Karrinyup Dental Centre

Everything You Need to Know About Health Funds for Dental Crowns

Karrinyup Dental Centre

Written by:

Dr. Justin Soon

Published on:

Everything You Need to Know About Health Funds for Dental Crowns

A dental crown is widely used for a smile makeover after root canal therapy or implants. But let’s be honest, this procedure can cost a lot of money. That’s where health funds come in. These can be helpful since they can shoulder some of the expenses that come with dental crowns.

Dental crown cover varies from health fund to health fund. Some may provide extensive assistance, whereas others may not. We have the important details you need to know.

We’ll look into how to identify a reputable health fund and the strategies for minimising the out-of-pocket cost for dental crowns. Let’s dive into health funds and how to get your next dental crown paid for by your provider.

Summary of The Content

  • Dental crowns are essential for maintaining strong, healthy smiles, but understanding health funds can be hard.
  • Choosing the right health funds for dental crowns can greatly reduce your financial burden.
  • Health funds vary greatly in their dental crown cover, including differences in annual limits, assistance percentages, and waiting periods.
  • Key features to look for in a health fund include high annual limits, flexibility in dentist choice, and straightforward claim processes.
  • Common exclusions and limitations in health fund policies often include cosmetic procedures, pre-existing conditions, and specific treatment caps.
  • Practical tips for reducing out-of-pocket cost for dental crowns involve understanding policy details, using preferred providers, and considering a wide range of treatment options.

Overview of Health Fund Cover for Dental Crowns

Dental crowns have become a popular option because of their aesthetic appeal and dental benefits. They help address damaged teeth, discoloured teeth, and decayed teeth, improving smile appearance and preventing complex treatments like tooth extraction. However, the cost of dental crowns varies depending on various factors, such as crown material.

Every dental health fund has its own approach to crown assistance, much like each of us has a unique, attractive smile. Some health funds might shoulder a big chunk of the cost of dental crowns, while others offer a more modest helping hand. This variety means there’s a lot to consider when you’re weighing up which health fund meets your dental needs.

Health funds in dental procedures could be the key to reducing expenses and keeping your mouth healthy. It’s about finding a match that aligns with your dental health journey and financial situation.

Key Features to Look for In Health Funds for Dental Crown Cover

Choosing the right health fund for a dental crown process is crucial for both your oral health and your finances. It’s important to know which features are important in order to make you feel well-supported during dental treatments. Here are the key financial aspects to consider:

  • Annual Limits:
    Consider how much you can claim each year. Higher dental claim limits mean more return in your pocket for major dental treatments.
  • Percentage of Assistance:
    Some health funds shoulder a set percentage of your bill, like 60% or even 80%. The higher the percentage, the more return.
  • Waiting Periods:
    These are the times you need to wait before claiming. Shorter dental waiting periods get you to the chair quicker.
  • Choice of Dentist:
    Having the freedom to pick your dentist means you can stick with your preference or find one that suits your needs.
  • Other Inclusions:
    Check what else is included beyond crowns. Good inclusions can mean better dental care in the long run.
  • Claim Process:
    Easy claim processes prevent headaches. Look for health funds that offer simple, fast claiming, maybe even on the spot at the dentist.

Finding the right health fund for your dental crown needs can be a game-changer. It’s about getting the support you need while keeping your wallet happy.

Various Health Funds Compared for Dental Crown Cover

Navigating through health funds for dental crowns can be confusing. Each has its unique benefits and considerations. Here’s a comparison in terms of dental crown cover, policies, and claim processes:

Annual LimitsOffers a generous annual limit for dental work, including crowns, with flexibility based on the level of assistance.Provides specific annual limits for dental crowns, with options to increase assistance through higher-tier plans.
Assistance PercentageShoulders up to 60-70% of the dental crown price, depending on the policy.Offers up to 70-80% assistance for dental crowns under comprehensive plans.
Waiting PeriodsHas a 12-month waiting period for major restorative procedures like crowns.Imposes a 12-month waiting period for dental crowns, similar to HBF.
Choice of DentistAllows the freedom to choose any dentist, with additional benefits for using network providers.Encourages using a CBHS dental choice network dentist but also shoulders dental services by non-network dentists.
Additional AssistanceIncludes assistance for other extensive treatments, with the specifics depending on the chosen policy.Offers broad added assistance, including orthodontic treatment and general dental, with specifics varying by plan.
Claim ProcessFeatures straightforward claim processes, including on-the-spot HICAPS claims for immediate discounts.It provides easy claims through online portals and the CBHS mobile app, as well as HICAPS for on-the-spot claims.

Selecting the right health fund for dental crown procedures involves weighing various factors. Both HBF and CBHS offer competitive options, but the choice depends on your specific needs, preferences, and financial situation.

