Medicare Bulk Billing
Cosmetic Dental Care do bulk
billing through Medicare (conditions apply).
The
Medicare Chronic Disease Dental scheme was introduced in November
2007. The scheme allows chronically ill people who are being
managed by their GP under an Enhanced Primary Care (EPC) plan
access to Medicare rebates for Dental services.At Cosmetic
Dental Care (Sydney) , we bulk bill medicare, so essentially
there is no out of pocket expense.
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.
Once you have been referred by their GP to our dental practitioner,
the patient can call Medicare Australia on 132 011 to check
that the necessary GP care planning items have been claimed
and paid before starting dental treatment – even where their
GP has signed a referral form. If the relevant items have
not been claimed and recorded, Medicare Australia cannot pay
benefits for dental services.
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.
The primary purpose of the dental treatment must be to improve
oral health or function. Medicare rebates will not be paid
for dental services that are purely cosmetic in nature.
Under the Medicare chronic disease dental scheme, Medicare
rebates cannot be claimed for dental treatment provided by
public dental clinics or where the patient is an in-patient
(i.e. an admitted patient) in a hospital.
Who can provide the services?
Most privately practising dentists, dental specialists and
dental prosthetists will be eligible to provide services under
the Medicare chronic disease dental items, but some may choose
not to treat patients under Medicare. Cosmetic Dental care
chooses to offer bulk bill Medicare so you do not need to
pay any out of pocket gap payments.
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.
Medicare Teen Dental Voucher
Use your $150 dental voucher at Cosmetic Dental Care and receive
a FREE dental check up & clean. No out of pocket expense.
Cosmetic Dental Care will bulk bill. Don’t let your teen voucher
go to waste.
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
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