New South Wales
F) Are there any treatments with a nil rebate? Which ones?
- Some funds provide no rebates on legitimate treatments available to you. You should enquire if this is to occur under the cover you are seeking.
- If some funds pay no rebate for some treatments, this would seem to be a tactic adopted by funds to avoid legitimate claims.
- The disparity between fees charged and the rebate paid by the insurer is often large. Usually fees charged by your dentist are within the band of normal. Fees cannot be uniform as some procedures can be more complex than others.
- The ADA regularly receives reports from fund members that the health fund has advised that the reason for the very significant ‘gap’ between fee charged and rebate received is due to the “ADA setting the fees to be charged”. This statement is completely incorrect.
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