Many countries offer citizens and residents access to a universal, government-funded health care system. Australia’s health care system is considered one of the best in the world, providing affordable, quality care to Australians. Thanks to an attentive health care system that prioritizes the challenges of an ageing population, medical research funding, utilising emerging medical technologies, and making the best use of health data, Australians have one of the world’s longest life expectancies. Like most health care systems, Medicare only covers so many treatments and services. Take a look at what Medicare covers for dental treatment.  

What is Medicare?

Medicare is a government-sponsored program that provides healthcare to Australian citizens. The program is funded by taxpayers through a Medicare Levy of two percent of taxable wages.

Medicare provides free or subsidized health care services by medical professionals, free treatment and stay for patients in a public hospital, and 75 percent of treatment costs for private patients in a public or private hospital. Note that in the instance of private patients, neither the costs of hospitalization or medicine are covered.

In order to be eligible for Medicare, at least one of the following requirements must be met: you must have either Australian or New Zealander citizenship, have either Australian permanent resident status or applied for it, have coverage by Ministerial Order, possess a Resident Return visa, or be covered under a Reciprocal Health Care Agreement from another country. 

How does it work? 

Enrolling in Medicare means full or partial coverage of necessary health care. Participants receive a Medicare card and a benefits schedule detailing which services are paid for. Services such as seeing a General Practitioner or specialist, tests and scans, most surgeries and procedures, and eye tests performed by optometrists are covered either partially or in full. 

Medicare is not responsible for ambulance transport, most dental services, glasses or contacts, hearing aids, or elective surgery. Medicine is also not covered, but Medicare can help make costs more affordable under the Pharmaceutical Benefits Scheme.

What is covered? 

Medicare will only cover dental care if treatment is deemed essential to patient wellbeing. Government funding covers the cost of essential treatments for children and eligible adults through the Child Dental Benefits Schedule and the Child and Adult Public Dental Scheme. These schemes are designed to alleviate oral health costs for Australians unable to afford private insurance. Everyone else capable of affording dental treatments by adding extras onto private health insurance can opt for coverage ranging from general preventative care to major dental procedures and orthodontics. 

Terms and conditions for Medicare coverage does vary by Australian state and territory, but each dental program can be supplemented with private insurance extras. Medicare may cover, again conditionally to location, diagnostic procedures, preventative procedures to an extent (this can save costs for more expensive oral issues later on), limited costs of oral surgery, and partial costs of restorative work. 

The State Health Department outlines public dental services according to each state and territory. 

Where to get dental coverage

Finding the right dental insurance can be made easier with third party services. Many of these services work with households of all kinds to help them understand the difference between general dental vs. major dental plan coverage, premium vs. standard plans, and comparisons of benefits and costs associated with each private insurer.