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How does private health insurance work?

Private health insurance is similar to other types of insurance. You pay a monthly or yearly fee called a premium.

1.

Getting Referred

If you have a health issue, see your GP and let them know that you have private insurance. They may refer you to a specialist, and you might choose to go to private hospitals or specialists not offered by the NHS.

2.

Informing Your Insurer

Tell your insurer that you want to make a claim. They'll check if your policy covers the treatment you need. If it does, your claim will be approved.

3.

Cost Coverage

Your GP will book your appointment, and your insurer will cover the cost as long as your policy is active. Depending on your policy, you may be required to pay an excess.

What is a dental cover?

Dental cover is a component of health insurance that focuses on taking care of your oral health needs. It includes a range of services, from a regular check-up to handling emergencies and providing treatments like fillings, crowns, and oral surgeries. Here’s how it works: you pay for your dental treatment upfront, whether through a private dentist or the NHS and later, your insurer reimburses you for the expenses. That’s right: even within the NHS, dental care expenses can add up quickly. Also, you have the option to pay an excess, similar to other medical insurance plans.

Does health insurance cover dental?

No, health insurance that covers dental by default isn’t that common. However, some plans offer it as an extra option for an added fee. Alternatively, you can choose standalone dental insurance, where you pay upfront and get reimbursed later.

Just keep in mind, these plans have a limit on how much they’ll cover each year, like £300. Also, whether dental is part of your health insurance depends on the specific policy you choose. Some cover outpatient dental and vision care, and others only cover hospitalisation expenses for related treatments, like accidents or certain health conditions.

What is included in dental cover as part of health insurance?

Dental insurance covers many different treatments and care options to keep your oral health in top shape. Here’s what you can expect:

  • Routine dental treatment — Regular check-ups, x-rays, and basic hygiene.
  • Emergency care — Bleeding, abscesses, or knocked-out teeth.
  • Restorative treatment — Dentures, fillings, crowns, and bridges to fix up any damage.
  • Special situations — E.g., diagnostic tests, surgical interventions, radiation therapy, and other treatments for mouth cancer.
  • Oral surgery — Surgical intervention for impacted wisdom teeth or corrective jaw surgeries.

Just remember to check the specifics of what your insurance covers when you’re signing up for dental cover.

What types of dental care are not covered in health insurance?

Cosmetic dental treatments, like tooth whitening, braces, clear aligners, and veneers, are generally not covered by dental insurance. Also, treatment for pre-existing conditions, such as recurring issues with a root canal, is excluded. Specialised treatments, such as TMJ (temporomandibular joint) disorder therapy or snoring appliances, are unlikely to be in the cover, too.

If you’re unsure about your coverage, consult your insurer and insurance broker.

Why should I have dental cover?

Dental insurance offers several key benefits that make it a smart investment:

Quick access to careYou can skip NHS waiting lists and prevent issues from getting worse while you wait.
Cost controlDental treatments can be expensive and upset your financial plans. Insurance helps manage these costs.
Preventive maintenanceCatching problems early means they’re easier to fix and save you from more treatments down the line.
Better overall healthRegular check-ups can catch signs of serious health issues, even those unrelated to oral health.
Peace of mindYou can relax knowing you’re covered for any dental surprises that come your way.

The benefits ultimately depend on the provider and the specific policy. So, take your time to explore their options thoroughly.

Insurers with dental cover plans

Many of the top insurers in the UK offer dental cover as an additional benefit. Here’s a shortlist to kickstart your search:

Bupa

While dental isn’t automatically included at Bupa, you have the option to opt for it. Here’s what’s included in Bupa’s dental cover:

  • Preventative dental treatment — Includes routine examinations, X-rays, polishing.
  • Restorative dental treatment — Covers problems like cavities or damaged teeth.
  • Dental injury — If you have an accident that injures your teeth or mouth, you’re covered for a variety of treatments to address it.
  • Dental emergency — For situations that require urgent dental care due to severe toothache, infection, or damaged teeth.
  • Oral cancer — Access to expert advice and support throughout the cancer journey.
  • Dental from home — Bupa Dental Care specialists available through phone or video consultations for emergencies or second opinions.

