To get this you must be:
- enrolled in Medicare
- diagnosed with an eligible cleft and craniofacial condition by a health professional.
If you were treated before 1 November 2023 you can only claim Medicare benefits if:
- you were under 28 years of age at the time of your treatment
- your treatment was to repair previous reconstructive surgery.
What treatment is covered
You can get certain dental treatment services for a cleft or craniofacial condition.
This includes any of these:
- some orthodontic work
- simple and surgical extraction of teeth
- some general and prosthodontic services by your family dentist
- oral and maxillofacial services.
You can get Medicare benefits for your treatment if it’s done by:
- an orthodontist
- an oral and maxillofacial surgeon
- a dentist
- a paediatric dentist
- a prosthodontist.
They can also diagnose you with eligible cleft or craniofacial conditions.
Some Medicare items require a referral.
Before you start treatment, ask your health professional if they can do your treatment under the Medicare Benefits Schedule (MBS) and if there’ll be any out-of-pocket expenses. If they can’t, you won’t get Medicare benefits for your treatment and may need to pay the full amount.