Medicare Teen Dental Plan

Saturday, May 12, 2012 at 09:46 am

With Medicare not providing much help with dental care for most people, many families struggle to afford dental cover. This can be worrying for parents, as it may mean that youngsters struggle to maintain good oral health later on as they have not got into the habit. The Australian government has recognised this concern, and introduced the Medicare Teen Dental Plan in 2008. This is designed to make annual dental check-ups more affordable and get teenagers used to taking care of their teeth.

Dental insurance

Image by Lin Pernille Photography

Is your teen eligible?

The Medicare Dental Plan covers eligible teenagers aged 12-17. He or she must be eligible for Medicare. Certain benefits also need to be received by the teenager themselves or their family, guardian or carer. These conditions only need to be met for a single day in the calendar year in some cases. A letter will be sent to you to if you are eligible – there is no need to apply.

What is covered?

The Medicare Teen Dental Plan is designed to make preventative check-ups less costly. The voucher covers an oral examination, but may also include x-rays, a scale and clean, a fluoride treatment and fissure sealing if needed. If the check-up indicates that any other dental work should be carried out, it will not be covered by this voucher.

How it works

Once the voucher has been received, there are several steps that you need to take.

  1. Making an appointment. Firstly, you need to book an appointment for the check-up. Be sure to confirm that the dentist will cover the check-up under the Medicare Dental Plan, as not all will necessarily accept the voucher. Ask about the costs too – some dentists will charge more than the $163.05 claimable from Medicare, which would leave you with out-of-pocket costs to cover.
  2. Attending the appointment. Take your Medicare card along with the voucher.
  3. Claiming the Medicare benefit.
    • Your dentist may bulk bill Medicare directly. This does not require you to do anything other than sign an Assignment of Benefit form.
    • However, your dentist may ask you to pay upfront, and you can then claim the cost back from Medicare.
    • In some cases, you may need to take an unpaid account to Medicare. You will then receive a cheque to give to your dentist. If your dentist charges above the Medicare benefit, you will need to pay the difference.

Beyond the Medicare Teen Dental Plan

The Medicare Teen Dental Plan is designed to cover check-ups. If your teen is lucky, this may be sufficient, but you cannot count on this to be the case. If your teen needs dental work or is not eligible for help from Medicare, a private health fund may help with your dental costs.

Private health insurance is not always as expensive as you might think. Compare health insurance policies to find a plan that fits the needs of the whole family. Look into the details of extras cover like dental plans during your health insurance comparison, as there can be variations in the items covered and the amount you can claim.