Why doesn’t Medicare cover dental in Australia?

Dr Aran Moorthy

This article was written by Australian dental surgeon Dr Aran Moorthy, BDS. Dr Moorthy has a Bachelor of Dental Surgery from the University of Adelaide. You can read more about Dr Moorthy here >

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Australians have never benefited from the support of Medicare for dental care. Of course, good dental health has plenty of benefits, so it’s easy to argue the merits of government funding.

Change seems unlikely, though, because, like most things in politics, it primarily comes down to money. Here’s why—and (more helpfully) what you can do if you’re struggling to pay dental bills.

Why won’t Medicare cover dental?

Any Aussie can visit a doctor’s clinic and receive bulk billing or a healthy government rebate via Medicare. It’s a popular system that’s been with us since 1975 – first as Medibank via the Whitlam government, then revived by the Hawke government as Medicare in 1984.

But Medicare doesn’t cover dental.

Sadly, Gough Whitlam intended to include it, but the idea was abandoned due to money and politics.

Public dental cover has been debated for decades, and there are good arguments for dental cover, especially when good oral health is vital. For example, we know poor dental health compromises your oral health and ability to eat. However, poor dental health has also been linked to several chronic conditions and diseases, such as cardiovascular disease, diabetes, stroke, lung conditions and oral cancers.

Surely, by funding dental care, we could eliminate some of these ailments?

Funding could help prevent several serious physical conditions and diseases enormously. But sadly, the cost would also be enormous. In 2019, the Grattan Institute estimated the cost of covering dental would be around $6.5 billion a year.

Dolling out billions of dollars would put an extreme burden on our budget. Faced with this dilemma five decades ago, the Whitlam government decided private health insurance funds would be the best option to help service us Aussies.

The outcome? Those with money took out health insurance and cared for their teeth better than those without money — or insurance. Consequently, our lack of government funding for dental has become a clear illustration of the disparity between rich and poor Australians for decades.

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Does the government cover any dental systems now?

Medicare CDBSA small percentage of our population receives government assistance for dental. If you have a health care or pension card, you’ll likely be eligible for free basic Medicare dental services like dental checkups and fillings.

Children up to 17 may be eligible for the CDBS (Child Dental Benefits Scheme), provided their parents or carers receive government assistance like the Family Tax Benefit Part A.

IMPORTANT: Only 35% of children eligible for CDBS use the schedule each year. This is simply due to a lack of awareness. Find out if you are eligible here.

Additionally, in Western Australia, the following governance services and benefits are available:

  • Indigenous healthcare services such as Derbarl Yerrigan Dental Health
  • Healthcare card and pensioner concession card holders can receive dental care at a public dental clinic.
  • The cleft lip and cleft palate scheme offers Medicare benefits for some dentistry treatments and surgeries for eligible people under 28 years.

Read more about our children’s dental services and the CDBS >

The cost of emergency dental care

Did you know that due to people not getting the dental care they need, we have more than 800,000 GP consultations and hospital admissions each year for dental conditions alone?

There aDental examinationre also waiting lists for public dental — and the outcomes of individuals on those lists are far worse than those receiving private health care. Data from the Australian Dental Association shows that about one-third of the millions of Australians eligible for public dentistry avoid food because of problems with their teeth.

“About a quarter of Australian adults say they avoid some foods because of the condition of their teeth; for low-income people, it’s about a third. Low-income people are more likely to have periodontal disease, untreated tooth decay, or missing teeth.”

– Grattan Institute

 

Who is in favour of public dental services?

Various political parties (such as the Greens), the Australian Dental Association, the Grattan Institute, groups like the Consumer Health Forum of Australia and public advocacy groups have all called for the Federal government to expand publicly funded dental care.

These groups have argued that better dental healthcare integrates into overall health and well-being. Consequently, they claim it should receive the same level of attention as other medical services.

Spending money on health insuranceHow to keep dental costs down

While we wait for any reform, there are some things you can do to help keep your dental costs down, whether you do or don’t have health insurance.

  • Look after your teeth – We cannot emphasise the importance of brushing regularly, avoiding sugar and having regular scale, clean and exams. At Oxford Street Dental, we often have dental specials for this service to help keep the cost down.
  • Shop around – Dental fees can significantly vary as there are no set amounts for specific treatments. (Be wary of expensive suburbs.)
  • Get private health insurance if you can – We understand insurance can be expensive. Still, we recommend health insurance to help take the sting out of any nasty major dental expenses that you may incur.
  • Spread your dental treatment over two years (if insured) – Suppose you need two dental implants. If your health insurance will only cover you for one, plan to have the first implants placed at the end of one calendar year and then the other in the new calendar year. Then you will be covered for both.
  • Look out for discounts – Many dental clinics offer dental discounts and offers, so shop around.
  • See if you qualify for government rebates — If you have a health care card or disability pension, you may be entitled to government rebates for certain general dental services.
  • Contact dental schools – Dental universities and schools often offer discounted services performed by the students (closely supervised by their tutors).
  • Be honest with your dentist – Don’t be shy about your finances. If your dentist suggests a dental service is too expensive, let them know. They may recommend a cheaper alternative.

Medicare, dental care and costs: common questions

Dentist inspects patient before tooth fillingWhat is the cost of a dental checkup in Australia

Without insurance, an examination, clean, scale, x-rays & fluoride is approxiametely $350. At Oxford Street Dental, we offer a $199.00 special for those uninsured. If you do have insurance, we bulk bill, meaning you pay no out-of-pocket expense.

Why is dental not covered by Medicare?

Medicare does not cover dental care due to financial reasons. Covering dental would cost the government billions of dollars each year, putting significant strain on their budget. Therefore, several decades ago, the Australian government decided that the best solution for dental care was private health insurance.

Can I fix my teeth with Medicare?

If you have a pension or healthcare card, you’ll likely be eligible for free basic Medicare dental services like dental checkups and fillings. Children up to 17 may be eligible for the CDBS (Child Dental Benefits Scheme), provided their parents or carers receive government assistance like the Family Tax Benefit Part A. If you, like many, don’t fall under any of these categories, you will not receive a Medicare rebate for dental care.

Wasn’t dental originally included in Medicare?

Dental care was never included in Medicare. Initially, the Whitlam government wanted to include Medicare (in 1974). However, negotiating with dentists looked too difficult when negotiating with doctors was already consuming their efforts. More significantly, the cost would be too expensive for the government.

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