How will my SmartTeeth dental rebate be calculated?

We'll pay a percentage of the dentist’s fee, up to a set maximum benefit for each item of service. For example, with our Premium Options Extras, you get:

  1. Top 24 general dental services: 80% to 100% of the fee, up to a set maximum benefit per item.
  2. All other general dental services: 70% of the fee, up to a set maximum benefit per item*.
  3. All other (i.e. major) dental services: 60% of the fee, up to a set maximum benefit per item*.
* Benefits  differ for Vital Options cover. Benefits may also be limited where potential rebates exceed dental service sub-limits or annual limit. Please contact us for more details on these services.

Here's your at-a-glance guide to our top dental services and benefits.

Item NameItem#Visit/ServiceExtras Benefit Payable
   Premium OptionsSuper OptionsSpecial OptionsSaver Options
   % of provider fee up to the set maximum benefitSet maximum benefit payable by HIF% of provider fee up to the set maximum benefitSet maximum benefit payable by HIF% of provider fee up to the set maximum benefitSet maximum benefit payable by HIF% of provider fee up to the set maximum benefitSet maximum benefit payable by HIF
Comprehensive Oral Examination011First visit100%$59.25100%$59.25100%$59.25100%$59.25
Subsequent visits80%$47.4080%$47.4080%$47.4080%$47.40
Periodic Oral Examination012First visit100%$52.75100%$52.75100%$52.75100%$52.75
Subsequent visits80%$42.2080%$42.2080%$42.2080%$42.20
Oral Examination - Limited013All visits80%$31.4070%$27.4565%$25.5065%$25.50
Consultation014All visits80%$38.6570%$33.8065%$31.4065%$31.40
Intraoral Periapical or Bitewing022All visits80%$27.3070%$23.9065%$22.2065%$22.20
Removal of Plaque and/or Stain111First visit100%$61.50100%$61.50100%$61.50100%$61.50
Subsequent visits80%$49.2080%$49.2080%$49.2080%$49.20
Removal of Calculus114First visit100%$107.15100%$107.15100%$107.15100%$107.15
Subsequent visits80%$85.7080%$85.7080%$85.7080%$85.70
Bleaching - Internal (per tooth)117All visits70%$92.1565%$85.5560%$79.0060%$79.00
Bleaching - External (per tooth)118All visits80%$38.9570%$34.1065%$31.6565%$31.65
Topical Application of Remineralising Agent121First visit100%$31.60100%$31.60100%$31.60100%$31.60
Subsequent visits80%$25.3080%$25.3080%$25.3080%$25.30
Provision of a Mouthguard (indirect)151First visit100%$116.25100%$116.25100%$116.25100%$116.25
Subsequent visits80%$93.0080%$93.0080%$93.0080%$93.00
Bi-maxillary Mouthguard153First visit100%$171.50100%$171.50100%$171.50100%$171.50
Subsequent visits80%$137.2080%$137.2080%$137.2080%$137.20
Fissure Sealing161All visits80%$36.6570%$32.0565%$29.7565%$29.75
Removal of Permanent Tooth311All visits80%$98.4570%$86.1565%$80.0065%$80.00
Metallic Restoration (amalgam, direct)511One surface70%$63.8565%$59.3060%$54.7060%$54.70
512Two surfaces80%$92.5070%$80.9565%$75.1565%$75.15
513Three surfaces80%$106.1070%$92.8065%$86.2065%$86.20
Adhesive Restoration - Anterior521One surface80%$82.9070%$72.5065%$67.3565%$67.35
522Two surfaces80%$99.6070%$87.1565%$80.9065%$80.90
523Three surfaces80%$115.6570%$101.2065%$93.9565%$93.95
Adhesive Restoration - Posterior531One surface80%$92.0570%$80.5565%$74.8065%$74.80
532Two surfaces80%$117.1070%$102.5065%$95.1565%$95.15
533Three surfaces80%$136.9070%$119.8065%$111.2565%$111.25
Pin Retention575Per pin80%$21.3070%$18.6065%$17.3065%$17.30
Cusp Capping577Per cusp80%$26.1570%$22.9065%$21.2565%$21.25

SmartTeeth maximum dental rebate example.

Mary is covered under Super Options and she visits her family dentist who completes Mary’s first oral examination and her first plaque removal in the calendar year. As recommended by her dentist, Mary has a second (6 monthly) examination later that year. The following table is an example of the dentist’s fee and the rebates Mary will attract.

