The true cost of dental services: What is covered by Medicare?

Everywhere you look these days, whether it’s on the TV, in magazines or movies, it seems like people have the perfect ‘Hollywood smile’, but the reality of looking after your teeth as you age is far from easy with many people struggling to afford the costs of simple check-ups or treatments.

The cost of treatment is the main reason people avoid the dentist’s chair, with a routine check-up, clean and fluoride treatment setting patients back an average of $66 a time, according to The Australian Dental Association’s Dental Fee Survey, with some people shelling out as much as $92 for a basic dental exam. While the average cost for a filling is $175, a root canal averages out to $278 and a wisdom tooth extraction can cost anywhere between $500-3000.

So what does Medicare cover?

Unfortunately, Medicare doesn’t always help with dental care. According to comparison site Finder, Medicare will only cover some dental treatments if they are considered essential for your general health. Most dental examinations and treatments are not covered.

But the good news is, if you have a Health Care Card, Pension Concession Card issued by Centrelink, Commonwealth Seniors Health Card, Pensioner Concession Card issued by the Department of Veterans’ Affairs you are eligible for publicly funded dental care.

Services available at publicly funded dental clinics for no charge include fillings, tooth removal and minor oral surgery, making new or repairing existing dentures, emergency care to relieve pain, dental x-rays and check-ups (it’s important to note that every state has slightly different criteria).

The only downside is there’s a waiting list for publicly-funded services, but in some cases you may be offered a voucher for treatment at a private dental practice.

Not eligible for public dental treatment?

If you’re not eligible for public dental treatment, you will need to seek dental care privately and health insurance can be a great way to cover your dental expenses.

Compare the Market health expert Anthony Fleming told Starts at 60 that older Australians should think seriously about taking out cover for their dental health, so they don’t run into unexpected costs and can have peace of mind in case the worst does happen and they need major dental work in the future.

“Dental bills can be very expensive – particularly for major procedures. It is in these instances that having appropriate private health cover can be reassuring, to assist in reducing high out-of-pocket costs. Most dental treatments can be covered under extras within your health insurance policy and the amount you get rebated and your annual limits will vary, based on the level of cover you purchase.

“Older Aussies can reduce expensive dental bills by taking out a private health insurance policy that offers common services such as regular dental check-ups and fluoride treatments as part of a general treatment package. For those who may need more comprehensive cover for their dental needs, a policy that includes major dental procedures such as root canals, dentures and crowns or veneers could be more suitable.”

He continued: “Choosing the right health cover for your needs can give older Aussies peace of mind in case the worst should happen. We encourage Aussies of every age to shop around for a private health policy that not only suits their needs but their budget too.”

So why are Aussies still putting off dental treatment?

According to COTA Australia (Council on the Ageing) older Australians are still putting off dental treatment due to unaffordable fees and it’s affecting their overall health.

“In COTA’s State of the (Older) Nation report in 2018 oral and dental health services were cited as the hardest service for older Australians to access and afford,” a COTA spokesperson told Starts at 60. “Research shows a firm association between oral health (periodontitis, tooth decay/cavities, and tooth loss) and coronary heart disease, stroke, and peripheral vascular disease.

“People aged 75 years can have rates of gum disease and root decay that are 2–3 times as great as the population at large. The number of teeth decayed, missing, or filled in older people aged 65-plus is around 24, as compared to around 8 in people aged 25 to 44. Poor oral health contributes to co-morbidities associated with chronic disease in older people, and further compromises healthy ageing.”

Recent research from comparethemarket.com.au found that an overwhelming majority (61 per cent) of Australians have delayed necessary dental treatment and procedures in a bid to avoid the out-of-pocket costs. And the figures revealed that it is the recommended biannual check-ups that people skip most regularly, with 32 per cent of the 1,087 people surveyed admitting they’ve pushed back their routine exam due to the expense.

It isn’t just general check-ups that patients are foregoing either, as almost a third said they’ve delayed pricier treatments such as orthodontics, which can cost anywhere between $5000-9000, and 30 per cent confessed to waiting before having a necessary cap or crown fitted because of the associated cost, which can be more than $1,500 for a full crown.

People aren’t just putting off treatment temporarily either it seems, as the survey also found that one fifth of respondents hadn’t been to the dentist for at least two years, while 15 per cent confessed that it had been more than three years since they last sat in the chair.