Medicare, Public, Private – What does this mean?
Is Wisdom teeth removal covered by Medicare?
In Australia, Medicare does not cover all dental care, so the cost of having wisdom teeth removed is not routinely covered. This means that there will be an out of pocket fee to pay.
Medicare, however, does provide the Children’s Dental Benefits Scheme (CDBS), which offers eligible children $1000 over 2 years to spend at the dentist. This includes common dental services such as check-ups, x-rays, cleans, fillings and extractions.
If you decide to have your teeth removed under general anaesthesia, you will get a percentage of the anaesthetist fee back from Medicare. If you have a health fund, the remaining amount may be covered.
Can I get it done at a public hospital?
Some public hospitals with oral surgery units may perform wisdom teeth removal usually if the patient has significant medical conditions which increase their risk of complications and require management in the hospital setting. However, most public hospitals have long waiting times for surgery which is not ideal for patients who are in pain. You may also be required to hold a concession card in some instances.
At Wisdom Teeth Clinics, our surgeries are performed at private day hospitals.
What if I have private health insurance?
If you have private health insurance, you may be covered for part of the costs of wisdom teeth surgery, depending on your Health Fund and the level of cover. For most health funds, wisdom teeth extractions fall under the general dental category (not major dental).
For example, if you are with Bupa Top extras 60, you would expect to get the following back for teeth extractions (depending on the item number used):
Item 322: $84.80 covered by health fund
Item 323: $107.60 covered by health fund
Item 324: $127 covered by health fund
In addition, your health fund will also cover part of the anaesthetist fee after the Medicare rebate for general anaesthetic (read about local vs general anaesthetic here). Day hospital fees will depend on your excess, meaning you may not have any out of pocket fees.
If you are unsure, contact your health fund to find out what you are covered for, and the waiting times.
What if I cannot afford the out of pocket fees?
Even after contributions from Health Funds, or for patients who do not have private health insurance, assistance with fees may be required. Wisdom Teeth Clinics offers payment plans for the dental surgeon fees with options such as Afterpay or Zip Pay to help reduce the stress of the costs of wisdom teeth surgery and make treatment more affordable and accessible.
Please see refer to the website for more information on Afterpay or Zip Pay
If you like to read more about what affects your wisdom teeth removal cost, click here.