Top image: AI-generated illustration.
If you’re trying to work out what you’ll pay for a dental visit at Ellen Stirling Dental in Ellenbrook, this guide explains what Medicare covers, what it doesn’t, and where else help can come from.
Ellen Stirling Dental practice notes:
- Ellen Stirling Dental accepts payments from the Child Dental Benefits Schedule.
- Ellen Stirling Dental is fully equipped with HICAPS facilities for health fund claims.
Maybe you’ve got a toothache and you’re wondering whether to wait it out. Or your kids are due for a check-up and you’ve heard there’s “a Medicare thing” for children but you’re not sure if you qualify. Dental costs are one of the most common worries people bring to us, and the rules can feel scattered across different websites.
Here’s the short answer. For most adults, Medicare doesn’t pay for dental care. healthdirect says most dental care is not covered by Medicare. Children are different: Medicare does pay part or all the cost of some dental services for children who meet the eligibility requirements, through the Child Dental Benefits Schedule. Adults with a concession card can use public dental services in WA, and health fund extras can help with the rest.
Does Medicare cover dental for adults?
Generally, no. healthdirect explains: “The Australian Government does not generally cover the costs of dental services. You will need to pay most dental costs yourself.” That applies to check-ups, cleans and fillings for most adults, as well as bigger treatment.
It also explains why prices differ between clinics: there are no standard fees for dentists like there are for doctors, and each clinic determines their own fees. That’s why it pays to ask what’s included in a quote before you book.
There are a few narrow exceptions. healthdirect notes that the Cleft Lip and Cleft Palate Scheme provides Medicare benefits for some dentistry treatments and surgery for eligible people under 28 years of age. For everyday dental care, though, adults pay privately, use a health fund, or use public dental if they hold a concession card.
Please note: This is general information about how dental costs and government schemes work, not personal financial or dental advice. Rules and amounts change, so check your own eligibility with Services Australia, Dental Health Services or your health fund.
What does Medicare cover for children?
For eligible families, quite a lot of basic care. The Child Dental Benefits Schedule (CDBS) is the Medicare program for children’s dental care. Services Australia says the CDBS provides basic dental services to eligible children aged 0 to 17 years.
Services Australia says dental services under the CDBS are capped at $1,158 over 2 consecutive calendar years, and the cap amount is indexed yearly on 1 January. The 2-year cap period starts when a child or teenager first gets an eligible dental service.
What the CDBS covers, according to Services Australia
| Group | Services |
|---|---|
| Covered | examinations, x-rays, cleaning, fissure sealing, fillings, root canals, extractions and partial dentures |
| Not covered | orthodontic work such as braces, cosmetic dental work, and dental services provided in hospital |
Good news on cost: healthdirect says most Child Dental Benefits Schedule services are bulk billed, so you don’t pay anything. Our Child Dental Benefits Schedule page says our team can check if your child is eligible for a bulk bill dental check-up.
Is my child eligible for the CDBS?
Services Australia says your child can get CDBS when all of the following applies:
- they’re eligible for Medicare
- they’re between 0 and 17 years old for at least one day that calendar year
- you or they get an eligible payment at least once that calendar year
You don’t have to fill in a form. Services Australia says: “You don’t need to apply or register for CDBS. If your child is eligible we’ll send you a letter.” If you’re not sure whether you got that letter, or how much of your child’s balance is left, ask us when you book. We can check before any treatment starts.
What help is there for adults with a concession card?
If you hold a Health Care Card or Pensioner Concession Card, public dental care is available in WA through Dental Health Services (DHS). healthdirect says adults need a Health Care Card or Centrelink Pensioner Concession Card to be eligible, and that you may have to wait up to a year or more to see a public dentist.
DHS says its general dental clinics provide subsidised general and emergency dental care for those who hold a current health care card or pension concession card. It also says children aged 0 to 4 whose name appears on their parent’s Health Care or Pension Concession Card are also eligible to attend a general dental clinic for care.
On cost, DHS says treatment is subsidised by the Western Australian government up to a maximum of 75% of the cost of the treatment, and the actual level of dental subsidy a person is entitled to is based upon their Centrelink income.
Can I use public dental subsidies at a private clinic?
Sometimes, yes. DHS runs the Metropolitan Patients Dental Subsidy Scheme (MPDSS). It says the scheme, when funding permits, gives eligible metropolitan patients on a public dental waiting list an authority to undergo a course of non-urgent subsidised general dental care at participating private dental practitioners.
Our MPDSS page explains that we assist patients with health care cards to have their dental treatment done right here in Ellenbrook under the scheme. DHS’s voucher letter says the fees are the same as at the government dental clinic, and that if your subsidy level is 75%, you will pay 25% of the government-scheduled fee.
What about school-aged children in WA?
WA has its own free service for students. DHS says the School Dental Service provides free general dental care to students who attend a Western Australian Department of Education recognised school aged 5 to 16 years or until the end of year 11.
