We all know how important our oral health is, right? Of course, brushing and flossing daily is essential for keeping our teeth and gums in top-notch condition, but it’s not always enough.

If you really want to take your oral health seriously, you should be going for regular dental check-ups. We know that this can sometimes be a little tough on the wallet, but that’s what dental health insurance is for!

While Australia has a pretty great medical system, Medicare doesn’t cover all dental services, so taking out general dental (or major dental), might be the smartest move to keep your teeth and gums happy for years to come.

So, what does Medicare cover? Let’s find out.

Medicare and Dental Services

Contrary to popular belief, Medicare, the heart of Australia’s healthcare system, does not cover most dental services.

You are mostly on your own for routine check-ups, fillings, extractions, and dentures – and these check-ups and procedures can be costly.

However, don’t despair just yet!

The Australian government does have specific programs under Medicare that cover various dental treatments for eligible children and adults. Let’s check these out.

Child Dental Benefits Schedule (CDBS)

For the little ones, the Australian Government provides the Child Dental Benefits Schedule (CDBS). This program offers coverage for basic dental services up to $1,000 per eligible child over two consecutive calendar years. It’s available for children aged 2 to 17 years of age who meet the eligibility criteria.

CDBS covers a range of services, including dental check-ups, x-rays, cleaning, fissure sealing, fillings, root canals, and tooth extractions.

However, it doesn’t extend to orthodontic or cosmetic dental work.

Public Dental Services

For adults, each state and territory provides public dental services, but the eligibility criteria and services covered may vary. These services are often provided through public dental clinics in major city centres and regional areas across New South Wales, Victoria, Queensland, Western Australia, South Australia, Tasmania, the Australian Capital Territory, and the Northern Territory.

Generally, public dental services give priority to people holding a Health Care Card, Pensioner Concession Card, or other specific Centrelink cards.

These services often cover preventative and restorative treatments, including fillings and dentures, as well as specialist services upon referral.

Medicare Benefits for Specific Dental Procedures

Medicare also provides benefits for specific dental procedures necessary for the patient’s overall general health.

For example, dental services provided “in hospital” under a Medicare-relevant specialist or consultant physician can be claimed under Medicare.

The Cleft Lip and Cleft Palate Scheme, another exception, offers Medicare benefits for specific dental treatments for eligible people with cleft lip and cleft palate conditions.


Does private health insurance offer more dental coverage?

Yes, private health insurance often covers more dental services than Medicare. Depending on your level of coverage, you might have reduced out-of-pocket costs for general dentistry and major dental procedures. Check with your insurance provider for specifics.

Does Medicare cover the cost of wisdom teeth removal?

Medicare typically doesn’t cover wisdom teeth extraction unless it’s performed in a hospital under general anaesthesia.

What is bulk billing in relation to dental services?

Bulk billing is when your health provider accepts the Medicare benefit as full payment for services provided, meaning no out-of-pocket costs for you. However, not all health providers, including dentists, offer bulk billing.

How can I find out if I’m eligible for public dental services?

You can check your eligibility by contacting the health department in your state or territory, or by visiting the Department of Health or Services Australia websites.

Is dental x-ray covered under Medicare?

Dental x-rays are not generally covered under Medicare unless they are part of the services included under the CDBS or specific public dental services in your state or territory.

Let CHI Find the Right Dental Insurance Policy For You

While the coverage for dental care under Medicare might seem limited, knowing the ins and outs of what’s available can help you make the most of the services on offer. Always check with the relevant departments or your local dental clinic for the most accurate information.

If you’re looking for more bang for your buck when it comes to your dental health, taking out a dental insurance policy might be just what you need.

Let Compare Health Insurance take away all the headaches of comparing policies. In just a few minutes, you can check out and compare what different health funds have to offer. Say goodbye to the stress, because we’ll help you discover the ideal dental coverage that not only meets your unique needs but also fits your budget like a glove.