Does Medicare Cover Dental? What Is and Is Not Covered in Australia
- Star Light Dental
- January 22, 2026
- [email protected]
It is one of the most common questions we hear at reception: can I use my Medicare card here? For most adult dental care the short answer is no. Medicare was never designed to cover routine dentistry, which is why a check-up is not bulk-billed the way a GP visit can be.
There are important exceptions, though, and thousands of families miss out on help they are entitled to because nobody has explained them. Here is what Medicare and the public system do and do not cover, and what your options are if you fall through the gaps.
1. The Short Answer
For adults, Medicare does not pay for check-ups, cleans, fillings, crowns, dentures, root canal treatment or orthodontics at a private dentist. Dental care for adults in Australia is funded mainly by patients themselves, with help from private health insurance extras.
Government support does exist, but it is targeted at two groups: children in families who receive certain payments, and people who hold a concession card.
2. Children: the Child Dental Benefits Schedule
The CDBS is the main way Medicare does pay for dental care. It provides up to $1,158 per eligible child over two calendar years for basic services such as check-ups, X-rays, cleans, fissure sealants, fillings, root canals and extractions.
A child is eligible if they are aged 0 to 17, have Medicare, and the family receives a qualifying payment such as Family Tax Benefit Part A. Star Light Dental is a CDBS provider, and our CDBS guide explains how to check your child’s balance.
3. Concession Card Holders: NSW Public Dental Care
Public dental services are run by the states, not by Medicare. In NSW, adults are eligible if they live in the state, have Medicare, and hold a Health Care Card, Pensioner Concession Card or Commonwealth Seniors Health Card. All children under 18 are eligible.
To be assessed, call the public dental contact centre on 1800 679 336. Depending on your needs and the waiting list, you may be seen at a public clinic or given a voucher to use at a private dentist. We accept those vouchers, and our guide to NSW dental vouchers explains how they work.
4. Hospital Treatment and Special Schemes
- Surgery in hospital. Medicare can contribute to some oral and maxillofacial surgery performed in hospital by a specialist. It does not extend to ordinary dental treatment.
- Cleft lip and cleft palate. A dedicated Medicare scheme helps with specialised dental and orthodontic treatment for eligible patients.
- Veterans. The Department of Veterans’ Affairs funds dental care for eligible card holders.
5. If None of That Applies to You
- Private health extras. Most extras policies pay benefits for general dental, and higher levels cover major dental. We accept all health funds and claim on the spot. See our guide to getting more from your dental cover.
- Payment plans. Medipay and Afterpay let you spread the cost of larger treatments.
- Prevention. The cheapest dentistry is the kind you never need. A regular check-up and clean costs far less than the treatment it prevents.
6. A Quick Way to Work Out Where You Stand
- Children under 18, and the family receives Family Tax Benefit Part A or a similar payment? Check the CDBS.
- Hold a Health Care Card, Pensioner Concession Card or Commonwealth Seniors Health Card? Call 1800 679 336.
- Have private extras cover? Bring your card and we will claim for you on the day.
- None of the above? Ask us for a written quote and about payment plans before you decide anything.
Not Sure What You Are Entitled To?
Call Star Light Dental on (02) 9432 2833. With your Medicare card we can check a child’s CDBS eligibility in a couple of minutes, and we will always explain the costs before any treatment starts.
This article is general information and was accurate at the time of writing. Government programs change, so check Services Australia and NSW Health for current details.