Medicare Teen Dental Plan

Important notice

Recent changes to the Medicare Teen Dental Plan program.

If you had a claim for a preventative dental check rejected because the voucher had not been issued before seeing the dentist, you now may be eligible to resubmit your claim.

For more information call 132 011 or visit your local Medicare office.

Background

What is the Medicare Teen Dental Plan?

On 1 July 2008, the Australian Government introduced the Medicare Teen Dental Plan to help with the cost of an annual dental preventative check. The program aims to make it more affordable for families to keep their teenager’s teeth in good health.

Who is eligible under the Medicare Teen Dental Plan?

You are eligible for the plan if you are a teenager:

• aged 12–17 years:
  • receiving Family Tax Benefit Part A (FTB(A)), ABSTUDY, Carer Payment, Disability Support Pension, Parenting Payment, Special Benefit, Youth Allowance; or
  • whose family/carer/guardian receives Family Tax Benefit Part A (FTB(A)), or Parenting Payment or the Double Orphan Pension for the teenager; or
  • whose partner receives FTB-A or Parenting Payment; or
  • 16 or older and receiving financial assistance under the Veterans’ Children Education Scheme (VCES) or the Military Rehabilitation and Compensation Act Education and Training Scheme (MRCAETS) from the Department of Veterans’ Affairs
• eligible for Medicare.

How will I be advised of my eligibility?

A letter and voucher advising of a teenager’s eligibility for a preventative dental check will be sent to either the teenager, family or carer receiving the government payment. If the teenager is in equal shared care arrangements, a letter and voucher will be sent to each parent or carer. The first family to claim the service with Medicare Australia will be entitled to the full dental benefit.

What is the voucher for?

The voucher entitles you to claim a benefit from Medicare Australia up to the amount of $157.00^† per year once you have seen your dentist and had a preventative dental check. Vouchers are only valid for the person named on the voucher and cannot be transferred to another person. The voucher must be used within the calendar year it is issued.

^† Benefit as at 1 January 2010.

What is a preventative dental check?

A preventative dental check must consist of an oral examination and if necessary, your dentist may also:

• take x-rays
• provide a scale and clean
• provide a fluoride treatment
• give you oral hygiene instructions
• provide dietary advice
• seal pits or cracks in a tooth (fissure sealing).

How do I go about having a preventative dental check?

Once you have received your voucher the following steps will help you receive your benefit.

Step 1—make an appointment with a dentist

When making an appointment with the dentist, you will need to check:

• that the dentist will provide a preventative dental check under the Medicare Teen Dental Plan
• if you will be expected to pay anything up-front and if so, will it be more than the $157.00 dental benefit claimable from Medicare Australia.

Alternatively, if you are eligible for public dental services, you can call your nearest public dental clinic (including school-based clinics) to check if they are providing preventative dental checks.

Step 2—have your preventative dental check

You need to take your voucher to the dentist when you have your preventative dental check. 

Step 3—claiming for your preventative dental check

After your preventative dental check, the dentist will bill you in one of three ways.

1. The dentist will bulk bill the service by asking you to sign an Assignment of benefit form—this lets the dentist claim directly from Medicare Australia.
2. The dentist will ask you to pay in full for the service. You then claim your benefit by taking your account/receipt to your local Medicare office or sending your account/receipt, along with a completed Medicare Teen Dental Plan claim form, to Medicare Australia.
3. The dentist will give you an unpaid account. You then take your account to your local Medicare office or send it to Medicare Australia. We will send you a cheque made out to the dentist for the benefit amount. You must take the cheque to your dentist along with any outstanding balance you owe.

For more information

• Call 132 011
• Visit your local Medicare office
• Visit the Department of Health and Ageing website
• Medicare Teen Dental Plan brochure [PDF, 315Kb]
• Medicare Teen Dental Plan brochure [RTF, 61Kb]
• DC1-Dental benefit claim for Medicare Teen Dental Plan form [PDF, 222Kb]

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Last updated: 18 March, 2010