Private health insurance

In Australia, the private health insurance system is based on individuals or families purchasing an insurance policy that covers all or part of the cost of private health care. 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.

Key terms

  • Dentate: Having one or more natural teeth.
  • Edentulous: A state of complete loss of all natural teeth.
  • Constant prices: Constant price expenditure adjusts current prices for the effects of inflation— see Glossary in Health expenditure Australia 2016–17. 

Private health insurance cover for dental expenses

Data in this section were sourced from the National Dental Telephone Interview Survey 2013 (AIHW 2016). This section reports the proportion of Australians who held private health insurance cover for dental expenses at the time of the survey. 

Half (50%) of all people aged 5 years and over had some level of private health insurance cover for dental expenses

The proportion of people aged 5 years and over with some level of private health insurance cover for dental expenses was:

  • higher for adults aged 45–64 (57%) than those aged 15–24 (44%)
  • twice as high for dentate people (51%) than edentulous people (25%).

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

Nearly twice as many dentate people aged 5 years and over ineligible for public dental care (58%) had some level of private health insurance cover for dental expenses than those eligible for public dental care (31%)

The proportion of dentate people aged 5 years and over with some level of private health insurance cover for dental expenses:

  • was similar for males (50%) and females (52%)
  • higher for those living in Remote and very remote areas (57%) than those living in Major cities (53%), Inner regional (45%) and Outer regional (44%) areas
  • increased as annual household income increased, from 23% for those earning less than $30,000 per year to 78% for those earning over $140,000 per year.

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

Around 3 in 4 (77%) adults aged 18 years and over reported that their insurance paid some of the dental expenses of their last visit

  • Around 1 in 12 (8.5%) adults aged 18 years and over reported that their insurance paid all the dental expenses of their last visit.
  • Around 1 in 10 (10%) adults aged 18 years and over reported they paid all their own dental expenses of their last visit.

Around 1 in 5 (19%) of insured adults aged 18 years and over who paid all their own dental expenses reported that dental care caused a large financial burden

  • Around 1 in 25 (4.1%) of insured adults aged 18 years and over whose insurance paid all of the dental expenses reported that dental care caused a large financial burden.
  • Around 1 in 10 (10%) of 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 3 below.

Health expenditure by private health insurance funds

In 2016–17, 13.5 million Australians (55%) were covered by a general treatment policy (APRA 2018) and dental services attracted $1.9 billion (12.0%) of expenditure by private health insurance funds (AIHW 2018).

Net benefits paid by private health insurance funds for dental services increased from $1.6 billion in 2014–15 to $1.9 billion in 2016–17

Explore the data using the Private health insurance interactive 4 below.

References