Most health fund extras policies pay part of the cost of dental care, and you pay the difference, called the gap.
Published 13 October 2026
Most health fund extras policies pay part of the cost of dental care, and you pay the difference, called the gap. At Dentist @ Burswood, we claim from your fund on the spot with HICAPS, so you only pay the gap before you leave. How much you get back depends on your fund, your level of cover and whether your dentist is a preferred provider.
What does extras cover pay for?
Dental is part of extras cover, not hospital cover. Most policies split dental into two groups:
General dental: check-ups, X-rays, scale and cleans, fluoride and simple fillings.
Major dental: treatment like crowns, bridges, root canals, dentures and orthodontics, depending on your policy.
Lower levels of cover may only include general dental, so check what your policy includes before booking larger treatment.
What is a preferred provider?
A preferred provider has an agreement with your health fund that usually means bigger rebates and lower out-of-pocket costs for you. Dentist @ Burswood is a preferred provider for HBF, Bupa, Medibank, HCF, NIB and CBHS, and accepts all major health funds.
What each preferred provider program means
HBF: HBF members usually get reduced out-of-pocket costs, and we bill HBF directly through HICAPS on the day.
Bupa Members First: predictable out-of-pocket costs for most dental services, and 60 to 100% back on general dental depending on your level of cover.
Medibank Members' Choice: eligible members can get 100% back on their yearly check-up and clean, excluding X-rays.
HCF More for Teeth: eligible members get maximum cover on preventive care, including up to two exams and two scale and cleans a year.
NIB: lower out-of-pocket costs on many treatments, depending on your NIB policy.
CBHS Choice Network: selected policies have no out-of-pocket costs for preventive treatments like exams, X-rays, a scale and clean and fluoride.
Program details can change, so check with your fund for your exact cover.
What is the gap?
The gap is the difference between the treatment fee and what your fund pays back. Being treated by a preferred provider usually makes the gap smaller.
How HICAPS works
HICAPS lets us claim your rebate from your health fund while you're at the practice. Bring your health fund card, we swipe it at the end of your visit, and you only pay the gap. There's no claim form to fill in and no waiting for a refund.
Annual limits: use it or lose it
Most extras policies have a yearly limit on how much they pay for dental. Limits usually reset each calendar or financial year, depending on your fund, and unused limits usually don't carry over. Booking your check-up and clean before your limit resets is an easy way to get value from your cover.
Waiting periods
New policies usually have waiting periods before you can claim, often shorter for general dental and longer for major dental. If you've just joined or upgraded your cover, check your waiting periods before booking.
Other ways to cover dental costs
Child Dental Benefits Schedule: eligible children aged 2 to 17 are bulk billed under the Medicare CDBS for check-ups, X-rays, cleans, fissure sealants, fillings, root canals and extractions. Check eligibility in your Medicare online account.
Pensioner and Health Care Card holders: subsidised dental care through the WA Government's Dental Health Services program. Call (08) 9361 2796 to check what's covered.
Veterans: we work with the Department of Veterans' Affairs. Gold Card holders are covered for a broad range of dental care, and White Card holders for treatment related to accepted conditions.
Afterpay: spread the cost of treatment over four instalments.
How to make the most of your cover
Check what your policy includes for general and major dental.
Ask us for a written quote, then check your rebate with your fund.
Book your check-up and clean before your annual limit resets.
Bring your health fund card to every visit.
Questions about your cover?
Call Dentist @ Burswood on (08) 9361 2796 and we'll help you understand what your fund covers. You can also book online or read more about health funds and payment at our Rivervale practice.
Need help now?
Dentist @ Burswood is a dental practice in Rivervale, open six days a week with gentle, unhurried care for Burswood, Rivervale, Victoria Park, Lathlain, Belmont, East Perth, Kewdale and Carlisle.