How do health funds help with dental?
If you have private health insurance with extras, it can cover part of the cost. healthdirect says health funds will pay a part of the cost and you will need to pay the rest yourself, and that dental services are part of the ‘Extras’ or ‘Ancillary’ section of your policy.
Policies use different labels, but healthdirect describes two broad groups:
Routine and major dental, as healthdirect describes them
| Type of cover | What it may include |
|---|---|
| Routine dental | x-rays, examinations, cleaning and polishing, fluoride treatment and simple fillings |
| Major dental | complex fillings, crowns, veneers, bridgework, implants and dentures |
healthdirect also notes that policies vary widely between different health funds, and there may be limits on how much you can claim each year. Some health funds have preferred providers, with lower fees, higher rebates and more preventive services, but you may have less choice of dentists.
At Ellen Stirling Dental, our health funds page says we accept insurance rebates from all private health insurers in Australia, and we are participating providers of HCF’s More For Teeth and HBF Members Plus. With HICAPS, you can claim your health insurance entitlements straight away after each appointment. What you get back depends on your own policy, so check your cover before you book.
What if you don’t have cover or a concession card?
You’ll pay the clinic’s fee, so it’s worth knowing what you’re paying for. healthdirect suggests a few questions before you agree to treatment:
- Ask your dentist how much the procedure will cost.
- Ask for the item numbers then contact a few dentists to compare prices.
- Ask whether you really need this procedure. Do the benefits outweigh the risks?
- Ask whether there are less expensive alternatives.
- Talk to your dentist about how you can prevent tooth decay and gum disease in future.
If you’d rather spread the cost, our payment options page lists the plans we work with, including Afterpay, Humm, Supercare, Zippay and Openpay. Each provider sets its own terms and approval rules, so read them before you sign up. Our article Afterpay for Dental Treatment in Perth: What to Check Before You Pay walks through the questions to ask.
Looking after your teeth matters for cost too. healthdirect says the best way to reduce the cost of dental care is to look after your teeth, including to visit a dentist for a check-up at least once a year.
Which help might apply to you?
Use this as a quick guide, then check the details with the organisation named.
- My child is under 18 and our family gets an eligible government payment: ask about the CDBS, checked with Services Australia.
- My child is at school in WA and aged 5 to 16: ask about the School Dental Service through DHS.
- I hold a Health Care Card or Pensioner Concession Card: ask DHS about public dental care and the MPDSS.
- I have private health insurance with extras: check routine and major dental limits with your fund.
- None of these apply: ask for an itemised estimate and the item numbers before treatment.
Booking at Ellen Stirling Dental
Ellen Stirling Dental is at 48 Ellen Stirling Parade, Ellenbrook WA 6069. Call (08) 6192 1036 or use our online booking page.
When you call, you could say: “I’d like to book a check-up. Can you tell me which item numbers it includes, and can you check whether my child is eligible for the Child Dental Benefits Schedule?” Bring your Medicare card, your health fund card if you have one, and your concession card or DHS letter if you’re using a government scheme.
Frequently asked questions
Is a check-up and clean covered by Medicare for adults?
Generally not. healthdirect says most dental care is not covered by Medicare. Adults usually pay privately or claim through health fund extras, unless they’re eligible for public dental care.
Can my teenager use the CDBS for braces?
No. Services Australia says the CDBS doesn’t cover orthodontic, cosmetic dental work or dental services provided in hospital.
Does the CDBS cover the whole cost?
It covers eligible services up to the cap over two calendar years. healthdirect says most Child Dental Benefits Schedule services are bulk billed. Ask us to check your child’s remaining balance before treatment.
Do I need a referral to use the MPDSS?
You need the authority from DHS first. DHS issues it to eligible patients on its waiting list when funding permits. Bring that paperwork to your appointment.
Final thoughts
Medicare won’t usually pay for adult dental care, but that isn’t the end of the story. Children in eligible families can get basic care through the CDBS, concession card holders can access public dental and the MPDSS, and health fund extras help many people with routine visits. Ask for item numbers, check what applies to you, and you can plan your visit without surprises.
By Dr Rachit Shah, Principal Dentist, Ellen Stirling Dental.
Sources
General published information, not personal financial or dental advice. Sources checked 29 October 2026.
- healthdirect: Cost of dental care, last reviewed October 2023.
- Services Australia: Child Dental Benefits Schedule features and Who can get the Child Dental Benefits Schedule.
- Dental Health Services, Government of Western Australia: Quick Guide to Dental Health Services and Subsidised Private Dental Services.
- Ellen Stirling Dental: Child Dental Benefits Schedule, MPDSS, Health funds, Payment options, Our dentists and Contact us.
- Photos in this article are AI-generated illustrations, not photos of Ellen Stirling Dental, its staff or patients.
General health disclaimer: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Individual results may vary.
