Payments, Health Funds and Fees | Hobart Place Dental

Most people want to know what a visit will cost before they book it. That is a reasonable thing to ask, and this page sets out how the money side works at our Canberra City practice: what you will be told before any treatment starts, how health fund claiming works on the spot, what Medicare does and does not cover, and what to do if cost is the reason you have been putting a visit off.

One thing worth saying at the start. Dental fees are not set by the government the way medical fees are. As healthdirect puts it, “there are no standard fees for dentists like there are for doctors” and each clinic determines its own fees. That is why nobody can quote you a national price for a filling, and why asking us directly is the fastest way to get a real number.

What you are told before treatment starts

You should never be surprised by a dental bill. Before we start anything beyond a straightforward examination:

You get the findings first, in plain language, including anything we are watching rather than treating.
You get the options. Where there is more than one reasonable way to treat something, you hear about each one, what it involves, and what it costs. That includes the option of doing nothing yet, where that is reasonable.
You get a written estimate with the item numbers for each proposed service. The item numbers matter: they are what your health fund needs in order to tell you exactly what it will pay.
You get time to think about it. For anything substantial, take the estimate away, call your fund, and come back to us.

This is the standard the profession sets for itself. The Australian Dental Association’s position on informed financial consent is that information about treatment costs “should ideally be provided to patients prior to their treatment”, that dentists should provide “the relevant item numbers from The Australian Schedule of Dental Services and Glossary… to enable the patient to confirm the applicable private health insurance benefit or government rebate”, and that patients “should be encouraged to contact their health fund… and be afforded the time to give due consideration to the out-of-pocket costs of treatment before treatment commences” (ADA Policy Statement 5.16).

An estimate is an estimate, not a fixed price. The same ADA policy is direct about this: advice on expected charges “should include advice that the estimate is not guaranteed and the cost to the patient may increase if the planned procedure takes longer than expected or other procedures are required”. If something changes once we are underway — a tooth turns out to be more broken down than the X-ray suggested, say — we stop and tell you before we keep going, not afterwards.

Health funds and HICAPS

We have HICAPS, so if you have extras cover you can claim on the spot. Swipe your fund card at the front desk after your appointment, the claim goes through immediately, and you pay only the difference between our fee and what your fund pays back. No forms, no waiting for a reimbursement.

We are an NIB preferred provider and a member of the HIF Choice Network. Depending on your policy, those arrangements can mean your fund pays a higher benefit for treatment here than it would elsewhere, which leaves less for you to pay. What it does not mean is that everything is covered — that depends entirely on your own level of cover, and it is worth checking rather than assuming.

What your extras cover actually pays

This is where most of the confusion sits, and it is genuinely not the dentist’s to resolve. A few things to know:

Cover varies enormously between policies. The ADA describes it plainly: “due to the plethora of different private health insurance policies, there is inconsistency between rebates for a particular dental service”, and notes that patients sometimes “wrongly assumed that the fee for the dental service is fully or mostly covered by their health fund” (ADA Policy Statement 5.16).
Annual limits apply, and they reset. Extras policies cap what they will pay for general dental each year, often with separate sub-limits for particular categories. The Private Health Insurance Ombudsman lists knowing your limits among its basic rules of private health insurance (Ten golden rules). If you have limit left and treatment that can reasonably wait, timing a course of work across two benefit years can reduce what you pay.
Waiting periods apply on new policies. Waiting periods are set by each insurer and generally run “from two to six months for items such as general dental” and “up to 12 months or more for major items such as orthodontics” (privatehealth.gov.au).
We cannot tell you your gap. We know our fees. We do not have visibility of your policy, and the ADA is explicit that dentists “cannot be expected to know the difference between their dental fees and the benefits (gap) payable by private health funds”. Ring your fund with the item numbers from your estimate and they will tell you exactly.

The Ombudsman’s suggested questions are worth borrowing before any significant treatment: what are the item numbers and the charge for each, will there be out-of-pocket costs and how much, and will I get a written estimate before I agree.

Medicare, and dental care for children

For adults, the short answer is that Medicare will not cover your general dental care. As healthdirect states, “the Australian Government does not generally cover the costs of dental services. You will need to pay most dental costs yourself” (Cost of dental care).

Children are different, and this is the part families most often miss.

The Child Dental Benefits Schedule

The Child Dental Benefits Schedule covers basic dental care for eligible children, and we bulk bill it. That means for most CDBS services there is nothing for you to pay.

