PHI delivers record dental benefits, according to APRA

21 May 2019Media Releases

The value of PHI in funding the dental care of Australian consumers has been confirmed by the latest APRA statistics. Health funds paid a record $2.79 billion in dental benefits on behalf of members in the year to March 2019. This represents a 4.4 percent increase in dental benefits paid compared with the previous twelve months.

According to APRA’s March quarterly statistics, dental utilisation rates and benefit growth rates in 2019 are greater than the average premium increase of 3.25% for 2019.

Other key features of the report include:

  • PHI funded 42.7 million dental services in the 12 months to March 2019 (4.1% increase on the previous 12 months)
  • 53% of all extras PHI claims are paid for dental services
  • Dental benefits paid per dental service has increased by +2.6% in the March 2019 quarter compared to the previous December 2018 quarter.

“In recent years health funds have played an increasingly important role in this area of healthcare but more needs to be done,” said PHA Chief Executive Dr Rachel David.

“While the PHI industry had concerns about the open-ended nature of the ALP pensioner dental plan, there’s no question that access to oral healthcare should be a priority for Government and health funds are willing to work with policy makers to achieve this in a sustainable and cost-effective way.

“Health funds have the experience and infrastructure in place to provide a more affordable and accessible dental health system. Health funds are contracting with dentists and vertically integrating with dental practices, thereby consolidating and creating economies of scale. This is driven largely by a need to standardise quality, increase transparency on services provided, and reduce out-of-pocket costs for consumers.

“Reform of the dental health sector should be a priority for policy makers and the focus must be on access, quality, affordability and tackling waste. This can be achieved by working with health funds who have the experience and infrastructure to deliver a better dental health system,” said Dr David.


Media contact: Jen Eddy 0439 240 755