Understanding Exclusions and Limitations in Dental Crown Cover

When it comes to dental crown treatment, not everything might be shouldered by your health fund. Knowing the common crown procedure limitations and exclusions can help prevent surprises. Here’s a rundown to keep you in the loop:

  • Cosmetic Procedures:
    Many health funds do not pay for dental crown expenses that are purely for cosmetic reasons. If it’s not medically necessary, you might be footing the bill.
  • Pre-existing Condition Exclusion:
    If you have a dental health issue before joining the health fund, some policies might not shoulder additional treatment for a set period.
  • Waiting Periods:
    Almost all funds have waiting periods for dental crowns, usually around 6 to 12 months. Jumping in before the time’s up means you’re likely paying out of pocket.
  • Annual Limits:
    You can only claim a certain amount each year. Once you hit this yearly limit, any additional dental crown costs are yours to pay.
  • Percentage of Assistance:
    Funds usually shoulder a percentage of the treatment cost, not the whole thing. Know what your health fund offers to be ready.
  • Choice of Dentist:
    Some funds might only shoulder dental restoration services from a network of dentists. Going outside this network could mean lower assistance.

Navigating the exclusions and limitations in your health fund’s dental crown cover is crucial for keeping your attractive smile shining without unexpected costs. Being aware helps you make knowledgeable choices about your dental care.

Tips for Reducing Out-Of-Pocket Costs for Dental Crowns

Custom crowns can be a necessity for keeping our smiles in good shape, but you don’t have to break the bank. Here are some savvy tips for reducing the out-of-pocket cost for dental crowns:

  • Choose the Right Health Fund:
    Look for a fund that offers good assistance for dental crowns, including high annual limits and a good percentage of assistance.
  • Understand Your Policy:
    Know the ins and outs of your health fund policy, including waiting periods and exclusions, to avoid surprises.
  • Use Preferred Providers:
    Some health funds have agreements with certain registered dentists. Affiliated clinics may offer lower costs for tooth crowns.
  • Ask for a Payment Plan:
    Many dental clinics offer payment plans, spreading the cost of dental crowns over time to make it more manageable.
  • Get a Pre-Treatment Estimate:
    Before proceeding, ask your dentist upfront for a detailed estimate. This way, you can know what to expect and discuss it with your health fund representative.
  • Consider All Dental Treatment Options:
    Sometimes, there might be more than one dental health treatment option. Discuss these with an experienced dentist to choose the most cost-effective one.
  • Take Advantage of Preventative Oral Care:
    Dental visits for regular check-ups and cleaning dental appointments can prevent problems that might result in higher-cost procedures.

A bit of knowledge and preparation can go a long way in managing dental health. Keeping your dental expenses in check, especially when it comes to crowns, is all about being informed and proactive.

Policy Waiting Periods on Dental Crown Procedures

Waiting periods in health fund policies build anticipation but also serve an important purpose. When it comes to dental crown procedures, understanding these waiting periods is key to timing your treatment just right. Here’s why they matter:

  • Prevents Immediate Claims:
    It’s about fairness to all members. Waiting periods discourage people from joining a health fund, claiming a dental crown, and then leaving the fund.
  • Varies Between Funds:
    Different health funds have different waiting periods for dental crown services, usually ranging from 6 to 12 months.
  • Affects Timing of Treatment:
    You need to have been with the fund for the duration of the waiting period before your treatment is paid for. Planning ahead is crucial.
  • Emergency Exceptions:
    Some policies may have provisions for emergency dental work. Check to see if your situation qualifies.

Waiting periods are a fundamental part of health fund policies, designed to let the system work fairly for everyone. Knowing how these periods work can help you plan your dental crown procedure without any unwelcome financial surprises.

Making an Educated Choice About Dental Crown Cover

Making an educated choice means dedicating time to research and compare various health funds for dental crowns. Understand their assistance and match this with your dental health needs and financial situation.

Look into the details, including the percentage of costs shouldered, annual service limits, waiting periods, and any exclusions or limitations. Consider your dental health history and future needs as well. It’s also wise to consult with your dentist about what treatments you might need. They can provide insights into the cost-effective and beneficial options for your dental health.

A little time spent researching now can help prevent hassle and expense later. With the right health fund, you can enjoy the peace of mind that comes with knowing you’re prepared for dental expenses.

Final Thoughts

Having the right health fund can significantly ease the cost-related aspect of maintaining a healthy, beautiful smile. Understanding the benefits of health funds for dental crowns is key to making decisions for your dental health investment.

If you’re feeling a bit overwhelmed by all the information or just have more questions, remember you’re not alone. Karrinyup Dental Centre is here to help you understand your health fund and decide on dental treatment options.

We invite you to schedule a consultation appointment with us. Whether you prefer to call or visit our website, our team is ready to help you achieve your goals. Let’s work together to keep your smile bright and healthy for years to come.

Dr. Justin Soon


Dr. Justin Soon

Dr. Justin completed his Bachelor of Dental Surgery at the University of Western Australia. Dr Justin completed his surgical implant training under the mentorship of Dr. Glen Liddelow, Dr. Graham Carmichael, and Dr. Brent Allan at the Branemark Centre.

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