What Is Gap-Free Dental And How Can You Benefit From It?
Posted on: 23 July 2021
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When a tooth deteriorates to the point that it falls out or must be extracted, it leaves a gap in your smile. As such, you'd hope that all dental procedures would loosely be classified as gap-free dental work. However, this is not what a dentist means when they offer gap-free dental services. What does it mean, and how does it benefit you?
The Medicare Benefits Scheme
Medicare cardholders can access subsidised healthcare via the Medicare benefits scheme (MBS). The MBS details the various procedures that Medicare will pay for, along with what has been decided to be a fair market value for these procedures (as determined by the Australian government). The Medicare rebate can cover the entire cost of the procedure, and this is when you don't pay a fee for seeing a medical professional (such as a standard visit to a GP). Other procedures only offer a partial rebate. While Medicare pays for the majority of the cost, the remaining amount (known as the gap) will be charged to you.
Private Insurance Coverage
Gap-free dental (also known as no gap dental) can be applied when you have private insurance coverage. While Medicare will offer a partial rebate for certain dental services, the remaining payable amount may be below the minimum claimable amount set by your insurance provider. Some dental practices, in conjunction with insurance providers, offer no gap dental, meaning that you don't have to pay for services that are above the maximum Medicare threshold, but below the minimum claimable threshold set by your insurer.
Available Services
The types of services accessible with gap-free dental will vary. However, it's generally limited to standard preventative care. This can include a standard examination, professional cleaning (scaling and polishing), along with regular diagnostic testing (such as x-rays and radiographs). Should you require a more intensive form of dental care, this is likely to meet the minimum threshold for your insurance coverage, meaning that gap-free care is no longer applicable. Many forms of cosmetic dentistry will not be covered by the gap-free scheme, and whether your private insurance will reimburse you for elective procedures depends on your specific policy.
Gap-free dental is simply a way of encouraging people to receive the level of preventative dental care they need, without worrying about the cost. So if you have private health insurance, it's very much in the best interests of your teeth and your wallet to take full advantage of the scheme.