Does private health insurance cover dentures?

Denture fittings are essential, but can cost thousands of dollars and generally are not covered by Medicare. So what are your options and can private health cover help? Here is what you need to know.

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by Gary Andrews

Last update 15 Apr 2021

Overview

Australians aren't great at looking after their teeth.

A study by the Australian Institute of Health and Welfare noted that the number of us with untreated tooth decay increased between 2006 to 2017.

It also means that an increasing number of us have some form of dentures fitted.

The AIHW's data suggests that 42% of the over 65s have a mixture of dentures and their natural teeth.

But dental treatment isn't cheap -- and neither are dentures.

So can private health insurance cover the cost of dentures and what should you look for in a policy?

We'll take you through all you need to know about dentures, frequently asked questions, and how to ensure you're not down in the mouth because of the high cost of treatment.

Key Points

Dentures are customised fake teeth made to replace missing teeth.
The cost of dentures is generally not covered by Medicare.
Different states and territories have different eligibility criteria to help pensioners cover the cost of dentures.
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What are dentures?

Dentures are, quite simply, artificial teeth.

They can either replace a small number of teeth, a full jawline, or even the whole set.

Artificial teeth have advanced a lot since your parents or grandparents needed false teeth, and often look completely natural.

There's many reasons why somebody may need dentures.

Poor oral health such as decay and gum disease can mean you'll need artificial replacements.

Alternatively, athletes who like getting stuck in on the footy field may also have one or two replacement teeth after one too many big hits.

Getting dentures can improve your quality of life beyond just getting your perfect smile back.

A set of good teeth can also make mealtimes less painful and even talking that little bit easier.

How much does a full set of dentures cost in Australia?

Dentures aren't cheap.

According to the 2019 Australian Dental Association Fee Survey, the average cost of full upper and lower acrylic dentures is $2448, and the average cost of either an upper or lower denture is $1350.

Aged based discount

Aged based discount

These are only the average costs though: there are other factors as well that determine the cost, such as the treatment you require and the materials used.

How long do you have to wait to get dentures?

It really depends on the type of dentures you need.

Some dentures can be made and inserted on the same day you get your teeth pulled out.

Others can take around two to three weeks to make and fit.

Even if you're getting your dentures fitted on the same day, you'll probably need to make a few visits both before and after the fitting to make sure you're comfortable and your mouth is able to support the dentures.

Can pensioners get concessions on dentures?

Pensioners who hold an eligible concessions card can get subsidised dental services.

This varies between states and territories, so it's worth checking to see what you're eligible for.

The federal government's health direct site is a good place to start -- they have links to the relevant info from states and territories.

What is the cheapest way to get dentures?

Dentures aren't cheap, sadly, and you could end up paying out thousands for your fitting.

There's no guaranteed way to get cheap dentures but having appropriate private health insurance can help cut your out-of-pocket costs.

It's also worth making sure your dentist of choice has an agreement with your health fund, otherwise you could be hit with large out-of-pocket costs.

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You may be able to get help with the cost of dentures, but it varies between states and territories.

Generally, you'll need to be eligible for Medicare and hold an eligible card such as a Commonwealth Seniors Health Card or a Health Care Card.

It's always worth checking the cost and what discounts you're eligible for before you agree to dental treatment.

Are dentures covered by Medicare?

Medicare doesn't usually cover dental treatment outside of hospital, and that includes dentures.

There are some cases where you can get government assistance for dental treatment.

These largely apply to children and pensioners, although some adults are eligible as well.

Dentures are unlikely to be covered, as Medicare doesn't include any cosmetic treatments or non-emergency dental treatments.

Even if you are covered by the public system, expect a long wait for dental treatment.

Are dentures covered by private health insurance?

Yes, but they're not covered on every type of policy. Dentures generally sit under major dental in your extras cover, and not all policies will include this.

Appropriate extras cover will give you back a percentage of your dental treatment, up to a set limit per year.

You can find out more about how this works in our dental cover guide.

The best way to ensure you've got the right major dental cover is to compare policies.

How can older Australians find private health insurance for dentures?

The best way to find private health insurance for seniors is to compare policies.

However, doing all the work on your own can be a long-winded process.

Our specialists at Compare Club take the hassle out of comparing policies.

We'll do all the hard work for you, and give you options from our panel of trusted insurers that cover your dental needs.

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This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.

References Australian Dental Association, 2019 fee survey NSW Health, Dental Information For Patients Health Direct, Cost of Dental Care Privatehealth.gov, What Is Covered By Medicare Australian Institute of Health and Welfare, Older Australia at a Glance Australian Institute of Health and Welfare, National Oral Health Plan