Looking for a policy that includes endodontics? Find out which health insurers cover this type of dental treatment.
Endodontics is a field of dentistry that exclusively deals with teeth interiors, or the soft organic tissue beneath the hard exterior. Endodontists are the specialists that handle the procedures. Depending on the circumstances and the procedure required, you may or may not be able to claim endodontic procedures on your private health insurance.
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Features
GoldStar
Premium hospital cover with complete cover for hospital expenses. Save 4% when you pay for 12 months of your cover upfront.
All theatre fees covered
Unlimited maternity cover
Choose no excess or $200, $400, $500 per admission
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More info
High Hospital with $0 / $250/ $500 Excess Options
Provides a high level of cover for hospital including pregnancy cover and assisted reproductive services.
Cover starting from $36.22 weekly
Two month waiting period for wisdom teeth
65% back on extras
Choice of $0, $250 and $500 excess
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Top hospital 500
Top hospital 500 provides cover for a comprehensive range of services from psych to obstetrics to the removal of tonsils.
Spinal fusion
Weight loss surgery
All joint replacements
Rehabilitation
More info
Mid Hospital with Pregnancy
Mid Hospital with Pregnancy covers you for pregnancy and related services in addition to what the standard Mid Hospital policy covers.
Pregnancy and related services
Nine month waiting period for pregnancy in public hospital
12 month waiting period for pregnancy in private hospital
Day surgeries
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Premium Family Package
This is GMHBA's most comprehensive policy and providing a range of benefits including a pregnancy option.
Pregnancy and birth related services
Assisted reproductive services (IVF)
No hospital excess for kids
100% back on optical
More info
Premium Hospital Cover
Comprehensive hospital protection with complete cover including pregnancy.
No excess for kids
No excess for accidents
Cover for pregnancy, heart surgery, joint investigations
Free access to health and wellbeing programs
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Top Hospital Cover
NIB's premier Hospital protection with cover for pregnancy and birth services, obesity surgery and all other benefits covered across other policies.
$250 / $500 excess
Pregnancy and birth services cover
Infertility Investigations cover
Renal dialysis cover
More info
Top Hospital with Top Extras
Get comprehensive hospital and extras cover and tailor your policy to your needs.
Pregnancy and birth services cover
Back surgery cover
$1000 general dental annual limit
$600 physiotherapy annual limit
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How Australian health funds cover endodontics
Health fund
Extras cover that pays towards endodontics and the benefit limits* for treatment
Find out more
The benefit limit for endodontics increases annually and caps after five years.
Premium Options. Annual benefit limit starts at $700 and caps at $1,200.
Super Options. Annual benefit limit starts at $500 and caps at $1,000.
Special Options. Annual benefit limit starts at $300 and caps at $800.
Vital Options. This provides a shared annual benefit limit of $800 which can be spent on any of the eligible services which includes endodontics.
More info
High Extras. Shared annual benefit limit of $750.
Middle Extras. Shared annual benefit limit of $700.
Basic Extras. Shared annual benefit limit of $600.
Simple Extras. Shared annual benefit limit of $500.
Extras 50. Annual benefit limit of $750.
More info
Super Extras. Shared annual benefit limit of $1,000.
Family Extras. Shared annual benefit limit of $600.
Lifestyle Extras. Shared annual benefit limit of $600 for singles and $1,200 for families.
Black 60. Shared annual benefit limit of $600 for singles and $1,200 for families.
More info
Gold Extras. Annual benefit limit of $400.
Silver Extras. Annual benefit limit of $300.
Bronze Extras. Shared annual benefit limit of $600.
Basic Extras. Shared annual benefit limit of $350.
More info
Gold Extras. Annual benefit limit of $400 for singles and $800 for family memberships.
Silver Extras. Annual benefit limit of $350 for singles and $700 for family memberships.
More info
Platinum Extras. Initial shared annual benefit limit of $900 which increases each year until it caps at $1,300 in year six.
Gold Extras. Initial shared annual benefit limit of $600 which increases each year until it caps at $1,000 in year six.
Silver Plus Extras. Shared annual benefit limit of $500.
More info
Top Extras. Shared annual benefit limit of $1,300.
Core Plus. Shared annual benefit limit of $1,000.
Core Extras. Shared annual benefit limit of $600.
