Does Medicare cover dental treatment?

Medicare doesn’t cover dental – but there are a few exceptions for children and concession card holders.

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Most dental treatments aren't covered by Medicare, which is why most of us take out extras cover. However, if you're a concession card holder or you have children but can't afford to pay, you might be eligible for free dental with Medicare.

Who can get dental coverage under Medicare?

Child

Children

Children aged between 2 and 17 whose parents receive certain Centrelink benefits – such as the Family Tax Benefit Part A – are eligible for the Child Dental Benefits Schedule (CDBS). The benefits are capped at $1,013 per child every 2 years and can pay for examinations, X-rays, cleaning, fissure sealing, fillings, root canals and extractions. It doesn't cover orthodontic, cosmetic or in-hospital dental treatment though.

ID Icon

Concession card holders

Health Care Card, Centrelink Pensioner Concession Card or Department of Human Services (DHS) Card holders are often eligible for free dental through Medicare. State public dental services can cover you for general dental, emergency dental services and, in some cases, referrals to specialist hospital services like orthodontics.

What dental services are covered by Medicare?

If you're eligible for dental through Medicare, you should be able to get treatment for the following services:

  • Diagnostic. These procedures are normally covered if a medical practitioner needs to perform a specific procedure to diagnose a dental issue.
  • Preventative. Procedures such as cleaning and scaling are covered up to certain limits for eligible groups because they prevent larger, more expensive dental issues from developing later in life.
  • Oral surgery. Surgery of the mouth or teeth is sometimes covered. In many cases, though, you will be referred to a hospital and won't receive treatment at the dental clinic.

What dental procedures are not covered by Medicare?

In most circumstances, Medicare doesn't cover dental services if:

  • They are out-of-hospital. Medicare doesn't generally pay a benefit towards out-of-hospital services like physiotherapy, podiatry and dental for most Australians. This includes most dental examinations and treatment.
  • You can afford to pay. The general rule of thumb is, if you can afford to pay for extras cover, you won't be covered by Medicare for dental procedures.
Claim straight away on Private Dental

Need your check up right now? Extras can be a good option. With the Lifestyle Extras plan from ahm, there's no waiting period on general dental from $53.9 monthly. You get other discounts with that too, including physio and new glasses.

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How does private health insurance cover dental?

You can get covered for dental with an extras policy. It can help pay for the following:

General Dental

General dental

Most extras policies cover general dental. Costs start from around $3 a week and many come with no gap dental. This lets you visit any participating dentist and avoid out-of-pocket fees for things like check-ups, cleanings, X-rays and fluoride treatments.

Major Dental

Major dental

Major dental is included with mid-range extras policies which cost around $7 a week and cover treatments like wisdom teeth removal, tooth extractions, dentures and root canal.

Braces

Orthodontics

Orthodontics is included in some extras policies and can help pay for braces and other services such as correcting overbites and underbites.

Compare dental private health insurance

Extras cover can be a great way to cover your dental expenses and can help you skip the Medicare queue if you're in a little pain.

We've rounded up a few of the basic level dental policies from Finder partners. They all have a general dental limit which includes annual check-ups, minor extractions, dental X-rays, minor fillings and teeth cleaning. All these options have a 2-month waiting period.

Name Product Detail Annual Limit Price Per Month Hide CompareBox Apply
ahm black 50 saver
Includes no gap dental check-ups
$400
$12.60
Frank Basic Extras
Get the same amount back each time you visit
$350
$13.55
Peoplecare Simple Extras
50% back
$500
$26.10
Medibank Healthy Start Extras
60% Extras claim back
$500
$26.50
HBF Flex 50
75% Extras claim back
$800
$27.59
Qantas Basic Extras
60% rebate up to your limit
$600
$33.05
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Compare up to 4 providers

Quotes are based on single individual with less than $90,000 income and living in Sydney.

Out-of-pocket costs for dental care

Public system

Medicare

If you're eligible for dental through Medicare, you shouldn't have any out-of-pocket fees, so long as you go to a dentist that bulk bills. You can find a bulk billing dentist near you with the healthdirect health service finder.

Private Contracrt

Private health

You might have some out-of-pocket expenses for dental treatment with extras cover. For example, many policies cover a percentage of the total fee – usually around 50% to 75% – so if you require a tooth extraction and the bill comes to $300, you'll likely still have some out-of-pocket expenses.

Dental care in different states

Queensland icon

Queensland

Who is eligible for public dental care in QLD?

