Going to the dentist…we all dread it, don’t we?
However, it is not only the fear of the drill and the scary chair which make us uneasy.
For most of us, there is something a lot more scary than this: the bill at the end!
Dental care in Australia is VERY expensive regardless of if you need a filling or a root canal treatment and unless you are a child or teenager, Medicare pays nothing!
As a result, many Australians simply can’t afford to go to the dentist and research shows we have some of the worst teeth in the developed world (with remote areas in Australia faring especially badly, which is hardly surprising).
The ABC’s consumer affairs show The Checkout (of which I am a massive fan!), did a piece about the dental fees and how to manage them.
I must admit that personally, I found the humour a bit strange in this particular segment and not the usual sophisticated quirkiness The Checkout are known for. That ‘tooth fairy’ is a full blown psycho I reckon… 😉
Anyways, the content and the information itself are absolutely top notch as usual.
Check it out and be the judge for yourself.
The video mentioned information about average charges for various dental treatments provided by the federal government.
This information is available here but keep in mind that it was collected in 2015 so may be outdated by now.
For more up-to-date information, you can refer to this data collected through the Australian Dental Association’s annual fee survey.
Finally, this is the recommended fee schedule from the Australian Dental Council, which is the industry regulator and accreditation authority for all the Australian dental professions.
The most common solution that Australians turn to in order to lower their dental care costs is private health insurance and this is one of the leading reasons for getting what’s called “extras” cover which is cover for services and treatments received outside hospital.
However, private health insurance is not cheap with prices constantly going up while government rebates are going down.
Furthermore, research has also shown that being tied to a health fund can actually reduce your dental care options.
We are all familiar with the phenomenon of going to the dentist to get treated and being hit with a nasty ‘Gap Payment’ which can often amount to thousands of dollars. The gap payment is what you have to pay on top of what your health fund, to whom you paid decent amount of your hard earned over the years, is paying towards your treatment.
So what is one to do? Is there a way to further reduce the cost of dental care other than resorting to going overseas to a developing country in order to get major work done on your teeth?
Well, looks like now there is!
The Smile Dental Plan
Smile describe themselves as “Australia’s first dental care plan”.
“So what’s a dental care plan anyway?”
Well, Smile works in quite a different way than your health fund when it comes to dental care. They follow a business model which is quite common in other developed countries but is not yet well known in our ‘great southern land’.
Instead of complex limits, exclusions and waiting periods, Smile simply gives you an upfront discount on your dental care for a simple and low annual membership fee.
There are no health checks, waiting periods or exclusions and the discounts on some of the services can amount to as high as 40%.
We are talking about some serious dough here people!
Furthermore, with Smile there are no contracts or commitments of any kind. This, together with the fact that there are no waiting periods, means that you can choose to be a member only in years where you expect to require a lot of work done.
Better yet, the discount provided by Smile is on top of any rebate from your private health fund so you can definitely ‘double dip’ to further lower your dental care expenses.
How does it actually work?
The way it works is that first you get the Smile discount off the cost of your treatment directly from the dentist.
Then, you pay whatever discounted dental bill that is due.
Later on, you approach your health fund directly (if you’re a member of one) and claim from them whatever rebate you are entitled to. Smile advises their members to not use any on the spot claiming mechanism (e.g. HiCaps) their dental surgery might have and instead claim directly from the Health Fund after they’ve already paid the bill at the surgery.
This process seemed a bit convoluted and cumbersome to me so I approached them for an explanation as to why members can’t claim on the spot at the surgery and instead have to pay the bill first and then claim whatever rebate they are entitled to later.
Here is the official explanation I received:
You do not have to keep the fact that you also have private health insurance a secret at the practice.
You simply can only use your Smile card at a participating practice to receive your reduced fees, then use the receipt after you leave to claim back from your health insurance provider.
If you get your reduced fees with Smile and then swipe your health fund card at the practice, the practice’s fees can actually reset, meaning you miss out on your reduction from Smile. This doesn’t happen within every practice, and is also dependent on the practice software, however this is the simplest method to maximise your savings.
