Private health insurance

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In Australia, individuals or families can purchase private health insurance to cover all or part of the cost of health care not covered by Medicare. 

Private health insurance cover is generally divided into hospital cover, general treatment cover and ambulance cover. General treatment cover provides insurance against costs of treatment by ancillary health service providers, including dentists. The extent of cover depends on the type of policy purchased.

Private health insurance cover for dental expenses

Data in this section were sourced from the National Dental Telephone Interview Survey (NDTIS) 2021 (Luzzi et al 2023). This section provides information about the proportion of Australians who held private health insurance cover for dental expenses at the time of the survey. 

In 2021, around 1 in 2 (54%) people aged 18 years and over had dental insurance

In 2021, the proportion of people aged 18 years and over with dental insurance was significantly higher for those:

  • ineligible for public dental care (61%) than those eligible for public dental care (33%)
  • who usually visited for a check-up (66%) than those who usually visited for a problem (29%).

Explore the data using the Private health insurance interactive 1 below:

Private health insurance interactive 1: Proportion of people aged 18 years and over with private health insurance cover for dental expenses, by selected characteristics

Column chart showing private dental insurance cover by selected characteristics. In 2017–18, males 51.1 per cent and females 54.3 per cent.

Column chart showing private dental insurance cover by selected characteristics. In 2017–18, males 51.1 per cent and females 54.3 per cent.

Downloadable data tables are available on Data. See Data tables: Private health insurance.

In 2021, around 3 in 4 (76%) adults aged 18 years and over with dental insurance reported that their insurance paid some of the dental expenses of their last visit.

For those adults with some form of private health insurance that included cover for dental care:

  • Around 1 in 6 (16%) reported that their insurance paid all the dental expenses of their last visit.
  • Around 1 in 25 (4.0%) reported they paid all their own dental expenses of their last visit.

In 2021, around 1 in 7 (14%) of insured adults aged 18 years and over who paid all their own dental expenses reported that dental care caused a large financial burden.

For those adults with some form of private health insurance that included cover for dental care:

  • Around 1 in 10 (9.7%) insured adults aged 18 years and over whose dental expenses were paid for by the Government reported that dental care caused a large financial burden.
  • Around 1 in 15 (6.6%) insured adults aged 18 years and over whose insurance paid some of the dental expenses reported that dental care caused a large financial burden.

Explore the data using the Private health insurance interactive 2 below:

Private health insurance interactive 2: Use of private health insurance cover for dental expenses, adults aged 18 years and over

Column chart showing source of payment for adults 18+. In 2017–18, 75.7 per cent reported both insurer paid some and they paid some of dental expenses.

Column chart showing source of payment for adults 18+. In 2017–18, 75.7 per cent reported both insurer paid some and they paid some of dental expenses.

Downloadable data tables are available on Data. See Data tables: Private health insurance.

Health expenditure by private health insurance funds

In 2022–23, 13.2 million Australians (50%) were covered by a general treatment policy (excluding ambulance only cover) (APRA 2025) and dental services accounted for $2.5 billion (13%) of expenditure by private health insurance funds (AIHW 2024).

Net benefits paid by private health insurance funds for dental services increased from $2.3 billion in 2020–21 to $2.5 billion in 2022–23.

Explore the data using the Private health insurance interactive 3 below:

Private health insurance interactive 3: Expenditure(a) by private health insurance funds on dental services, constant prices(b)

Column chart showing private health insurance funds’ expenditure on dental services. In 2022–23, net benefits paid were about $2.5 billion.

Column chart showing private health insurance funds’ expenditure on dental services. In 2022–23, net benefits paid were about $2.5 billion.

Downloadable data tables are available on Data. See Data tables: Private health insurance.

Private health insurers data

The General Treatment Dental (GT-Dental) data collection contains de-identified unit record information relating to patients and general treatment dental services for which the private health insurer paid a benefit. This information is reported to the Commonwealth Department of Health and Aged Care by private health insurers (Department of Health and Aged Care, 2023).

In 2021–22, across Australia the median charge, benefit and gap for a diagnostic comprehensive oral examination was $60, $45 and $14, respectively.

In 2021–22, across Australia:

  • the median charge, benefit and gap for a preventative service involving the removal of plaque and/or stain was $61, $40 and $19, respectively
  • the median charge, benefit and gap for a restorative service involving the adhesive restoration of one surface of an anterior tooth was $150, $74 and $74, respectively
  • the median charge, benefit and gap for the removal of a tooth or part(s) thereof was $180, $87 and $95, respectively
  • the median charge, benefit and gap for a full crown was $1600, $650 and $903, respectively.

Explore the data using Private health insurance interactive 4 below:

Private health insurance interactive 4: Charge to patient, benefit paid and gap, median (50th percentile) and 90th percentiles, for private dental services in Australia

Bar and column charts showing charge, benefit and gap for private dental services at median and 90th percentiles. In 2021–22, median comprehensive exam charge was $60.

Bar and column charts showing charge, benefit and gap for private dental services at median and 90th percentiles. In 2021–22, median comprehensive exam charge was $60.

Downloadable data tables are available on Data. See Data tables: Private health insurance.

In 2021–22, the charge for a diagnostic comprehensive oral examination ranged from $30 to $115, the benefit ranged from $17 to $75 and the gap ranged from $0 to $75 across Australia.

In 2021–22, across Australia:

  • the charge for a preventative service involving the removal of plaque and/or stain ranged from $23 to $129, the benefit ranged from $14 to $80 and the gap ranged from $0 to $88
  • the charge for a restorative service involving the adhesive restoration of one surface of an anterior tooth ranged from $50 to $290, the benefit ranged from $25 to $156 and the gap ranged from $0 to $221
  • the charge for the removal of a tooth or part(s) thereof ranged from $67 to $420, the benefit ranged from $28 to $207 and the gap ranged from $0 to $337
  • the charge for a full crown ranged from $800 to $2,750, the benefit ranged from $63 to $1,375 and the gap ranged from $62 to $2,200.

Explore the data using Private health insurance interactive 5 below:

Private health insurance interactive 5: Range of charge, benefit or gap for private dental services in Australia

Dot plot showing percentile ranges for charge, benefit and gap by category and procedure. In 2021–22, exam charge ranged $30–$115, benefit $17–$75, gap $0–$75.

Dot plot showing percentile ranges for charge, benefit and gap by category and procedure. In 2021–22, exam charge ranged $30–$115, benefit $17–$75, gap $0–$75.

Downloadable data tables are available on Data. See Data tables: Private health insurance.

In 2021–22, more dental services for which the private health insurer paid a benefit were provided to females (around 18.4 million) than males (around 15.0 million).

In 2021–22:

  • most dental services for which the private health insurer paid a benefit were provided to those aged 55–59 years, around 2.5 million services
  • around 1.4 million services were provided to females aged 35–39 years compared with around 1.1 million services provided to males of the same age.

Explore the data using Private health insurance interactive 6 below:

Private health insurance interactive 6: Number of private dental services by age group and sex

Line graph showing volume of private dental services by age and sex. In 2021–22, about 18.4 million services were for females and 15 million for males.

Line graph showing volume of private dental services by age and sex. In 2021–22, about 18.4 million services were for females and 15 million for males.

Downloadable data tables are available on Data. See Data tables: Private health insurance.

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