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Medicare Teen Dental Plan

What is the Medicare Teen Dental Plan?

On 1 July 2008, the Australian Government introduced the Medicare Teen Dental Plan to help with the cost of an annual preventative dental check. The program aims to make it more affordable for eligible families to keep their teenagers’ teeth in good health.

Who is eligible under the Medicare Teen Dental Plan?

To be eligible under the Medicare Teen Dental Plan a teenager must be:

  • aged 12-17 years, and
  • eligible for Medicare, and
    • receiving Family Tax Benefit Part A (FTB A), ABSTUDY, Carer Payment, Disability Support Pension, Parenting Payment, Special Benefit, Youth Allowance; or
    • their family/carer/guardian receives Family Tax Benefit Part A    (FTB A), or Parenting Payment or the Double Orphan Pension for the teenager; or
    • their partner receives FTB A or Parenting Payment; or
    • 16-17 years and receiving financial assistance under the  Veterans’ Children Education Scheme or the Military Rehabilitation and Compensation Act Education and Training Scheme from the Department of Veterans’ AffairsExternal link

Important: a teenager may still be eligible if  the above conditions are met for a minimum of one day in the calendar year.

How will a teenager be advised of eligibility?

A letter and voucher advising of a teenager’s eligibility for a preventative dental check will be sent to the teenager, family or carer/guardian receiving the government payment. If the teenager is in equal shared care arrangements, a letter and voucher will be sent to each parent or carer/guardian. The first family to claim the service with Medicare will be entitled to the full benefit payable.

Note: if a teenager becomes eligible in November or December and has not received a voucher, call 132 011 or visit your local Medicare Service Centre to confirm whether there is an entitlement in that calendar year.

What is the voucher for?

A preventative dental check consists of an oral examination and if necessary, the dentist may:

  • take x-rays
  • provide a scale and clean
  • provide a fluoride treatment
  • give you oral hygiene instructions
  • provide dietary advice
  • seal pits or cracks in a tooth (fissure sealing).

How does an eligible teenager go about having a preventative dental check?

Once the eligible teenager has received their voucher:

Step 1—make an appointment with a dentist

When making an appointment with the dentist, check:

  • that the dentist will provide a preventative dental check under the Medicare Teen Dental Plan
  • whether payment is needed up-front and whether it will be more than the $163.05† dental benefit claimable from Medicare.

If the teenager is eligible for public dental services, call the nearest public dental clinic (including school-based clinics) to check whether they provide preventative dental checks.

Step 2—have the preventative dental check

The teenager will need to take their voucher and Medicare card to the dentist when having their preventative dental check.

Step 3—claiming for the preventative dental check

After the preventative dental check, the dentist will bill in one of three ways.

  1. The dentist will bulk bill the service. An Assignment of benefit form must be signed—there is no cost as the dentist will claim directly from Medicare.
  2. The dentist will ask for the service to be paid in full. The benefit can then be claimed (up to $163.05†) from Medicare, just like other Medicare benefits.
  3. The dentist will provide an unpaid account. Take the account to a Medicare Service Centre or send it with a completed claim form to Medicare, GPO Box 9822, in your capital city.

A cheque (made out to the dentist) for the benefit amount, will be sent to the person who is responsible for the account. This cheque with any balance owing must be forwarded to the dentist.

For more information

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Last updated: 3 January, 2012