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Health insurance for wisdom teeth and dental surgery

How to avoid large out-of-pocket costs for your wisdom teeth surgery. 

two people looking at an x-ray scan of wisdom teeth
Last updated: 21 March 2022
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Checked for accuracy by our qualified fact-checkers and verifiers. Find out more about fact-checking at CHOICE.

Need to know

  • If you opt to have wisdom teeth surgery in hospital, you need both hospital and extras insurance
  • Always check with your dentist and health fund to clarify costs before agreeing to any procedure
  • Public dental cover is also available for some people but waiting times can be long

Wisdom teeth can often cause problems like overcrowding of the existing teeth, and your treatment options and costs will depend on several factors, like if you need only one or several removed and the general complexity of the situation. 

Your dentist will take an X-ray and may recommend treatment in the dentist's chair at your dental surgery or in hospital under general anaesthesia. If you choose to have your wisdom teeth removed in a dental surgery, you may be able to have a portion of the fee covered under your extras policy.

However, if you opt to have the teeth extracted in hospital, you may find yourself facing additional out-of-pocket costs.

What are wisdom teeth?

Wisdom teeth, also called third molars, are the very back teeth at your upper and lower jaw and usually appear in your late teens or early twenties.

Some people never develop wisdom teeth and for others they don't cause any problems.

But quite often people's jaws aren't big enough to allow the wisdom teeth to take up their correct position. This can cause difficulties in cleaning the teeth and could lead to tooth decay, gum problems or infections and even mouth ulcers if a wisdom tooth leans sideways and rubs against the cheek.

How much does wisdom teeth surgery cost?

For the extraction of one tooth or part of a tooth, the median cost is $159 ($83 health insurance benefit, $76 out-of-pocket costs).

Source: Australian Institute for Health and Welfare in 2017/18.

The cost of wisdom teeth removal varies depending on where you live, your clinical circumstances, the treatment options open to you, and which of those you choose.

simple case at your regular dentist (including local anaesthetic) can cost, on average, between $175 and $230 per tooth.

A complex case in hospital or day surgery carried out by a specialist (day surgery and anaesthetist fee not included) can cost, on average, between $385 and $475 per tooth.

Source: Australian Dental Association (ADA) fee survey from 2020.

What health insurance cover do you need for wisdom teeth?

There are a number of different costs involved with wisdom teeth surgery depending on the treatment you choose, but extras cover is essential. Even if you have your treatment in hospital you'll need to have extras cover to claim anything back on the surgical fee.

Even if you have your treatment in hospital you'll need to have extras cover to claim anything back on the surgical fee

Extras health insurance policies cover extractions under general anaesthetic or major dental, and waiting times (if you take out extras cover for the first time) can be up to 12 months.

Wisdom teeth surgery at the dentist

You only need extras cover. Wisdom teeth surgery at your dentist is considered an out of hospital service and your hospital policy won't cover you.

Wisdom teeth surgery in hospital

You need extras and hospital insurance. Hospital cover pays a benefit for the hospital admission part of the costs including accommodation, theatre fees and anaesthetist, while extras cover pays a benefit towards your dentist/surgeon's surgical fee.

Cheapest hospital policies covering wisdom teeth

Dental surgery is covered by all Silver hospital policies. However, some Bronze Plus policies also cover dental surgery and they're generally cheaper than Silver hospital cover. The cheapest ones include:

  • HBF Bronze Hospital Plus ($750 excess)
  • Phoenix Bronze Plus Essentials ($750 excess).

Bupa and Medibank also offer Bronze Plus policies including dental surgery cover:

  • Bupa Bronze Plus Simple Hospital ($750 excess)
  • Medibank Bronze Plus Progress ($750 excess).

If you take out hospital insurance for the first time or switch to a policy that covers dental surgery, you'll have to serve a waiting period of 12 months for a pre-existing condition.

To help you look at health insurance policies from more than 36 insurers, our experts have created a tool which lets you compare health insurance so you can find the best deal for you.

Does Medicare cover wisdom teeth removal?

Medicare does not cover dental costs. However, there are some public dental services that provide some cover.

Public dental care

Public dental care is available only to a limited segment of the Australian population and waitlists can be very long. Eligibility requirements for public dental care vary across states and territories but it's usually available to those with a healthcare or pensioner concession card.

Child Dental Benefits Scheme

Many families can use the Child Dental Benefits Scheme, which is available if you get an eligible payment from Centrelink such as Family Tax Benefit Part A and have a child up to 17 years old and eligible for Medicare.

Each child can receive $1026* for basic dental services, including extraction, and can use it at most dentists. The payment is indexed each year and capped for a two-year period. For more information, contact Services Australia.

*Two-year period starting at 1 January 2022.

Questions to ask your dentist and health fund

Ask your dentist or oral surgery specialist:
  • for an estimate of fees for wisdom tooth extraction, including aftercare (such as removing stitches)
  • for the item numbers for each service 
  • for the name of the anaesthetist so that you can contact them for an estimate of their fees (if you're going to hospital).
Call or email your insurer:
  • to check if your extras and hospital policy cover wisdom tooth extraction and if you've served all relevant waiting times
  • to give them the item number and ask how much of the dental/oral surgeon fee they'll cover.
If you're going to hospital, ask:
  • whether the hospital is an agreement hospital and if you'll be fully covered for accommodation and theatre costs
  • how much of the anaesthetist fee you'll be covered for
  • if there are any other out-of-pocket costs.
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