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Does Medicare Cover Dental Care?

Rachel Horan

Rachel Horan

May 19, 20213 minute read
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Medicare, the Australian healthcare system, covers or subsides a range of medical services. Unfortunately, dental treatment is typically not one of these services. However, there are certain situations in which you can qualify for dental care under Medicare.

On this page:

    What are your options for dental work if you don’t qualify to be covered by Medicare? Is it better to get private health insurance, or pay for dental costs outright? It can be tricky to know what is best for you.

    In this helpful guide, Jacaranda Finance dives into whether dental work is covered under Medicare, how private health insurance can help, and more.

    Does Medicare cover dental work?

    The Australian Government typically doesn’t cover the costs of most dental services. However, in some cases, Medicare can pay for essential dental care for eligible children and adults. This is in the form of the Child Dental Benefits Schedule (CDBS) and public dentists.

    Child Dental Benefits Schedule

    This schedule provides $1,000 over two years for children aged two to 17 years old for basic dental services. These services can include dental examinations, x-rays, cleaning, sealing cracked teeth, fillings, root canals, and extractions. However, any orthodontic or cosmetic dental work will not be covered by Medicare. Additionally, dental care that needs to be provided in the hospital will not be covered.

    Most of these services are bulk-billed (meaning that you don’t need to pay anything) and are only offered to families that are already receiving government benefits. To find out whether your child is eligible for the CDBS, refer to the Department of Human Services.

    Public dental services

    State and territory governments provide public dental services for children and adults. This can include emergency dental services or referrals to specialists (like orthodontics). Generally, adults must hold a Health Care Card or Centrelink Pensioner Concession Card to be eligible for public dental services, though this can vary depending on your individual circumstances. Keep in mind, public dentists can have waiting times of up to one year or more.

    Private health insurance

    If you don’t qualify for dental assistance via Medicare, you may wish to consider a private health insurance plan that includes dental cover.

    Dental insurance is provided in extras private health insurance policies. This type of insurance can be helpful to assist with the cost of dental bills. There are two main types of dental cover: general dental cover and major dental cover.

    General dental cover

    General cover is for mostly preventative work, including annual checkups, cleaning, x-rays, minor fillings, and more (depending on the policy).

    Major dental cover

    Major dental is used for more complicated dental procedures, usually leading to costly bills. For example, root canals, tooth extractions, bridges, crowns, and more.

    How much is dental care with and without cover?

    Dental cover is designed to save you money on dental expenses not covered by Medicare. Unfortunately, most dental coverage plans will still have a gap payment, meaning you may be left with out-of-pocket expenses. However, some dentists offer gap-free dental, so check with your dentist beforehand.

    To give you an idea of how much you can expect to pay at the dentist, with and without dental insurance, an example has been given below for a person with dental coverage of 60% (meaning that the insurer covers 60% and the person pays the remaining 40%).

    Dental procedure Without insurance With insurance
    Routine dental check up $230 to $320 $92 to $128
    Simple filling $160 to $240 $64 to $96
    Complex filling $1,000 to $460 $120 to $184
    Crown installation $1,600 to $2,040 $640 to $816
    Simple tooth extraction $190 to $280 $76 to $112
    Complex tooth extraction $415 to $560 $166 to $224
    Root canal without a crown $2,000 to $3,400 $800 to $1,360

    How to avoid expensive dental care

    If you want to avoid expensive dental care, it is important to look after your teeth. Having good dental health can minimise the need for expensive dental care, and is also important for your general health.

    According to Healthdirect, the best way to look after your teeth is to:

    • Brush your teeth twice a day;
    • Floss once a day;
    • Limit sugar in your foods and drinks;
    • Visit a dentist for a routine dental check up once a year.

    Plus, if you require dental work and wish to find the best deal, Healthdirect recommends doing the following:

    • Ask your dentist how much the procedure will cost.
    • Ask for the item numbers and call other dentists for quotes.
    • Ask if the procedure is necessary. Are there any risks? Do the benefits outweigh these risks?
    • Ask if there is a less expensive alternative.
    • Talk to your dentist about how to prevent tooth decay and gum disease in the future.

    Copyright © www.jacarandafinance.com.au Jacaranda Finance Pty Ltd ® ABN 53 162 078 195 Australian Credit Licence 456 404, Pawnbroking License Number 4221738. The information on this web-page is general information and does not take into account your objectives, financial situation or needs. Information provided on this website is general in nature and does not constitute financial advice.

    Rachel Horan
    Rachel Horan

    Written by Rachel Horan

    Rachel Horan is a Content Writer for Jacaranda Finance. Rachel has previously produced content for Brisbane City Council, Black & White Cabs, and Clubs Queensland. She has a Bachelor of Mass Communication with Distinction from the Queensland University of Technology.

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