The public health care system, particularly in WA, takes really good care of little teeth. They have a bunch of programs that cater to prevention and treatment of kids’ dental issues. But these programs are not always accessible or available to everyone, and that’s where your private health insurance comes in.
The private system covers everything the public system covers for kids’ dental, and then some. It offers better overall
access to dental care. The only thing you need is the right kind of health insurance.
To figure out whether public or private is better for your kid’s teeth (and your wallet), you need to first understand
how dental issues are categorised.
General Dental vs. Major Dental vs. Implants & Orthodontics
While there’s no universal system for categorising dental issues, they mostly fall into two or three categories. With
HBF, dental services fall into three categories:
- General Dental
General dental focuses on minor dental services, including consultations, x-rays, scale and cleans, simple fillings
- Major Dental
Major dental, as the name implies, refers to more complicated treatments, including root canals, crowns, bridges
- Implants & Orthodontics
Implants & orthodontics include the replacement of missing teeth with an implant (a fake tooth screwed into your
jaw) and orthodontic work.
While HBF has three categories, other health funds might have two… or four. And the way health funds categorise specific
treatments can vary as well. For example, one health fund might classify a tooth extraction as a general dental treatment,
while another might consider it major dental.
The public system can also classify things differently to the private system.
Keeping all that in mind, let’s look at what the public system covers for kids’ dental.
Accessing dental treatment in the public system
The majority of WA families rely on two public dental programs:
The School Dental Service run by the WA State Government, and
The Child Dental Benefits Schedule run by the Federal Government.
Both programs provide free or subsidised dental care for kids. So, what’s the difference between them?
School Dental Service (The WA Service)
The School Dental Service (SDS) provides free
General dental care to all children aged 5 – 16 years old* who attend a WA Department of Education recognised school.
If your kid is enrolled in one of these schools, they can access dental services via Dental Therapy Centres,
which are either mobile vans or fixed clinics within schools.
The range of dental services provided by the SDS includes dental examinations, dental radiographs (x-rays), scale and cleans,
fluoride applications, fissure sealants and fillings.
The service also provides oral hygiene education, so your kids can be full bottle on the latest brushing and flossing techniques.
Free Emergency dental treatment is also provided during any Dental Therapy Centre’s normal opening hours. This service
is limited to situations where your child needs pain relief, haemorrhage control, infection control, or initial treatment
following trauma. It does not include treatment beyond the emergency phase, e.g. it won’t include a completed
*Or until the end of year 11, whichever comes first.
Child Dental Benefits Schedule (The Federal Service)
The Child Dental Benefits Schedule (CDBS) provides free or partially subsidised general dental and a few major dental services for kids age 2 -17 that meet
certain eligibility requirements.
If your family’s eligible for the CDBS, Medicare provides $1000 per child over two consecutive years that can be used
to cover the cost of dental care. Once that time is up, if you’re still eligible, you can apply for another $1000
per child to use over the following two years. And so forth until your child is 17.
The CDBS covers the same kinds of general dental services as the School Dental Service (SDS)—so
really, you’re better off using the SDS for most things.
Where the CDBS shines is for more complicated Major dental treatments like root canals and extractions.
The only things you can’t use the CDBS for is orthodontics, cosmetic dental work and dental services provided
in a hospital.
To access your $1000, simply contact your family dentist upfront and check whether they participate in the CDBS—it’s
a voluntary program, so it’s important to confirm your dentist participates before you take your kids to see them.
NOTE: You can’t claim from both the CDBS and your private health insurance on the same dental
Funding your kids’ dental care through Private Health Insurance
You also have the option of using your private health insurance to help fund your child’s dental care.
There are two key benefits of using your health insurance.
The first one is your child can get treatment for any dental issue, so long as it’s covered by your health insurance.
Not all kids’ dental treatments are covered in the public system—health insurance can step in to cover what
the public system doesn’t.
And the main dental treatment the public system doesn’t generally cover is orthodontics, which is where private health
insurance really comes in handy. If you are thinking ahead for orthodontics, just be sure your Extras insurance covers
it—not all health funds categorise orthodontics in the same way.
The second benefit of using your health insurance is you can choose your dentist. That means you can see your family dentist
or another of your choice instead of going to the Dental Therapy Centre. Just watch out, as your benefits might change
depending on the kind of agreement your health fund has with the dentist you see.
Some health funds also have additional perks for you and your kids.
If you’re with HBF, most policies let you add your kids for free—that means they’ll be covered for everything
you’re covered for, with no additional cost to your premium.
So long as you have General dental on
your HBF Extras insurance, your kids will also be fully covered for preventative dental treatment at a Member Plus dentist,
which means no out-of-pocket for things like scale and cleans and mouthguards. You can find your closest Member Plus dentist here.
While health insurance won’t always cover the full cost, the right product can shave 1000s off your kids’ dental