Who is eligible. A child must be 0 to 17 years old for at least one day in the calendar year, be eligible for Medicare, and either receive a qualifying payment from Services Australia themselves or have a parent, carer or guardian who does (Services Australia).
How much. Up to $1,158 per eligible child across two consecutive calendar years. The cap is indexed each 1 January. If you do not use the full amount within the two years, the remainder does not carry over (What’s covered).
What it covers. Check-ups, X-rays, cleaning, fissure sealing, fillings, root canals and extractions.
What it does not cover. Orthodontic work, cosmetic work, and any dental services provided in a hospital. CDBS services also do not count towards the Medicare Safety Net.
Worth checking first. Services Australia notes there are some item and time restrictions on basic dental services, and advises checking with your dentist before starting. Confirm your child’s balance through your Medicare online account or by calling us, and bring your Medicare card to the appointment.

If your child is eligible, this is the single easiest way to keep their teeth looked after at no cost to you. A first visit somewhere between age one and two is a reasonable starting point, and early visits are usually short and uneventful by design.

How you can pay

HICAPS on-the-spot health fund claiming
EFTPOS
Visa and Mastercard
Humm and Afterpay

A note on the last two, because we would rather you heard it from us. Buy now pay later is credit. Since 10 June 2025 these products have been regulated under Australia’s national credit law, with the National Credit Code extended to buy now pay later contracts and providers required to hold a credit licence (ASIC). They are a useful way to spread the cost of treatment you need now, and they are still a debt with consequences if repayments are missed. Read the provider’s terms, and if you would rather not use them, talk to us about sequencing the treatment differently instead.

Seniors and student discounts

We offer two discounts. Both are 10 per cent off our fees, and both apply to all dental treatment we provide at the practice.

Seniors — 10 per cent off, for ACT Seniors Card holders. Hobart Place Dental is listed in the ACT Seniors Card Discount Directory. Bring your card to the appointment.

Full-time university students — 10 per cent off. Bring a current student card showing you are enrolled full time.

Please mention the discount when you book, so that the written estimate we give you already has it applied rather than it being a surprise adjustment at the counter. If you are not sure whether you qualify, ask us on the phone. The discount is applied to our fee, so where you are claiming from a health fund the amount your fund pays is worked out on the discounted fee. Treatment already bulk billed under the Child Dental Benefits Schedule costs you nothing, so there is nothing there to discount.

If cost is why you have been putting it off

You are in very large company. Around one in three Australian adults delayed or did not go to a dental professional when they needed to, and roughly one in six pointed to cost as the reason (AIHW).

Some practical options:

Say so. If there is a budget you need to stay inside, tell us before we plan the treatment rather than after. It genuinely changes what we recommend and in what order.
Ask about staging. Not everything has to be done at once. Urgent work first, the rest sequenced across months or across benefit years, is a normal and sensible way to do it.
Ask what else would work. healthdirect’s advice is to ask whether you really need the procedure, whether there is a less expensive alternative, and for the item numbers so you can compare (Cost of dental care). We would rather you asked us those questions than avoided the appointment.
Check whether you are eligible for public dental care. ACT residents who are the primary holder of a Pension Concession or Health Care Card, a DVA white or gold Veteran Card, an ACT Services Access card or a Commonwealth Seniors Health card may be able to access public dental services through Central Health Intake on (02) 5124 9977. General treatment there is capped at $550.30 per treatment plan, excluding root canal therapy, splints and denture work, and an emergency appointment is $52.50 (Canberra Health Services). Waiting times apply for non-urgent care, and the surrounding NSW areas such as Queanbeyan and Yass are not covered. We will tell you if that is likely to be the better route for you.
Prevention costs less than repair. Regular check-ups exist to catch things while they are small, when the fix is smaller too. That is not a sales line — a filling costs less than the root canal or crown that the same tooth needs a few years later.

What is worth knowing

Being straight about the limits of what is on this page:

Fees depend on what is actually involved. Two teeth that look similar on the surface can need quite different work, so a figure over the phone is a guide and the estimate after an examination is the real number.
We cannot tell you what your health fund will pay. Only your fund can, and only with the item numbers in front of them.
An estimate can change if the treatment changes. If that happens, you hear about it before we continue.
Health fund arrangements and government schemes change. The CDBS cap is indexed every January, and policy limits reset annually, so last year’s figures are not this year’s.

Ask us before you book

If you want a sense of the cost before you commit to an appointment, call us on (02) 6247 9230 and describe what is going on. We will tell you what a visit would likely involve, what the examination costs, and what to ask your health fund. If you are booking for a child, mention the Child Dental Benefits Schedule and we will check eligibility with you.

The practice has been in Civic since 1965, and we would rather have the conversation about cost up front than have you avoid coming in. New patients are welcome. For what an appointment itself involves, see our dental check-ups page; if something is hurting now, start with emergency and urgent care.