Does Medicare cover dental treatment?

Most dental treatments aren't covered by Medicare, which is why most of us take out extras cover. However, there are a few circumstances where you may be eligible for some dental procedures under Medicare and can avoid paying a hefty bill, depending on your state's rules.

How do I get dental coverage with Medicare?

Medicare only covers some dental and under specific circumstances. You may be able to access free dental coverage through:

Child Dental Benefits Schedule (CDBS)

This is open to children across Australia who are aged between 2 and 17 years, are eligible for Medicare and whose parents receive certain Centrelink benefits such as the Family Tax Benefit Part A, carer payment or disability support pension. The benefits are capped at $1,000 per child every two years and they cover services such as examinations, X-rays, cleaning, fissure sealing, fillings, root canals and extractions. It doesn't cover orthodontic, cosmetic or in-hospital dental treatment though. You can claim at the dentist when you pay, through myGov, a Medicare claim form or the Express Plus Medicare app.

State public dental services

Every state is slightly different but generally, you can get access to some public dental treatments if you:

• Are eligible for Medicare and are a resident of the state you're in, and
• Have a Health Care Card, Centrelink Pensioner Concession Card or Department of Human Services (DHS) Card.

State public dental services can cover you for general dental, emergency dental services and in some cases, referrals to specialist hospital services like orthodontics. You can find out more about state eligibility below.

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?

Medicare doesn't generally pay a benefit towards out-of-hospital services like physiotherapy, podiatry and dental. This includes most dental examinations and treatment. They may only make an exception if you can't afford to pay for dental treatment; for instance, if you're a concession card holder or a child whose parents receive specific Centrelink benefits.

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. Extras policies start at around $3 a week, so it's pretty affordable, especially if you find a health fund that offers 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.

Another handy way to save is by using a provider that uses Afterpay so you don't have to pay for your dental bill all at once.

Compare private dental options

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.

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Name	Product	Detail	Annual Limit	Price Per Month	Hide CompareBox	Apply
ahm black 50 saver		Includes no gap dental check-ups	$400	$12.60		1300 670 233 Go to Site More Info	Compare	loading Fetching your data...
Frank Basic Extras		Get the same amount back each time you visit	$350	$13.55		Go to Site More Info	Compare	loading Fetching your data...
Peoplecare Simple Extras		50% back	$500	$26.10		1300 717 481 Go to Site More Info	Compare	loading Fetching your data...
Medibank Healthy Start Extras		60% Extras claim back	$500	$26.50		1300 179 942 Go to Site More Info	Compare	loading Fetching your data...
Qantas Basic Extras		60% rebate up to your limit	$600	$33.05		1300 641 719 Go to Site More Info	Compare	loading Fetching your data...

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Does Medicare cover wisdom teeth removal?

You might be able to get some help paying for wisdom teeth removal depending on your circumstances and the state you live in. Some states, including NSW, WA and NT, may partially cover extractions. 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.

Public waiting times can be as long as 12 months too, which may lead to more serious problems if you're not seen to quickly enough. If you want to be treated quickly, you can get wisdom tooth removal with most major dental policies, which start at around $25 a month.

How to find a bulk billing dentist

To avoid out-of-pocket expenses at the dentist, make sure you go to a dentist that bulk bills. You can find a bulk billing dentist near you with the health direct health service finder. They're available to people who hold a Medicare card and one of the following:

• Health Care Card
• Pensioner Concession Card
• Commonwealth Seniors Health Card

You can also get bulk billing through the Child Dental Benefit Schedule.

Medicare dental cover in New South Wales

Who is eligible for public dental in NSW?

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:

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.

Medicare dental cover in 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 and 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.

Medicare dental cover in 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:

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, your local School or Adult Dental Service. You can find your closest here.

Medicare dental cover in 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:

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:

Where can I access public dental services in QLD?

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

Medicare dental cover in the 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.

Medicare dental cover in the 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:

And specialist services such as:

Where can I access public dental services in NT?

You can find a list of dental clinics here.

Medicare dental cover in 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 $62 for emergency services and up to $160 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.

Medicare dental cover in 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:

And for adults:

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.

Use the free comparison tool to compare dental options

Think you may need something a bit more comprehensive? Or want to grab a few extra health perks? Simply enter your details on our health insurance tool.

For dental only, select extras then hit Search Policies. You can use the filters to sort policies by general dental, major dental, endodontic and orthodontic limits.

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