Does health insurance cover dental implants?

The price tag on dental implants can feel daunting, and it’s natural to have questions about cost or whether your health insurance might help.

The truth is, coverage for dental implants in Australia varies quite a bit. Understanding how it all works can help you plan with confidence and avoid surprises later.

In this guide, we’ll walk you through what to expect, how insurance typically applies and what other options are available to make treatment more manageable.

Understanding dental implants and their costs 

Dental implants are artificial tooth roots (typically made from titanium) that are surgically placed into the jawbone to support a replacement tooth, bridge or even a full arch of teeth. 

They offer a durable and natural-looking solution for missing teeth by mimicking the natural teeth closely in function, appearance and comfort. 

Factors that influence cost:

• Type of implant: A single implant costs less than a full-mouth restoration.
• Number of implants: Each implant is priced individually.
• Bone grafting requirements: Adds cost if bone support is insufficient.
• Location and technology: Prices may vary between clinics and cities.
• Expertise of the dentist: Experienced implant dentists may charge more for precision and outcomes.
• Crown material: Porcelain or zirconia crowns can change the final cost. 

How does health insurance work in Australia? 

There’s no standalone “dental-only” insurance plan in Australia. Instead, dental care is typically covered through private health insurance extras cover.

• General Dental – routine care like check-ups, cleaning and fillings.
• Major Dental – complex procedures such as implants, bridges and crowns.
• Hospital Cover – for medically necessary surgery performed in a hospital (rare for implants).

Most dental implants are classified as “major dental” under private extras cover. Medicare generally does not cover implants unless related to a serious medical condition or trauma.

Does private health cover dental implants? 

Generally, private health insurance can cover parts of the implant process, but full coverage for dental implants is rare. 

In short: partially — and it depends on your policy. Here are some examples of common policies: 

Please note, these are estimates only. Always confirm coverage details with your insurer — including annual limits, waiting periods and specific inclusions for implant-related procedures. 

What does insurance typically cover?  

Private health insurance may help with parts of your implant treatment, such as:

• Consultations and X-rays: Partial rebates for assessments or imaging.
• Preparatory treatments: For example, extractions or bone grafts.
• Implant placement surgery: Often covered partly under major dental.
• Abutments and crowns: May be included as restorative items.

However, cosmetic components and complex procedures might be excluded if your insurer classifies implants as elective.

Medicare 

Generally, Medicare does not cover dental implant treatments as it primarily focuses on essential healthcare. However, there are some exceptions: 

• Exceptions may apply if implants are part of a reconstructive or medically essential procedure — e.g., after trauma, cancer treatment or congenital conditions.
• These are assessed on a case-by-case basis, and the coverage tends to be minimal compared to what private health insurance offers. 

Factors that influence insurance coverage 

Several factors influence how much your insurer may contribute towards dental implant treatment:

• Annual Limits: Most health funds have a yearly cap for dental claims. Once reached, further treatment is paid out of pocket.
• Level of Cover: Higher-tier extras policies typically include more extensive dental benefits.
• Policy Inclusions: Not all extras policies include “major dental” procedures such as implants.
• Medical Necessity: Some funds offer greater support if the implant is required to restore oral function rather than for cosmetic purposes.
• Provider Networks: Using a dentist in your insurer’s preferred provider network can sometimes increase the rebate amount.
• Pre-Approval: Some health funds require pre-approval for major dental work before treatment begins.
• Pre-Existing Conditions: Certain oral health histories may influence eligibility or the level of cover.
• Waiting Periods: These often range from 12 to 24 months for major dental procedures.

Understanding waiting periods

Most health funds apply waiting periods to major dental services to prevent new members from claiming immediately for high-cost procedures.

For dental implants, waiting periods are typically 12–24 months, depending on the insurer and policy type.

Planning ahead can help you align your treatment timeline with your coverage availability.

How to maximise your insurance coverage for dental implants 

Maximising your insurance coverage for dental implants involves understanding your policy and making informed decisions. Here are some ways to ensure you get the most out of your health insurance:

• Review your current policy’s inclusions under major dental.
• Confirm annual limits and whether they reset each calendar or financial year.
• Request written confirmation of what’s covered before starting treatment.
• Check if your clinic is recognised as a preferred provider with your insurer.
• Ask your dentist for a detailed itemised treatment plan to submit for pre-approval.
• Plan treatment around policy renewal dates to make use of annual limits effectively.
• Ask your insurer about loyalty bonuses or incremental increases in rebates

Out-of-pocket costs to expect

Even with insurance, you may have personal costs for:

• Anaesthesia or sedation (if beyond local anaesthetic).
• Temporary crowns or dentures during healing.
• Bone grafting or sinus lifts.
• Follow-up visits and post-op care.
• Excess fees or co-payments.
• Over-the-counter medication or oral hygiene products.

What if my insurance doesn’t fully cover dental implants? 

There are still accessible pathways to help you manage costs and move forward with treatment confidently.

Flexible Payment Plans

We offer convenient, interest-free payment options through TLC (Total Lifestyle Credit) and Humm — allowing you to pay in easy instalments that fit your budget.

Accessing Your Superannuation

You may be eligible to use your Super Fund through SuperCare, under the Compassionate Release of Super (CRS) program, for medically necessary dental procedures.

Government Assistance

In select cases where implants are medically required (e.g., following trauma or disease), government support may be available. Programs vary by state, and our team can help you explore eligibility.

Making informed decisions about implant treatment 

We are committed to helping you find the best way to make dental implants affordable and accessible. Whether it’s through your health insurance, our flexible payment plans, or using your superannuation, our team is here to guide you through every step.

So, if you’re ready to take the next step towards your best smile, book an appointment with our experienced dental professionals today. We’ll help you explore all available options, create a personalised treatment plan and answer any questions you may have about financing your dental implants.

When you’re ready, our team can guide you through a tailored consultation to determine your suitability for treatment and discuss next steps at your own pace.

Disclaimer: We do not & cannot provide financial advice. The information provided is not (& cannot) be deemed as financial or tax advice as we are not financial or tax advisors. Always seek professional advice before making any financial decisions.

Not all dental treatments and conditions are suitable for Compassionate Release of Super. Our dental team will diagnose your specific ailment and let you know if you are eligible under the legislative criteria to apply for the use of your super to fund your dental treatment.

The ATO and your superfund will decide to approve or decline your application. Everyone’s dental health situation is different, therefore requiring a personalised treatment plan. Please book an appointment with our dentist to find out exactly what type of dental treatment is best for your particular situation. 

FAQs: 

Can I use extras cover for implant-related treatments?

Yes, some policies allow claims for supporting treatments such as consultations, X-rays, CT scans and the crowns that sit on implants. However, surgical placement of the implant itself is often excluded. Check your policy to identify which components are claimable to avoid surprises.

Are there waiting periods for implant coverage?

Most private health policies include waiting periods for major dental procedures, often ranging from 6–12 months. This means even if your policy covers a portion of implants, you may need to wait before claiming. Planning your treatment ahead ensures you meet the waiting period requirements.

Can Medicare help cover dental implants?

Medicare generally does not cover dental implants for adults, as they are considered elective procedures. Some limited exceptions exist for complex medical or reconstructive cases, but these are rare. 

What factors affect out-of-pocket costs for implants?

Costs depend on the number of implants, the complexity of surgery, the type of prosthetic used and any preparatory procedures such as bone grafting. Insurance may cover some components, but patients should be prepared for significant out-of-pocket expenses. A personalised quote provides clarity on the total cost.