Frequently Asked Questions

Health Funds

Date Posted: 12/1/2001

Question Why do dental rebates differ from health funds?

Answer Health funds have assessors who determine the level of rebate for particular dental items. There is a balance between the rebate and the level of premium you pay, the type of cover and other factors such as waiting periods, annual limits and any promotional offers. As a consumer, you choose the private health scheme that best suits your needs. Most have fixed rebates for treatments irrespective of the actual fees charged. The rebates are generally not designed to provide full cover for dental fees or even a consistent percentage. In addition, most schemes do not include all treatment items. Some common treatments have no rebate at all. Remember, 1. Your contract with the health fund is between you and the fund. It remains separate from the contract you have with your dentist. 2. There is no such thing as a ‘recognised fee’ or ‘schedule fee’ in dentistry and the ADA states categorically that any organisation that implies that their rebates are set to a percentage of a ‘schedule fee’ is misleading the public, regardless of whether it is an ‘internal’ schedule.