Children who are Queensland residents and/or attend a Queensland school and are eligible for CDBS or are listed as a dependant on a Health Care Card or Pensioner Concession Card. Adults are also eligible if they're entitled to Medicare and hold one of the following:

  • Pension Concession Card
  • Health Care Card

  • Commonwealth Seniors Health Card
  • Queensland seniors card

What dental services are covered in QLD? General and urgent or emergency dental care. You will need to join a waiting list for general treatment. Covered dental services include:

  • Diagnostic services including dental X-rays and check-ups
  • Preventive and early intervention services
  • Individual oral health education
  • Fillings
  • Tooth removal and minor oral surgery

  • Making new or repairing existing dentures
  • Root filling of front teeth
  • Management of simple orthodontic anomalies in children
  • Emergency care to relieve pain

Where can I access public dental services in QLD?

At a local QLD clinic. You can search for your closest here.

New South Wales icon

New South Wales

All children under 18 who are NSW residents are eligible for public dental services in NSW. Adults must be eligible for Medicare and have a Health Care Card, Pensioner Concession Card or Commonwealth Seniors Health Card.

What dental services are covered in NSW?
Emergency and general dental treatment including:

  • Dental trauma or injury
  • Swelling of the face or neck
  • Swelling in the mouth
  • Extractions
  • Fillings

  • Broken or chipped tooth
  • Bleeding or sore gums
  • Loose teeth
  • Other denture requests including broken plate or clasp
  • Check-ups

Where can I access public dental services in NSW?

At local clinics across the state. You can find your local clinic here. NSW Health also provides dental care to 21 Aboriginal Community Controlled Health Services (ACCHS). You can contact your local ACCHS here or on (02) 9212 4777.

For general dental, such as extractions, you may need to wait up to 12 months before receiving treatment, while general check-ups have a 2-year maximum waiting period.

Australian Capital Territory icon

Australian Capital Territory

Who is eligible for public dental care in ACT?

Children aged between 0 and 14 who live or attend school in the ACT, some 14-18 year olds and adults with a Centrelink concession card.

What dental services are covered in ACT?

Canberra Health Services offers general public dental services, emergency treatment and denture services including comprehensive assessments, oral health plans and general preventative, restorative and emergency treatment for children. Adults can also get access to general restorative, dentures and emergency dental services.

Where can I access public dental services in ACT?

At public dental service clinics located in Canberra City, Gungahlin, Tuggeranong and other parts of the ACT. You can find your local clinic here.

Victoria icon

Victoria

Who is eligible for public dental care in Victoria?

Adults must be 18 and over, and hold or be listed as a dependant on a Health Care Card or Pensioner Concession Card. All children up to 12 years are eligible, plus young people aged 13 to 17 years who hold or are dependants on a Health Care or Pensioner Concession Card. All refugees, asylum seekers and people in youth justice custodial care are also eligible.

What dental services are covered in Victoria?

Emergency and general dental treatment including:

  • Bulk-billed dental care for children
  • Free dental work performed by undergraduate dental students
  • Free dental treatment

Fees generally still apply to patients 18 and over who hold or are listed as a dependant on a Health Care Card or a Pensioner Concession Card, and children up to 12 years who do not hold a concession card or are not dependants of concession card holders.

Where can I access public dental services in Victoria?

At your local clinic. You can find a clinic near you by visiting the Dental Health Services Victoria website.

Tasmania icon

Tasmania

Who is eligible for public dental care in TAS?

Oral Health Services Tasmania provides dental and denture services for all Tasmanian adults who hold a Pensioner Concession Card or Health Care Card and dental care for all children up to the age of 18.

What dental services are covered in TAS?

Eligible services for children include:

  • Dental examination/check-up and necessary treatment
  • Preventative treatment (fissure seals)
  • Dietary advice

  • Oral hygiene
  • Mouthguards

And for adults:

  • Check-ups
  • Scale and clean

  • Fillings
  • Dentures

All adults need to pay a co-payment of $45 towards their dental treatment.

Where can I access public dental services in TAS?

There are at least 29 adult, child and teen dental clinics across Tasmania. Find the one nearest to you here.

South Australia icon

South Australia

Who is eligible for public dental care in SA?

All children under 18 years of age at school. Adults must have a Health Care Card or Pensioner Concession Card.

What dental services are covered in SA?

General and emergency dental care is available for children and adults, including orthodontic treatment for children if necessary. There are waiting lists for almost all adult dental services, with wait times depending on the clinic and type of dental care needed. Fees generally still apply for adults receiving general and emergency dental care. Currently, the fee is $63 for emergency services and up to $162 for general co-payments.

Where can I access public dental services in SA?

At one of South Australia's dental service clinics. You can search by postcode or suburb here.

Western Australia icon

Western Australia

Who is eligible for public dental care in WA?

To be eligible, adults must hold a Health Care Card or a Pensioner Concession Card, while all school children aged 5 to 17 are eligible for the School Dental Service program.

What dental services are covered in WA?