Dental ItemDescriptionDentist FeePercentage of FeeMaximum PayableRebate Paid to Mary
011Comprehensive Oral Examination (first visit)$55.00100%$59.25$55.00
114Removal of calculus (first visit)$120.00100%$107.15$107.15
012Periodic Oral Examination (second visit)$55.0080%$42.20*$42.20
* Figure represents 80% of the maximum rebate which is the maximum amount payable for subsequent visits.

So good, even dentists are smiling.

SmartTeeth must be good because HIF is the only corporate partner health fund of the Australian Dental Association of Western Australia (ADAWA). And talking of dentists, we don’t restrict you to ‘contracted suppliers’ like some of the other big private health funds do. So, as long as your preferred dentist is legally qualified to practise in Australia (and therefore recognised by HIF), you’re free to see whichever one you want. Find out more.

HIF dental annual limits.

IMPORTANT: Before commencing any dental treatment, please contact us with full details of the necessary dental service (as provided by the dentist) and we'll provide you with an estimate of your refund.

PremiumYear 1Year 2Year 3Year 4Year 55 Years+
General - UnlimitedNo LimitNo LimitNo LimitNo LimitNo LimitNo Limit
General - Limited$1,500$1,800$2,100$2,400$2,700$3,000
Inlay / Onlay$1,000$1,100$1,200$1,300$1,400$1,500
Denture, Crown, Bridge$1,200$1,300$1,400$1,500$1,600$1,700
Periodontic and Endodontic$700$800$900$1,000$1,100$1,200
Orthodontic lifetime limit and instalment payments*$1,500$1,800$2,100$2,400$2,700$3,000
Annual Limit per Person$1,500$1,800$2,100$2,400$2,700$3,000
SuperYear 1Year 2Year 3Year 4Year 55 Years+
General - UnlimitedNo LimitNo LimitNo LimitNo LimitNo LimitNo Limit
General - Limited$1,150$1,350$1,550$1,750$2,050$2,350
Inlay / Onlay$700$800$900$1,000$1,100$1,200
Denture, Crown, Bridge$900$1,000$1,100$1,200$1,300$1,400
Periodontic and Endodontic$500$600$700$800$900$1,000
Orthodontic lifetime limit and instalment payments*$1,300$1,500$1,700$1,900$2,200$2,500
Annual Limit per Person$1,300$1,500$1,700$1,900$2,200$2,500
Special OptionsYear 1Year 2Year 3Year 4Year 55 Years+
General - UnlimitedNo LimitNo LimitNo LimitNo LimitNo LimitNo Limit
General - Limited$800$950$1,150$1,350$1,550$1,750
Inlay / Onlay$500$600$700$800$900$1,000
Denture, Crown, Bridge$600$700$800$900$1,000$1,100
Periodontic and Endodontic$300$400$500$600$700$800
Orthodontic lifetime limit and instalment payments*$1,000$1,200$1,400$1,600$1,800$2,000
Annual Limit per Person$1,000$1,200$1,400$1,600$1,800$2,000
Saver OptionsYear 1Year 2Year 3Year 4Year 55 Years+
General - UnlimitedNo LimitNo LimitNo LimitNo LimitNo LimitNo Limit
General - Limited$750$850$950$1,050$1,150$1,250
Inlay / OnlayNot coveredNot coveredNot coveredNot coveredNot coveredNot covered
Denture, Crown, BridgeNot coveredNot coveredNot coveredNot coveredNot coveredNot covered
Periodontic and EndodonticNot coveredNot coveredNot coveredNot coveredNot coveredNot covered
Orthodontic lifetime limit and instalment payments*Not coveredNot coveredNot coveredNot coveredNot coveredNot covered
Annual Limit per Person$750$850$950$1,050$1,150$1,250

For benefits relating to our new entry-level cover 'Vital Options', please refer to the Vital Options Product Overview Page

Please note:
  • Refunds are paid only on accounts rendered by a registered Dentist or Dental Prosthetist. The Dentist or Dental Prosthetist must be in private practice.
  • Benefits for replacement dentures and partial dentures are not paid within three years of previous supply.
  • There are some items within item code ranges for which the fund does not pay a benefit, or if they are performed with another item in the same course of treatment.
  • Limits apply to the  number of times some items, such as bleaching attract a rebate.
  • Dental Prosthetists are allowed to perform a limited range of services for benefit purposes.
  • *The Orthodontic limit is a lifetime limit and forms part of the overall annual limit. Benefits towards orthodontic treatment (including payment plans) are not payable if treatment has commenced prior to joining HIF. Please refer to important information about your dental cover on page 46 of our PDS.

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