Members can also enjoy discounts on a variety of dental treatments within Bupa’s network. They have 20% off procedures that aren’t covered by the policy — extractions, crowns, bridges, dentures, orthodontic treatment, and periodontal treatment, among others.

AXA Health

AXA offers two levels of dental cover — Core and Premium. The Core cover level takes care of the costs of NHS treatment, and the Premium cover level provides reimbursement for both private and NHS treatments.

The Core dental plan covers:

  • Regular check-ups, cleanings, and treatments for gum disease provided by the NHS.
  • Dental treatments on the NHS for repairing damage or curing dental problems.
  • If you end up in the hospital because of a dental accident or mouth cancer, you’ll get £60 per night for up to 30 nights per year.
  • Even if you smoke, the plan covers treatment for mouth cancer. Members can receive up to £12,000 for one treatment course within 18 months after diagnosis.
  • Worldwide coverage of up to £2,500 for each incident; you can claim up to four times per person each year.

The Premium plan includes everything in Core, plus:

  • 50% coverage towards the cost of private or NHS dental treatment for fixing dental problems, up to a maximum of £1,000 each year per person.
  • For more extensive treatments like bridges, crowns, dental implants, inlays, and onlays, AXA covers up to £500 each year per person after three months of membership.

Members have the option to include their partner on either of AXA’s plans. While children under 18 receive free NHS dental treatment, they can be added to the Premium plan for extra coverage.

As an alternative, you can join the Dentist and Optician Cashback program to get back 80% of dentist fees, up to £400 yearly. The Cashback Plus program boosts these benefits — you’ll get 100% of dentist fees back, up to £500 yearly, without any waiting period. Plus, this plan includes dental accident coverage — up to £10,000 yearly, up to £2,500 cashback per incident, and up to four times maximum

Aviva

Inpatient treatment, such as surgical dental procedures performed in hospitals, is already included in Aviva’s standard health insurance coverage.

On top of it, with the Dental and Optical option, members enjoy additional benefits. This extends coverage to include routine dental and optical expenses. You’ll receive up to £250 for routine treatment, with a £50 excess, and up to £600 of treatment cover following an accident.

Vitality

At Vitality, dental coverage is a separate optical, dental and hearing plan, with benefits for routine dental appointments and treatments, as well as coverage for accidents:

  • 100% of the costs for regular appointments, like check-ups and hygienist visits, up to £100 a year.
  • 80% towards the cost of treatments, such as crowns, fillings, or implants. This coverage extends up to £400 a year.
  • If you have an accident that damages your teeth, they pay the entire bill, up to £2,500 per claim. You can make up to two claims a year.

WPA

WPA offers a separate dental plan called Providental, which provides comprehensive coverage for many dental needs:

  • General dental treatment — Reimbursement is 100% for NHS treatment and 75% of costs up to £250 for private treatment.
  • Dental emergencies — Up to £500 per episode (maximum of 2 episodes) or £1,000 per episode (maximum of 8 episodes)
  • Dental injuries — up to £10,000 or £20,000 coverage.
  • Restorative treatment — Up to £10,000 coverage for dental restoration after oral cancer treatment.
  • NHS hospital cash benefit — £200 per day/night, up to £2,000, for hospital stays due to dental injuries or oral cancer treatment.

Freedom

Under the Freedom plan, you’ve covered if you need certain oral surgeries that can’t be done by a regular dentist and require a specialist. As a standard, they’ll pay the full fees for procedures like:

  • Re-implanting a dislodged tooth
  • Addressing a jaw bone cyst
  • Conducting an apicectomy to remove infected tooth root tips
  • Performing the surgical extraction of impacted teeth

Any outpatient treatment costs related to these procedures will also be covered under the standard plan.

For more, you can opt for routine dental costs as an add-on benefit to the Essentials plan. This covers the full cost, up to £150, for routine dental services. With the Elite plan, you can get coverage for up to £300 for routine dental services and up to £600 for treatment of accidental dental injuries and severe acute pain relief.

If you’re considering purchasing the dental cover, hopefully, this post has made it easier for you to navigate your options.