Health insurance for wisdom teeth removal

Yes, but you’ll need extras cover and potentially hospital insurance, depending on your procedure and whether you’ll be going to hospital for it.

If your wisdom tooth removal is being performed at your dentist’s surgery, you’ll only need extras cover. However, depending on the complexity of the removal and your insurer, wisdom tooth removal can fall under either general dental or major dental.

Wisdom tooth removal may be performed in a hospital when a surgical extraction is required. For these cases, you’ll need private hospital cover as well as extras cover that includes dental surgery. The hospital cover will help pay for hospital admission costs and surgeon fees, while your extras cover can assist with the dental item numbers associated with the extractions. Silver tier and higher extras policies generally include dental surgery, although it’s often covered of many Bronze+ policies as well. Depending on your health fund and hospital policy, some out-of-pocket expenses may still be required in addition to your claim.

Medicare does not cover most dental treatments and dental services. However, there are some circumstances where you may be able to receive some essentials such as:

• Public dental services (provided they are performed in an Australian public hospital as a medically necessary inpatient service)
• Concession card holders may be eligible for some services
• Child Dental Benefits Schedule (CBDS) – a program designed to cover some or all costs for basic dental services for children aged under 17.⁴ Either the child or at least one guardian must be receiving Centrelink payments to be eligible.

Whenever you take out a new insurance policy, you’ll need to serve a waiting period before you can make a claim. For dental cover, there is a waiting period of 2 months for general dental and 12 months for major dental. The category your wisdom tooth removal falls into will depend on factors such as your insurer, whether the procedure is performed in a dental clinic or requires surgery and the complexity of the procedure.

If you’re being admitted into hospital for your procedure, you’ll need to serve a 12 month waiting period for pre-existing condition and 2 months for a new service, before your insurance will cover you.

If you’re changing funds and have already served a waiting period for dental services, you won’t have to serve it again, provided your new policy offers the same or less cover. If you’ve upgraded your policy, you’ll need to serve a waiting period for any inclusion you didn’t have before.