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What you need to know
Most dental treatments are not covered by Medicare, which is why most of us take out extras cover.
This can be a great way to cover your dental expenses and can help you skip the Medicare queue if you are in a little pain.
However, if you are a concession card holder or you have children but cannot afford to pay, you might be eligible for free dental with Medicare.
Who can get dental coverage under Medicare?
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.
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.
Which 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.
You can get covered for dental with an extras policy. It can help pay for the following:
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 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.
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
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.
We update our data regularly, but information can change between updates. Confirm details with the provider you're interested in before making a decision.
All prices are based on a single individual with less than $90,000 income and living in Sydney.
Out-of-pocket costs for dental care
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 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.
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
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
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
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?
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
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
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
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
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Frequently asked questions about Medicare dental
No, Medicare doesn't generally pay for dental because it's an out-of-hospital service – this is something that the Australian public healthcare system doesn't cover.
Only children whose parents are eligible for certain Centrelink payments and some concession card holders can get dental cover under Medicare.
Some states, including NSW, WA and NT, may partially cover wisdom teeth removal. However, you'll need a valid medical reason for having your wisdom teeth removed. Make sure you speak to someone at your state's local clinic about getting financial assistance (you can find information on this below) and go to a bulk billing dentist – otherwise a tooth extraction can cost a lot with no private health insurance to help out.
You'll need an extras policy to get covered for dental. They start from around $3 a week and can cover general dental which includes check-ups, X-rays and some extractions. More mid-range and comprehensive policies cost a few dollars a week more and can help pay for treatment such as wisdom tooth removal and orthodontics.
Gary Ross Hunter is an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, news.com.au, The Telegraph, Explore Travel and Escape. Gary holds a Kaplan Tier 1 General Insurance (General Advice) certification and a Kaplan Tier 1 Generic Knowledge certification which meets the requirements of ASIC Regulatory Guide 146 (RG146).
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