Dentures: Facts, Figures and Friendly Advice for Seniors

All you need to know about Dental Bulk Billing

11 March 2016

Herman Kim

Bulk billing is a provision of Medicare in Australia where the health provider directly bills Medicare for services rendered to a beneficiary of the scheme. You as a patient need not pay anything, including administration or booking fees. It is applicable to children (2–17 years) and pensioners/senior citizens.

Not all dentists accept to offer service on bulk-billing schemes, however, so you should confirm with your dentist in advance. Some dentists may also have a limit regarding the number of bulk-billed patients they can see in a period, so you may need to get an appointment. In dental healthcare, bulk-billing only applies to basic procedures, and is capped at $1,000 per patient for two calendar years.

Assigning your rights to a Medicare benefit

To do this, you need to duly complete an assignment of benefit form manually or online. Ensure that your assignment form has been filled out in all places, both by you and the dentist before submitting for approval. The practitioner goes through the form and signs to show acceptance, after which you become eligible to use bulk-billing.

What to do if you cannot assign your right

If you are unable to assign your rights as aforementioned, you are required to get signed approval from an eligible parent or guardian that qualifies according to the assignment form. The written approval should include an explanation as to why you are not able to sign for the benefit yourself. This may be described on a different form which will be given to you by your dentist.

Confirming your eligibility for dental bulk-billing

The following people are eligible to receive dental service on bulk-billing schemes:

• People with up-to-date concession cards or concession cards from the Veterans Affairs Department
• Dependants of persons who hold the above concession cards
• Children between 2 and 17 years
• Children whose primary caregivers/guardians receive specific government benefits, e.g. Family Tax
• Persons who are eligible for Medicare

You can confirm with your local dental practice about your eligibility for dental benefits before getting any services.

Understanding bulk-billing in specialised and standard treatment courses

Bulk-billing generally applies to basic services, and getting the same for specialised procedures is difficult. However, there are dental practices and hospitals which allow specialized treatments to be bulk-billed. Most often, these are institutions that are either wholly owned and run by the government, or work in partnership with the government. Even then, a co-payment may be required for specialised services since these are more complex/require more work to be done.

For standard treatments, bulk-billing is free for children in pre-school, primary and secondary. For eligible adults, the cost of services are generally free, but there are instances where they will be required to contribute to some dental care costs. Your Medicare benefit will cover main costs, while you will cater for the minor fees. For more information, talk to a bulk billing dentist.

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