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Dental Insurance FAQs - Sparkle Dental
Insurance FAQs We answer your most frequently asked questions about health insurance here.

Insurance FAQs


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Are you a preferred provider?

Our practice has chosen not to participate in any "preferred provider" schemes.  Without contractual obligations to any health insurance companies, the only people we have to be accountable to is you, and the primary question in our mind is how can we best serve you?

We also have the freedom to adjust our fees to reflect the level of service and care we provide.  This has enabled us to invest considerably in our team and training, and ensure that we can keep evolving to continually provide the best dentistry has to offer.

We believe that patients who pay full insurance premiums should have the same right to quality care and same rebate regardless of which dentist you choose. The following document will outline the most commonly asked questions.
 

We welcome patients from all insurance companies, and whether you see a preferred or non-preferred provider the annual rebate limit they will pay still remains the same.
 

How much can I expect back from my health fund?

That is a difficult question to answer.  There are so many health insurance companies and different levels of cover.

It also depends on the type of procedures you are having.  In general, preventive and basic services will receive a greater proportion of rebate, with cosmetic and reconstructive procedures offering a greater out of pocket expense.

Following your initial appointment at our practice, you will be given a written treatment plan that outlines your treatment costs, visits and item numbers.  Your insurance company will be able to determine your gap payments based on this plan.  Depending on your company, our front office co-ordinators may be able to determine this for you on the spot without the need for you to contact them directly.

Which is the best health fund?

We do not recommend any specific insurance company.  The most important factor when deciding is to look for one that offers you the freedom to select any health provider without penalty.  This is opposed to one that directs you to specific providers to maximise your rebate.

Should I join a health fund before I get my treatment?

A recent article with commentary from a leading expert in the health insurance industry and supported by Choice consumer group suggested that "extras" private health cover did not make financial sense for most people, and we tend to agree.  Read the article here.

It is important to weigh up the cost of insurance against the benefits you will receive. Health insurance is not like normal insurance because there is an annual cap to the benefits you will receive.  When they are not used in one year, they are not carried forward into the next.

Many patients, particularly those that require major treatment decide that the higher premiums and waiting periods for higher levels of cover are not for them.  It has made sense to save those monthly amounts aside for treatment.  If they are not used one year, they are not lost.  

In other cases delaying treatment until insurance rebates kick in has allowed dental problems to worsen and require more extensive treatment.

We can do immediate insurance claims for the following health funds through HICAPS:

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