Medicare Bulk Billing

In Cosmetic Dental Care we do bulk billing through Medicare (conditions apply). Cosmetic Dental care chooses to offer bulk bill Medicare so you do not need to pay any out of pocket gap payments.

Under the Medicare chronic disease dental scheme, Medicare benefits are available for most services provided by a dentist, dental specialist or dental prosthetist in private dental surgeries.

To receive a Medicare benefit for dental services, you will first need to meet certain eligibility criteria and be referred by their GP to us Cosmetic Dental care.


Who is eligible for dental services under the Medicare chronic disease dental scheme?

To be eligible, you must have a chronic medical condition and complex care needs and their oral health must be impacting on, or likely to impact on, their general health.

A chronic medical condition is one that has been or is likely to be present for at least six months. It may include, but is not limited to, conditions such as asthma, cancer, cardiovascular illness, diabetes mellitus, arthritis, mental illness, musculoskeletal conditions and stroke.

Complex care needs means that your patient is receiving ongoing care from a multidisciplinary team, which includes their GP and at least two other health care providers.

In practice, this means you will need to be managed by their GP under certain care plans. For most people this involves the preparation of a GP Management Plan and Team Care Arrangements. For residents of aged care facilities, it involves the GP contributing to a multidisciplinary care plan prepared for the resident by the facility.

If you believe you fulfil the criterias, You should talk to their GP about whether you are eligible for these plans. If you are eligible your GP must complete the plans and bill them before you have your first dental service.


What dental services will the Medicare chronic disease dental scheme cover?

A comprehensive range of dental services will be covered, including dental assessments, preventive services, extractions, fillings, restorative work and dentures.Eligible patients may access Medicare benefits of up to $4250 in total over two consecutive calendar years for dental services.


How do the GP referral arrangements work?

If you meet the eligibility criteria, you will be referred by a GP to us for further assessment and treatment, including full or partial dentures.

The referral will last for two consecutive calendar years from the first dental service. If additional treatment is required after this period a new referral from a GP is required.


What will a patient have to pay for the dental services?

Dental practitioners are free to set their own fees for services. To ensure you are aware of the potential costs you will need to obtain a written quote before starting a course of treatment if you are NOT using Cosmetic Dental Care for dental services.

As Cosmetic Dental Care chooses to bulk bill you the patient, there is no out of pocket gap payments for you. Essentially free treatment if you are eligible under this Medicare scheme.


For more information
For more information about the Medicare dental services, go to the EPC Chronic Disease Dental Scheme website or call the Medicare Australia Provider Enquiry Line on 132 150
or Call Us at 02 9683 6699