More info
Top Extras. Shared annual benefit limit of $500 which increases to a maximum of $1,000 after five years. Lifetime limit is $2,500.
More info
*Unless otherwise stated all benefit limits are per person.
A complete list of Australian health insurers who offer cover for endodontics can be found at the end of this article.
Benefit limit terms explained
Sub-limit. A sub-limit is the largest possible amount you can claim for a specific service, which is then deducted from a larger overall benefit limit. For example, your dental cover might include an overall benefit limit of $900 with sub-limits of $300 being applied to bridgework, endodontics and dentures. In this case, the maximum you could claim for any one of those services is $300.
Shared or combined benefit limit. This means that the benefit limit is shared amongst multiple services, rather than applying a limit to each one individually. While you are not restricted to claiming a capped amount like you are with sub-limits, your total overall benefit amount is spread over a wider range of treatments, so be sure not to claim excessively on one service and leave yourself without cover for others.
Lifetime benefit limit. This is the maximum amount you can claim for a service throughout your lifetime. Be aware that if you've reached your lifetime benefit limit with one insurer and switch to a new one, they may deduct that amount from your new policy. It is recommended that you check with your new provider to find out if these penalties apply.
What's covered in this guide?
What is endodontics?
What types of health insurance cover endodontics?
Can I get dental only health insurance?
What to be aware of when comparing policies
What is endodontics?
While general dentists primarily take care of the outside of the tooth, endodontists deal with the inside. Endodontic treatments include:
Root canals. If the tooth pulp (interior tissue) becomes inflamed or infected, then a root canal may be required. This involves carefully removing the infected tissue, cleaning and disinfecting the area and then resealing the tooth.
Endodontic retreatment. If a previously treated tooth suffers a fracture or other damage, it may become reinfected and need endodontic retreatment. This can happen if decay or injury reopens the tooth, an undetected dental issue present before the first treatment causes problems, or the previous treatment was otherwise incorrectly carried out or not permanently effective.
Endodontic surgery. This refers to specific procedures like apicoectomy, or root-end resection, which is required when infection persists in the bony area at the end of a tooth following a root canal. There are a variety of endodontic surgery procedures that can be used in this situation, but apicoectomy is the most common.
What types of health insurance cover endodontics?
Both private health funds and Medicare cover endodontic treatments to a certain extent.
Private health insurance
The majority of private health funds will cover endodontic procedures with either extras or dental policies. Limits, waiting periods and whether or not endodontics are actually covered will vary depending on the chosen provider and policy.
When looking for coverage of endodontic treatments in a private health insurance policy, you will almost always require an extras or a dental plan. General dentistry and basic health insurance policies typically do not offer any cover. Endodontics itself will typically be grouped within a policy in one of three ways:
Endodontics and periodontics. These are often grouped together.
Endodontics. It may also be its own distinct category.
Major dental. Many policies will group endodontics within the major dental category. Some may also have additional categories like “complex dental”, which might cover endodontics instead.
Check your health fund’s benefit schedule to see how endodontics is classified on your policy.
Medicare
The only endodontic-related costs that Medicare will cover are those related to dental radiology. This is when x-rays are used to diagnose dental issues. Endodontic treatments themselves are not covered by Medicare.
Can I get dental-only health insurance?
Some health insurance funds may also offer dental-only insurance policies. These will only cover dental procedures and will cost a lot less than standard hospital or extras policies. This can be useful if you are interested in finding a health insurance plan that only covers dentistry, or if you have extensive oral surgery needs and ongoing dental health requirements.
Dental-only plans typically offer high levels of cover for general dentistry such as check-ups and plaque removal.
The insurer may categorise endodontics as major dentistry, as “endodontics and periodontics”, or as a separate endodontics group. Alternatively, they might only list specific procedures, such as root canals, which are covered.
Dental-only health insurance policies typically cost less than most extras plans.
As with other policies, you may be able to select different types of dental-only health insurance, ranging from basic to comprehensive.
Because they are used for specific purposes, it is not uncommon for dental-only policies to have up to a 12 month waiting period for certain dental procedures. The same is true of many health insurance extras plans.
A complete extras plan rather than a dental-only policy will typically be more cost effective if you intend to claim for things other than dental procedures, or if you want to be able to claim for more unexpected health issues and treatments.
