Dentures: Facts, Figures and Friendly Advice for Seniors

Understanding the Medicare Teen Dental Program in Australia

31 August 2015

Herman Kim

The Medicare Teen Dental program in Australia, now known as the Child Dental Benefits Schedule, provides for some dental services for low-income children who are eligible for Medicare. While the coverage is not all-encompassing, if you or your family is eligible for Medicare and you have a child that comes under this program, you would do well to understand what is covered by the plan. Note the following, and remember that laws frequently change and are updated when it comes to Medicare coverage. If you have questions about any coverage for your child, call your family dentist like Hillarys Dental Care or your Medicare provider.

1. Preventative

A child who is eligible for Medicare dental coverage may receive one preventative checkup every year, with a coverage benefit of up to $166.15. This check can be done by a dentist as well as an oral hygienist, oral therapist, or other professional who falls under the oversight of a dentist. The coverage is provided by way of a voucher given to the family.

2. Age and eligibility

The age of those eligible under this plan include children who are between age 12 and 17. There is a means test, meaning an eligibility test that the family must fall under in order for the child to participate. This means test includes disability support payment, parenting payment, special allowance, or some other eligibility for Medicare coverage altogether.

3. Notification

Typically the government will send information and a voucher to families who have eligible children who fall under this type of dental coverage. However, if you feel that you have a child who may be covered by this Medicare dental plan, you can call your Medicare provider and ask for an eligibility packet to be mailed to your home. This packet will explain if a child is covered and how to apply for a voucher.

4. Private health insurer

If you have a private health insurer, you need to decide if you will claim the checkup for your child through the private insurer or through Medicare. The private health insurance cannot "top up" any type of this check that is not covered by Medicare. However, your private health insurer or private dental insurance can be used for any other type of dental exam and treatment without it interfering with the voucher you receive for your child's exam.

Remember that it's best to determine if your dentist will accept the voucher from Medicare before you schedule your appointment, to ensure that they accept Medicare vouchers and you are not left with the bill for the exam.

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