The term "bulk billing" refers to medical professionals, including dentists, who accept patients and clients who get their medical insurance through Medicare in Australia. In many cases, children and teens are also covered under this bulk billing arrangement when they visit a dentist. Note a few important questions you might have about bulk billing dental benefits for children and teens and how they may apply to your family.
1. Who is eligible for this benefit?
A child is eligible as long as they are aged 2 to 17 on any day of the calendar year, meaning they are still eligible to be part of this program the year they turn 18. The child or their family/guardian must also be receiving benefits from a government program like the Family Tax Benefit Part A for at least part of the year and must be eligible for Medicare. A child receiving a disability support pension may also be eligible, and there are also other circumstances that lead to eligibility. Your local Medicare office can help you to better understand the benefits for which your family may be eligible and note if this then also extends to your child, based on their current age and other such factors.
2. What benefits are covered?
The benefits under this program are capped at $1000 for the length of two consecutive years. After the second year, you cannot carry over any unused benefit to the next year, so it does you no good to try to "save up" the benefits for which you might be eligible. There are a number of services that are provided by this coverage, including basic exams, x-rays, needed fillings, root canals, tooth extraction, and even sealing. Note that cosmetic procedures and orthodontics, meaning braces and other means of straightening teeth, are not covered. If you're not sure if the procedure your teen or child needs is covered, talk to your bulk billing dentist.
3. How does the benefit work?
In most cases, the dentist will bill Medicare directly for any service they render. However, there are a few bulk billing dentists who will bill their patients; it would then be up to you to pay the dentist and make a claim for reimbursement through Medicare. If you're not comfortable with this type of paperwork, be sure you ask your bulk billing dentist if they bill Medicare or expect you to pay and then get reimbursed. Note too that a dentist needs to discuss the cost of services and payments before those services are rendered so you know what to expect.