What to be aware of when comparing policies
Extras policies cover important things that Medicare doesn’t. Endodontic treatments are a perfect example of this. When comparing extras insurance, look for the following features:
Waiting periods. This is the minimum amount of time you must wait between taking out a policy and being able to claim benefits with it. For endodontics and other major dental procedures, this is typically 12 months with most policies.
Limits. This is the most you can claim for either certain treatments, such as endodontics, or for certain categories of treatments, such as major dental or all dental. The main limit to consider is the annual amount per person. There may be separate limits for families all under the same policy, sub-limits that apply to certain treatments or types of treatments and lifetime limits that apply for the entire lifespan of the policy.
Exclusions. These are conditions under which you cannot claim benefits. Exclusions could include certain causes of damage, such as not following the advice of your your dentist, being treated by someone who is not a registered practitioner, or receiving treatment outside of Australia.
Required dental cover. If you are looking for a health insurance policy that covers endodontics in particular, then you should pay close attention to how it is categorised. Endodontics will typically fall into the major dental category, but it might also be separate.
Compare health insurance policies that cover endodontics with the aid of an adviser
Complete list of providers that cover endodontics
Health fund
Which policies include cover for endodontics and what are the benefit limits*?
Find out more
Super Extras. Shared annual benefit limit of $1,000.
Family Extras. Shared annual benefit limit of $600.
Lifestyle Extras. Shared annual benefit limit of $600 for singles and $1,200 for families.
Black 60. Shared annual benefit limit of $600 for singles and $1,200 for families.
More info
Gold Extras. Annual benefit limit of $400.
Silver Extras. Annual benefit limit of $300.
Bronze Extras. Shared annual benefit limit of $600.
Basic Extras. Shared annual benefit limit of $350.
More info
Platinum Extras. Shared annual benefit limit of $1,200.
Gold Extras. Shared annual benefit limit of $1,100.
Silver Extras. Shared annual benefit limit of $1,000.
Your Choice Extras. Shared annual benefit limit of $500 after one year of holding cover. Increases each year until it caps at $1,000 after year seven.
More info
Gold Extras. Benefit of $150 for filling one root canal only. No annul benefit limit.
Silver Extras. Benefit of $90 for filling one root canal only. No annul benefit limit.
More info
Gold Extras. Annual benefit limit of $500.
Silver Extras. Shared annual benefit limit of $1,000.
More info
Gold Extras. Annual benefit limit of $400 for singles and $800 for family memberships.
Silver Extras. Annual benefit limit of $350 for singles and $700 for family memberships.
More info
Lots Extras Cover. Annual sub-limit of $400 for singles and $700 for couples/families which is deducted from an overall benefit limit of $2,000 and $4,000 respectively.
Some Extras Cover. Annual sub-limit of $350 for singles and $700 for couples/families which is deducted from an overall benefit limit of $500 and $1,000 respectively.
More info
GU Health provides specialised policies to employers to offer to their employees. If you are covered by a GU Health plan through your workplace you should speak to the relevant department to find out if they have included cover for endodontics.
More info
Flexi Extras Plus. Shared annual benefit limit of $1,700.
Flexi Extras Mid. Shared annual benefit limit of $1,400.
Flexi Extras. Shared annual benefit limit of $1,100.
Saver Flexi Extras Plus. Shared annual benefit limit of $976.
Saver Flexi Extras Mid. Shared annual benefit limit of $825.
Saver Flexi Extras. Shared annual benefit limit of $675.
More info
Platinum Extras. Initial shared annual benefit limit of $900 which increases each year until it caps at $1,300 in year six.
Gold Extras. Initial shared annual benefit limit of $600 which increases each year until it caps at $1,000 in year six.
Silver Plus Extras. Shared annual benefit limit of $500.
More info
High Extras. Shared annual benefit limit of $750.
Middle Extras. Shared annual benefit limit of $700.
Basic Extras. Shared annual benefit limit of $600.
Simple Extras. Shared annual benefit limit of $500.
Extras 50. Annual benefit limit of $750.
More info
Gold Extras. Annual benefit limit of $1,000.
Silver Extras. Annual benefit limit of $500.
Bronze Extras. Shared annual benefit limit of $500.
More info
The benefit limit for endodontics increases annually and caps after five years.
Premium Options. Annual benefit limit starts at $700 and caps at $1,200.