Emergency and general dental treatment including:

  • Check-ups
  • Scale and cleaning
  • Extractions
  • Fillings
  • X-rays
  • Fissure sealants

  • Root canal treatments
  • Facial swelling
  • An accident involving damage to your mouth or teeth
  • Dental pain
  • Broken denture

Fees apply to adult services, with a maximum of 75% of the cost subsidised by the Western Australia Government. How much you have to pay will depend on the subsidy you are entitled to receive, which is based on the income you receive from Centrelink.

Where can I access public dental services in WA?

For emergency treatment, contact your local School or Adult Dental Service. You can find your closest here.

Northern Territory icon

Northern Territory

Who is eligible for public dental care in NT? You're entitled to public dental care in NT if you are:

  • A child under 18 years old who is still at school and does not work full time
  • Part of the federal government's cleft lip and cleft palate scheme
  • A Centrelink Pensioner Concession Card or Health Care Card holder
  • A remote resident more than 100km from your nearest health service and require emergency dental care

What dental services are covered in NT?

Routine and emergency dental services are covered under the public system in the NT. These include:

  • Check-ups
  • Pain and trauma management
  • Emergency care
  • Restorative fillings and repairs
  • Endodontics

  • Extractions
  • Oral hygiene
  • Oral health promotion
  • Denture services

And specialist services such as:

  • Orthodontics
  • Oral surgery

  • Dental treatment in hospital under general anaesthetic
  • Special needs dentistry

Where can I access public dental services in NT?

You can find a list of dental clinics here.

Frequently asked questions about Medicare dental

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10 Responses

    Default Gravatar
    ChantelAugust 16, 2019

    My child has to have root canal treatment, the estimated cost is over $3000 dollars, we simply can not afford it, he is only 12. Is it possible to get this done through Medicare/bulkbilling

      Avatarfinder Customer Care
      JeniAugust 17, 2019Staff

      Hi Chantel,

      Thank you for getting in touch with Finder.

      The Child Dental Benefits Schedule (CDBS) only covers up to $1,000 over 2 calendar years for basic dental services like root canals.

      I hope this helps.

      Thank you and have a wonderful day!

      Cheers,
      Jeni

    Default Gravatar
    ChantalJanuary 30, 2019

    I would like to know if the government dental services are as good as the private dentists. I am nervous about going to the dentist, so it’s a big decision for me

      Avatarfinder Customer Care
      JeniJanuary 31, 2019Staff

      Hi Chantal,

      Thank you for getting in touch with Finder.

      Please note that each state and territory has its own public dental program that you may benefit from while private health insurance can provide additional cover for a broad range of dental expenses under both general and major dental cover in extras cover. You may visit the Department of Health page and click on your state to learn more on the dental program, eligibility as well as to find your nearest public dental clinic you may have your oral check up with.

      I hope this helps.

      Thank you and have a wonderful day!

      Cheers,
      Jeni

    Default Gravatar
    BeeDecember 10, 2018

    Hello. My 16 yo needs a root canal. I believe this was to be covered by Medicare under Labor’s retained state gov in Victoria.
    Can you tell me more? Do we access this through an endodontist our general dentist?

      Avatarfinder Customer Care
      JeniDecember 14, 2018Staff

      Hi Bee,

      Thank you for getting in touch with Finder.

      All children and young people up to 18 years of age, who are in out-of-home care provided by the Children Youth and Families Division of the Department of Human Services, are eligible for dental treatments including root canals as per the Dental Health Services Victoria website. You may contact them directly for further clarification on this matter on 1300 360 054 from Monday to Friday, 8AM to 830PM.

      I hope this helps.

      Please feel free to reach out to us if you have any other enquiries.

      Thank you and have a wonderful day!

      Cheers,
      Jeni

    Default Gravatar
    ChantelOctober 10, 2018

    Hello,my daughter had a dental surgery last month which costed 2,300.she had four crowns and filling plus an extraction.i dont know if i can claim some money back from medicsre.thanks

      Avatarfinder Customer Care
      JohnOctober 10, 2018Staff

      Hi Chantel,

      Thank you for reaching out to finder, a comparison website.

      You may need to reach out directly to Medicare regarding this query to ensure that they know what type of surgery was done. This will also give you a better idea of what Medicare could cover based on the surgery done to your daughter. Hope this helps!

      Cheers,
      Reggie

    Default Gravatar
    TimApril 27, 2017

    I am an aged pensioner,i do not have any form of private health cover.Recently i had an abscess on a bottom back tooth.Whilst i was able to claim the visit to the g.p.for the antibiotics to fix the infection .I am wondering wether i can claim the actual dental work the root canals necessary to prevent further problems .the actual cost for the procedure was over $1000 .can i claim some of this cost through medicare
    Thank you

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