Health funds and HICAPS at Dentrust
We have HICAPS on site, so your private health fund is claimed at the appointment and you pay only the difference. No forms, no waiting for a rebate.
How claiming works here
Bring your health fund card to the appointment. When treatment is finished, we swipe the card through the HICAPS terminal, the claim goes to your fund straight away, and the rebate is deducted from the bill. You pay the gap on the spot and take the receipt with you.
What comes back depends on three things: the level of dental cover in your policy, the annual limits attached to it, and how much of those limits you have already used during the calendar year. Two people with the same treatment and different funds can pay very different gaps, which is why we cannot tell you your rebate in advance with certainty.
What we can do is give you the ADA item numbers for the proposed treatment on your written quote. Ring your fund with those numbers and they will tell you exactly what they pay. That is the reliable way to know your out-of-pocket cost before you commit.
Getting the most out of your cover
A few practical points that save people money every year.
Limits reset annually
Most extras policies reset on 1 January. Unused benefits are generally not carried over, so cover left unused at the end of the year is simply lost.
Use your item numbers
Ring your fund with the item numbers from your written quote and ask what they rebate. It takes five minutes and removes the guesswork.
Waiting periods apply
New policies and upgrades usually carry waiting periods, particularly for major dental. Check before booking extensive treatment.
Staging across years
Where a plan is extensive and not urgent, part of it can sometimes be sequenced across two calendar years so two annual limits apply.
CDBS for eligible children
The Child Dental Benefits Schedule is separate from private cover. Eligible children can be treated under the scheme.
Ask us
If you are unsure how your cover works, ask at the practice. We deal with funds every day and can usually point you in the right direction.
Preferred provider arrangements
Some practices have preferred provider agreements with particular health funds, which can change the size of the gap for members of those funds. If this is relevant to you, ring the practice and ask which arrangements currently apply — these change from time to time and we would rather tell you the current position than publish something that goes out of date.
Be aware that a preferred provider arrangement is a commercial agreement about fees. It is not an indicator of clinical quality, and no fund assesses the standard of care when entering one. Choose a dentist you are comfortable with, then work out the money.
If you do not have private cover at all, that is not a barrier to being seen. You will get the same written itemised quote, and we can discuss sequencing treatment if cost is a concern.
Common questions
Do I need to claim anything myself?
No. HICAPS claims at the appointment and the rebate comes straight off the bill. You pay the gap.
Which funds do you accept?
HICAPS works with the major Australian health funds. Bring your card and we will process the claim at the appointment.
How do I find out what I will get back?
Ring your fund and quote the ADA item numbers from your written treatment plan. They can tell you the rebate for each item and what limits you have left.
What happens if I have used up my annual limit?
You pay the full fee. Where treatment is not urgent, it can sometimes be deferred until your limits reset, and we will tell you whether waiting is clinically reasonable.
Is dental covered by Medicare?
General adult dental treatment is not. Eligible children may be covered under the Child Dental Benefits Schedule, which is a separate Commonwealth scheme.
Related pages
Other parts of the site people usually read alongside this one.
Written itemised quotes with ADA item numbers, so you can check your rebate first.
Examinations, cleans and X-rays — the six-month visit that prevents most of the rest.
Bring your fund card to your appointment
03 9899 0098 · 579 Middleborough Rd, Box Hill North VIC 3129
Rebates depend on your individual policy, level of cover and remaining annual limits. Dentrust cannot determine your entitlement — your fund can.