Does Bupa Cover Mouthguards?

Dental insurance mouth guard coverage depends on the insurance company’s healthcare policies and the type of guard you’re purchasing. For example, Bupa covers custom mouth guards prescribed for medical conditions like sleep apnea or bruxism (teeth grinding). Usually, it does not fully cover the generic sports mouth guards. Their benefits vary with extra covers, waiting periods, and annual limits.

Generally, dental insurance companies only cover custom-made mouthguards prescribed for specific medical conditions.

Factors that Affect the Dental Insurance Mouth Guard Coverage

Dental Insurance mouth guard coverage isn’t always straightforward. Certain significant factors contribute to your mouth guard coverage. Such as the type of guard, whether it is custom-fitted, boil-and-bite, or an over-the-counter one. Moreover, the reason for its usage, whether it's being used for a sports injury or sleep apnea, and lastly, its policy factors. These factors determine if your insurance will cover the cost or not.

Reason for the Use of a Mouth Guard

The medical condition you need the mouth guard for is a significant factor. If you’re struggling with bruxism (teeth grinding) or any sports-related dental injury, insurance will consider you as a serious applicant for dental insurance.

Policy Details for Private Health Insurance Mouth Guard

The applicant or the patient must understand the terms and conditions. With that, they also need to know the difference between dental and medical insurance. The insurance medical companies' policies are different in terms of preventive care and dental appliances, which the patient must understand.

How to Apply for Mouth Guard Insurance?

Getting coverage for a mouth guard can be a time-consuming process. First, you need to have an insurance provider, then you need to submit the pre-authorization. Then, after confirming with your dental office, you will be offered certain funding plans. Let's explore how these four steps will be followed.

Consulting the Insurance Provider

To assess the overall coverage, you need an insurance provider. In case if the condition is included under the company’s policy, you’ll be eligible; otherwise, your provider has to look for other options.

Prepare a Pre-Authorization to Submit

To evaluate your medical necessity and the relevance of the procedure, a pre-authorization is needed. Along with that, the coverage under a medical or dental plan is also included in your pre-authorization.

Verify the Details from the Dental Office

Your dental office will confirm certain policies and ensure that the plan covers your medical condition. They will also address any unnecessary costs or required documentation.

What is the Right Funding Plan for You

Different health insurance providers offer varying funding options based on your medical needs and policy type. Mouth guard plans vary from one company to another. For example, the Bupa medical insurance plan is available on their website. You could find the right insurance plan, pick your mouth guard, understand the coverage policies, and make the claim.

Is It Possible to Get Bupa’s Dental Claim or Rebates?

Bupa mouth guard policies vary for Australian members with extras. Eligible members can claim rebates, even 100% back at Members First Ultimate clinics, but understanding policies is essential before making claims.

Bupa’s Mouth Guard Dental Claims

Members can usually submit their mouthguard claims through the myBupa app or via their dentist if they’re a Bupa-recognised provider.

Bupa’s Health Fund Rebates For Mouth Guards

Bupa members may receive health fund rebates for custom-made mouthguards under extras coverage. The policies differ by the type of mouth guard, the network of the provider, and your annual dental limits for dental services, so reviewing specific terms is essential.

Make the most of your mouth guard insurance

Your medical condition and the insurance policies should go hand in hand. Ensure your insurance package covers your dental needs and that their financial plan is affordable. Only this way will you be able to secure the right mouth guard protection without unexpected expenses.

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