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How we do no gap with your health fund
Most “no gap” dental offers apply only inside one fund’s own network. Allura Dental in Truganina works the other way round: one published price for the comprehensive first visit, the same whatever fund you are with, and your fund’s benefit claimed against it at the desk.
How it works at the desk
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1Before
Bring your card
Whichever fund issued it. We check your entitlement through HICAPS before anything begins.
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2Then
Your benefit comes off
The fund’s benefit is worked out on our published fee and deducted on the spot, not claimed back later.
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3And
You hear any difference first
If the benefit comes to less than the fee, you are told the figure before treatment starts.
Three worked examples
Say the comprehensive first visit is claimed against a policy with preventive dental cover. What you pay depends entirely on what your own policy returns:
| Your situation | Fund pays | You pay |
|---|---|---|
| Full preventive limit available, benefit meets the fee | the full fee | nothing — no gap |
| Percentage policy, part of the limit already used | most of the fee | the difference, told to you first |
| Limit exhausted for the year | nothing | the published fee, nothing above it |
The fee does not move. It is the same number whether your fund pays all of it, some of it or none of it — so the worst case is known before you book, which is not true of an hourly or itemised quote.
If you are with nib
Allura Dental is a participating nib No Gap dentist and First Choice provider, for eligible nib Extras members. nib pays the full agreed price for an included preventive visit, for eligible members, up to two a year, with waiting periods and annual limits applying — and nib publishes the list of items that are included. The nib No Gap dentist page sets out that list and what nib pays at each kind of practice.
nib issues the cover sold under Qantas, AAMI, Apia, Suncorp, ING, Real, Australian Seniors and GU Health, and each of those brands lists Allura Dental in its own provider search — what your policy pays still follows that policy’s own terms, waiting periods and limits. What that means when you book.
Everyone gets the same inclusions
The part that does not depend on any fund: intraoral photos (ADA item 072) are included for every patient whatever fund you hold. Most practices bill them separately or skip them. We claim them against your general dental cover where you have one, and cover the rest — it is the practice’s own inclusion, not part of any health fund arrangement.
Making the benefit go further
Whether you end up with a gap is decided as much by your remaining limit as by your fund’s generosity, and most policies hold separate preventive and general limits with their own per-person and per-policy caps. A family that books four cleans in December can empty one pot and leave the other unspent when it expires.
Worth reading before you book the family in: how to get the most from your family’s dental cover sets out how the two limits work, with the arithmetic, and the order to do things in so nothing expires unused.
Ask us how
Bring the card and the question. We will check what your cover returns, tell you the figure before anything begins, and say plainly what is worth doing now and what is better left until your limits reset.
Questions
Common questions
Do you bulk bill or offer no gap with my health fund?
Allura Dental in Truganina publishes one price for the comprehensive first visit, the same whatever fund you are with, and claims your fund’s benefit against it at the desk through HICAPS. If your health fund covers the full cost there is nothing more to pay on the day; if it covers part, you are told the difference before treatment starts.
Do I have to be with a particular fund?
No. The published price is the same for every patient, and the practice is a HICAPS partner with every Australian health fund, so your benefit comes off at the desk whichever fund issued your card. Being inside a fund’s own preferred network changes how that fund calculates the benefit, not whether you can be seen.
What if my annual limit has run out?
You pay the published fee, and nothing above it. A fund benefit is paid from your annual limit, so once that limit is used there is nothing left for it to draw on. Most policies hold separate preventive and general limits, so one being exhausted does not always mean the other is.
Is Allura Dental an nib No Gap provider?
Yes. Allura Dental is a participating nib No Gap dentist and First Choice provider, for eligible nib Extras members, with waiting periods and annual and service limits applying. The nib page sets out the item list nib includes and what the network pays.
Will I know what I am paying before treatment?
Always. Your entitlement is checked through HICAPS before anything begins, and anything beyond the visit itself is quoted in writing with item numbers, so you can check it against your own cover before you agree to it.
Related
Related reading
nib No Gap dentist
The item list, what nib pays, and the suburbs we see members from.
Get the most from your family’s dental cover
How preventive and general limits work, and the order to do things in.
Payment & Health Funds
HICAPS claiming, CDBS for eligible children, and interest-free options.
This article is general information, not dental advice. Individual treatment suitability is assessed by a registered dentist in person.
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