendar years for eligible children aged 2 to 17, where the family receives a payment such as Family Tax Benefit Part A. It covers examinations, X-rays, cleans and fillings, but not cosmetic or orthodontic work.

The cap is reviewed from time to time, so confirm the current amount with Services Australia.

If you think your children qualify, our children and family dental care team can check and claim it directly.

Need More Info? Get in Touch with Perth City Dental Today!

Claiming on the spot is the simple part. Knowing what your policy pays before you sit in the chair is what saves you the surprise.

Check three things with your fund: whether you hold extras cover, what your annual limit is and how much of it is left, and whether general and major dental share the same pool.

Bring your card to every appointment, and we’ll swipe it after your treatment, so you only pay the gap.

We’re a preferred provider for HBF, Bupa, HCF and Fund My Dental, and we accept every other fund as well.

Get in touch with Perth City Dental today, and we’ll help you work out where you stand before you book treatment.