It's a brutal choice facing thousands of Australian pensioners every morning: do I pay the electricity bill, or do I fix that nagging toothache?
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The cost of living is forcing 61 per cent of older Aussies to skip the dentist, according to new research.
Dental care around the country is not covered by Medicare for people who don't hold a relevant concession, such as a pensioner concession card or health care card.
And for those eligible, public dental clinics may have long wait lists for non-urgent procedures, and access differs in each state.
Insurance company iSelect investigated how over-55s approach and think about healthcare.
A spokesperson said the results "(raise) concerns about the impact on health outcomes among older demographics".
Andres Gutierrez, the general manager of health at iSelect, said the results show access alone "isn't enough".
"There's a need for greater awareness, affordability, and encouragement to make preventive health care a routine part of life," Mr Gutierrez said.
If you do put off a check-up this year, you aren't the only one.
Read more from The Senior:
'Concerning' given disease
A 2024 report from the Australian Institute of Health and Welfare said although older Aussies are generally living longer, many live with chronic health conditions.
Some of these include heart and kidney disease, arthritis, oral and tooth issues, hearing and eyesight problems, and mental ill health.
Mr Gutierrez said certain visits become increasingly important with age and "help maintain quality of life and independence".
Despite a link with age and declining sensory health, over half of 65+ years olds didn't believe getting a hearing test was needed.
Mr Gutierrez said this mindset can be influenced by a lack of symptoms or underestimating the risk.
"This can be risky for older adults ... with conditions that are easier to manage if detected early," Mr Gutierrez said.
"While services exist, many older demographics are not using them, often due to cost, lack of awareness, or the belief that check-ups aren't necessary."
Three in four (71.4 per cent) people aged 55-64 delayed or skipped a hearing appointment in the last year. Dental checks followed, with only a third (33.3 per cent) doing so when recommended.
"This is concerning, given that age-related hearing loss and tooth decay can gradually occur," he said.
Many Aussies delayed or skipped a skin check, which are crucial for early detection of skin cancer.
More than 40 per cent of those aged 55-64 said cost is the reason they skipped or delayed physiotherapy sessions.
Subsidised physiotherapy is available for eligible pensioners through a chronic disease management plan for conditions lasting for at least six months in NSW, Tasmania, WA, SA, NT, and the ACT. It is free for eligible pensioners in Queensland.
Where to get cheaper dental care
If you happen to have private health insurance, look for "no gap" dental providers where you incur minimal (or none) out-of-pocket expenses.
In NSW, Queensland, and the Northern Territory (NT) people with a pensioner concession card can access free public dental care.
This includes services for emergency care, routine check-ups and treatments (such as fillings and extractions) and other general dental care.
In the NT people in remote areas or requiring emergency care may be eligible for free care. There are also schemes, for people with cleft lip and palate, in place.
In Victoria, pensioner concession card holders are eligible for subsidised dental care through the state's voucher schemes.
Eligible people can also get dental care from a private provider through the scheme.
Services at the dental teaching clinic are free for concession card holders, and emergency dental care is covered by the Victorian emergency scheme.
At the Royal Dentist Hospital Melbourne (RDHM), the maximum limit to pay for a course of general care is around $128, and $394 for specialist care.
In the ACT, the maximum is $550.30 for general care, and $52.50 for emergency care.
Denture repair has a minimum co-payment of $52.50.
For eligible Tasmanians the co-payment is up to $166 and $65 for emergency care.
But, veterans with concession entitlements are not covered.
South Australia (SA) also gives subsidised dental care for eligible pensioners with costs capped at a certain amount.
In Western Australia (WA), dental care for eligible pensioners covers around 50 to 75 per cent of the cost of treatment and is based on Centrelink income.
There may be little to no out-of-pocket costs for some veterans with gold or white cards, depending on entitlements.
The state also has an aged care program that gives participating centres access to a free annual dental screening examination and oral care plan.
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