Super Options. Annual benefit limit starts at $500 and caps at $1,000.
Special Options. Annual benefit limit starts at $300 and caps at $800.
Vital Options. This provides a shared annual benefit limit of $800 which can be spent on any of the eligible services which includes endodontics.
More info
Premier Gold and Family Care Gold. No annual benefit limit applies.
Premier Silver. Annual benefit limit of $1,200.
Premier and Premier Plus. Annual benefit limit of $1,000.
Dental Extras Cover. Annual benefit limit of $1,000.
More info
Top Extras. Shared annual benefit limit of $500.
Growing Family Extras. Shared annual benefit limit of $400 which increases each year until it caps at $600 after four years.
More info
Extras Plus. No annual benefit limit applies.
Basic Extras. Shared annual benefit limit of $550.
More info
Top Extras. Shared annual benefit limit of $1,300.
Core Plus. Shared annual benefit limit of $1,000.
Core Extras. Shared annual benefit limit of $600.
More info
Premium Extras. Shared annual benefit limit of $1,500.
High Extras. Shared annual benefit limit of $1,000.
Mid Extras. Shared annual benefit limit of $500.
More info
Top Extras. No annual benefit limit applies.
Mid Extras. Shared annual benefit of $1,500.
More info
Premium Extras. Annual benefit sub-limit of $600 which is deducted from an overall benefit limit of $1,400.
Essential Extras. Annual benefit sub-limit of $350 which is deducted from an overall benefit limit of $900.
More info
Super Extras. Annual benefit limit of $1,000.
More info
Top Extras. Shared annual benefit limit of $500 which increases to a maximum of $1,000 after five years. Lifetime limit is $2,500.
More info
Platinum Extras. No annual benefit limit applies.
Gold Extras. No annual benefit limit applies.
More info
Restricted fund**
Top Extras. Annual benefit limit of $660.
Intermediate Extras. Shared annual benefit limit of $400.
More info
Restricted fund**
Premier Extras. Shared annual benefit limit of $1,100.
Value Extras. Shared annual benefit limit of $900.
More info
Restricted fund**
Premium Extras. Annual sub-limit of $1,000 deducted from an overall benefit limit of $2,000.
Healthy Living Extras. Annual sub-limit of $700 deducted from an overall benefit limit of $1,500.
More info
Restricted fund**
Total Extras. Shared annual benefit limit of $1,000.
Essential Extras. Shared annual benefit limit of $800.
More info
Restricted fund**
SureCover Extras. No annual benefit limit applies.
More info
Restricted fund**
Premium Extras Cover. Annual benefit limit of $600.
Smart Extras Cover. Annual benefit limit of $500.
More info
Restricted fund**
Extras Cover. Benefit limit of $1,700 in any two years.
More info
Restricted fund**
Comprehensive Extras. Annual benefit sub-limit of $400 which is deducted from an overall benefit limit of $3,400. Both these limits increase each year until they cap at $560 and $4,695 after year seven.
Healthy Options Extras. Shared annual benefit limit of $1,000.
Mid Range Extras. Annual benefit sub-limit of $300 which is deducted from an overall benefit limit of $1,000.
More info
*Unless otherwise stated all benefit limits are per person.
**Restricted funds only provide cover to members of specific industries, groups and organisations. In some cases family members may also be eligible to join.
Benefit limit terms explained
Sub-limit. A sub-limit is the largest possible amount you can claim for a specific service, which is then deducted from a larger overall benefit limit. For example, your dental cover might include an overall benefit limit of $900 with sub-limits of $300 being applied to bridgework, endodontics and dentures. In this case, the maximum you could claim for any one of those services is $300.
Shared or combined benefit limit. This means that the benefit limit is shared amongst multiple services, rather than applying a limit to each one individually. While you are not restricted to claiming a capped amount like you are with sub-limits, your total overall benefit amount is spread over a wider range of treatments, so be sure not to claim excessively on one service and leave yourself without cover for others.
Lifetime benefit limit. This is the maximum amount you can claim for a service throughout your lifetime. Be aware that if you've reached your lifetime benefit limit with one insurer and switch to a new one, they may deduct that amount from your new policy. It is recommended that you check with your new provider to find out if these penalties apply.
Compare health insurance policies that cover endodontics with the aid of an adviser
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