Childrens Dental Benefits Scheme – not so rosey?

PARENTS may be better off claiming their child’s dental bills under private health insurance rather than relying on a new Medicare dental scheme that launches on January 1.

Some parents face out-of-pocket expenses of as much as 20 per cent of the fee under the new Medicare scheme, according to the Australian Dental Association.

Medicare will provide 3.5 million children whose families receive family Tax Benefit A with up to up to $1000 worth of dental care every two years.

However, some health funds provide full coverage of the cost of a child’s dental check-up if members use their preferred dental providers.



Australian Dental Association vice-president Carmello Bonnano says parents will have to do the calculations to figure out the best way to get their child’s dental bills covered.

“If you’ve got 40 per cent of the population covered by private health insurance, that is a decision parents will have to make,” he says.

“The onus is on dentists to say under Medicare this is what your out of pocket expense will be,” he said.

The Australian Dental Association says the Medicare rebate provided under the new child dental scheme is around 20 per cent less than the average dentists fee and some dentists may charge a gap payment.

For example, the average charge for a dental X-ray is between $35 and $39 but the Medicare rebate is 27 per cent less and parents may have to pay between $9 and $10 out of their own pocket for this service.

The average fee for removing a tooth was $167 but the Medicare rebate was 22 per cent lower and this was likely to leave parents with a $36 charge.


Children who need space maintainers, general anaesthetic and other simple orthodontics won’t be covered because the Medicare scheme covers only basic treatments.

The warning comes as dentists caution it may be difficult to make early claims under the scheme because there are no Medicare claim forms yet available.

The Department of Human Services says the Medicare claim form for child dental care will be available on its website from January 1.

“We’ve been talking to the department since March but there are still no forms to claim money back,” Mr Bonnano said.

The $620 million a year Growing Up Smiling scheme will cover children aged 2-17 and provide rebates for basic dental treatments like check ups, cleaning, X-rays, fluoride, fillings and extractions.

The Coalition promised in the election campaign to expand the scheme, introduced by Labor, to cover adults from 2018.

The scheme will work in the same way as a Medicare funded doctors visit.

At bulk billing dentists parents can present a Medicare card to get free treatment for their children.

At non bulk billing dentists parents will have to pay the full fee then claim back the Medicare rebate.

Some dentists may refuse to take part in the scheme so parents should check when they make an appointment.

The child dental scheme was part developed by the Greens and their health spokesman Senator Richard Di Natale is urging the new government to expand it to adults from 2015.

Phasing in the coverage of adult aged pensioners and Newstart recipients would see the program cover an extra 3 million people at a cost of $1 billion a year, Senator Di Natale said.

He says if there is no money in the budget polls have shown three in four voters would support a hike in the Medicare levy to pay for dental care.

In his health policy launched during the election campaign Tony Abbott pledged to “transition respective adult dental services to be included under Medicare” when the current national partnerships on dental care with the states expires in July 2018.

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