All participating practices also understand how this works. Health funds are also happy with this procedure. In fact we have had 27 health funds approach us to help them with their preferred provider schemes this year.
That’s fair enough I think.
The bottom line is that Smile membership can significantly reduce those dreaded ‘gap payments’ (or maybe even eliminate them altogether on some low end services).
Another cool thing about Smile is that you do not have to be an Australian citizen or permanent resident in order to join!
This means that if you are a student or someone on a temporary work visa, you can still join and will pay exactly the same as a ‘true blue’ Aussie. Smile does not discriminate.
This could be a great way to significantly reduce the cost of your dental care while in Australia without having to take an expensive overseas extras cover from a private health insurance company.
The breakdown of the various dental care services covered by Smile and their respective discounts are outlined on their website so you can have a look for yourself.
Some of you might ask at this stage :
“Is there a ‘catch’ to this? this all sounds too good to be true”.
Well, let me assure you that after conducting our own research into this, this is not the case and Smile are fair dinkum.
They have been around for several years now and are backed by some serious private investors so looks like this mob is here to stay!
There is however a small ‘catch’:
In order to receive the discounts offered to Smile members, you must utilise the services of a ‘participating dentist’ which basically means a dentist that has signed up with Smile and agreed to offer their members the prescribed upfront discounts on their dental care.
However, let us assure you that this is not an issue. Smile already has hundreds of participating dentists Australia-wide with almost 500 more waiting to come on-board (Smile employs a screening process to ensure all participating dentists are properly qualified, work in a quality practice and provide quality service to patients).
This means that if your current dentist is not already part of the scheme, he or she will soon be or you can always tell them about it and suggest they join.
The full list of Smile providers is available on their website and most of them are also members of the ‘preferred providers’ networks of the major health funds which means that if you also have dental care included as part of your private health insurance, you will get higher rebates with them. Again, keep in mind that these rebates are in addition to the discount offered by Smile.
Here is another statement we received from Smile regarding the screening process they use before allowing new dentists to join the scheme:
Although it is free for practices to participate, Smile’s Practice Services Team spends approximately 3 months on each practice that has applied before approving them.
Our aim is to provide quality and affordable dental care to all Australians. Spending 3 months researching each interested practice is the best way to ensure that Smile patients will also receive quality treatment.
As you can see, these people are not mucking around and based on member testimonials our team has received, as well as my own personal experience (yep, I’m a member myself), this is definitely a service you might want to look at if you need some dental work done (especially of the big and expensive kind).
Potential overcharging by dentists who are part of the Smile dental scheme
In the past, there have been a small number of reports about dentists who were ‘loading up’ their prices for Smile members which negated the discount offered.
I approached Smile regarding that and here is what they had to say on the matter:
Smile staff constantly checks practices through a series of calls throughout the year to ensure that they abide by the Smile Fee Schedule rules. These rules are as follows:
- Participating practices MUST abide by the Smile Fee Schedule and the fees we stipulate there are the maximum they can charge our members.
- If the practice’s normal fee is below our benchmark (which is 15% above the Smile Fee), the practice has to reduce their normal fee by a further 15%.
- The practice has to reduce all items not set out by the Smile Fee Schedule by 15%.
This guarantees that you always receive at least 15% off your treatment fees, and in the case of fees on the Schedule the savings can be up to 40% and in some instances even more.
It also means that it doesn’t matter what the practice’s normal fee is, as the vast majority of treatment members receive is set out by the Smile Fee Schedule (nearly 90% of all dental treatment).
All participating practices will be in line with these fees apart from a very small group that already have low fees. These practices have to reduce their normal fees by a further 15% for our members.
Smile also encourages feedback regarding practices and takes all comments very seriously. Our aim is to provide quality and affordable dental care to all Australians and member feedback is vital to our continuing success.
The Smile Dental Scheme in the news
Below are two videos featuring news reports about Smile which explain how and why the business was started and how it operates.
Just click on the banner below to get started or click here if you can’t see it for some reason.
As usual, if you have any questions or comments about this, just enter them in the box below.