Dental Health

Medicare Teen Dental Plan - questions and answers

The Medicare Teen Dental Plan delivers on the Government’s election commitment to provide financial assistance to families to encourage teenagers to care for their teeth by having annual check-ups and to maintain good oral health habits once they leave home. The program commenced on 1 July 2008.

PDF printable version of Medicare Teen Dental Plan - questions and answers (PDF 33 KB)

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Who is eligible for a preventative dental check?

To be eligible for a preventative dental check under the Medicare Teen Dental Plan, a teenager must have been issued with a voucher by Medicare Australia. To be issued with a voucher, a teenager must be entitled to receive Medicare benefits and, for at least some part of the calendar year:
be aged between 12 and 17 years; and
satisfy the means test for the program:

• the teenager must be receiving either Abstudy, Carer Payment, Disability Support Pension, Parenting Payment, Special Benefit, or Youth Allowance; or
• the teenager’s family/carer/guardian must be receiving either Family Tax Benefit Part A, Parenting Payment, or the Double Orphan Pension in respect of the teenager; or
• the teenager’s partner must be receiving Family Tax Benefit Part A or Parenting Payment; or
• the teenager must be receiving financial assistance under the Veterans’ Children Education Scheme (VCES) or the Military Rehabilitation and Compensation Act Education and Training Scheme (MRCAETS) and cannot be included as a dependent child for the purposes of Family Tax Benefit because they are 16 years or older.

How will a teenager/family know if they are eligible?

Each calendar year, Medicare Australia will send eligible families/carers and teenagers information about the Medicare Teen Dental Plan and a voucher for a preventative dental check.

What does the voucher cover?

The voucher covers one annual preventative dental check consisting of an oral examination and, if required, x-rays, a scale and clean, fluoride treatment, oral hygiene instruction, dietary advice and/or fissure sealing. Not all of these services may be required each year.

Who can provide the preventative dental check?

The preventative dental check can be provided by a dentist. A dental hygienist or dental therapist may also provide services under the supervision or oversight of a dentist.

Where can a voucher be used?

You can use the voucher at any private dental surgery if the dentist is registered with Medicare Australia (most dentists are). You should contact your dentist to ensure they are participating in the Medicare Teen Dental Plan.

You may also be able to use the voucher at a public dental clinic (including a school-based clinic). You should contact your local public dental clinic or state or territory health department for further information and to find out when it may be possible to schedule an appointment.

You should present the voucher when you have your dental check.

Vouchers cannot be used if you have a preventative dental check as an admitted patient in hospital (this includes where you are an admitted patient in a day-surgery facility).
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Will I have to pay anything?

Private dentists

Dentists are free to set their own fees for services. However, the Government encourages private dentists to bulk bill teenagers under this program.

If the dentist bulk bills the service (i.e. accepts the voucher as full payment), you will not have to pay anything. You will just need to sign a form allowing the dentist to claim directly from Medicare Australia. Your Medicare number will be required and the dentist will keep your voucher.

If the dentist does not bulk bill the service and asks you to pay up front, you will need to take (or send) your receipt to Medicare Australia to claim your dental benefit. Vouchers no longer need to accompany claims to Medicare Australia.

In some cases, the dentist may give you an unpaid account to take (or send) to Medicare Australia.

Public dental clinics

Preventative dental checks provided in public dental clinics are bulk billed. Your Medicare number will be required and the clinic will keep your voucher.

What if the dentist doesn’t charge the exact amount of the voucher?

Dentists can charge different prices for a particular service. If the dentist charges less than $153.45 for the preventative check, Medicare Australia will pay the amount you have been charged. If the dentist charges more than $153.45, Medicare Australia will pay $153.45 towards the total cost of the service and you will need to pay the additional amount.

Can I claim my preventative dental check on Medicare and my private health insurance?

No. You will need to decide whether to claim a benefit for your preventative check from Medicare Australia or your private health insurer. You cannot use your private health insurance to ‘top up’ the benefit you have received from Medicare Australia for this service.

What if I turn 18 or the eligible payments are stopped?

Once you have been issued with a voucher, you can use it for a preventative dental check in the respective calendar year – even if you turn 18 during the calendar year or if you stop receiving an eligible payment.

What if I lose the voucher?

If you lose the voucher, you can call Medicare Australia on 132 011*. As long as you haven’t already claimed for a preventative dental check during the calendar year, you will be sent a replacement voucher.
However, as vouchers are no longer required to accompany claims to Medicare Australia, replacement vouchers will only be issued if required for presentation to the dentist.

How often will I get a voucher?

As long as you remain eligible, you will receive a voucher each calendar year. Most people will receive their vouchers from mid-January each year.

Where can I get more information?

If you need more information about the Medicare Teen Dental Plan, call 132 011* or visit www.medicareaustralia.gov.au or any Medicare office.

*Call charges apply – 24 hour service