Cleft Lip and Cleft Palate Scheme
On this Page:
- What is the Medicare Cleft Lip and Cleft Palate Scheme?
- How do I enrol in the scheme?
- How long can I claim under the scheme?
- What if I have never been registered in the scheme?
- What is covered under the scheme?
- What if my details have changed?
- How do I claim Medicare benefits for treatment?
- Should I have a new identification card?
- Where can I get more information?
What is the Medicare Cleft Lip and Cleft Palate Scheme?
The Cleft Lip and Cleft Palate Scheme helps families to meet treatment costs for specialised services for cleft lip and cleft palate conditions.
How do I enrol in the scheme?
If you or your child has a cleft lip and cleft palate condition, your doctor or dentist needs to complete a Certification of Cleft Condition form and send it to Medicare Australia. If you or your child is eligible under the scheme, Medicare Australia will send you a cleft lip and cleft palate patient identification card.
How long can I claim under the scheme?
You can claim Medicare benefits for cleft lip and cleft palate conditions until the age of 28 years. The cleft lip and cleft palate identification card has an expiry date of the day before the person with the cleft condition turns 28 years.
If you are 28 years old and were registered in the scheme before you turned 22 and you require a specific course of treatment for repair of previous reconstructive surgery, you could be eligible to claim benefits. Please call Medicare on 132011 or 1300 652 492 for more information.
What if I have never been registered in the scheme?
If you are now over 22 years of age and have never been registered as a prescribed dental patient, you will not be eligible for registration or benefits under the scheme.
What is covered under the scheme?
The scheme provides Medicare benefits for dental treatment including:
- a limited range of orthodontic work
- surgical extraction of teeth by oral and Maxillofacial surgeons
- some general and prosthodontic services from your family dentist.
You need to check with your orthodontist that he/she is accredited under the scheme, before treatment takes place , in order to claim a Medicare benefit for orthodontic services.
To claim simple extractions by your dentist under the scheme you must have a referral from an accredited orthodontist.
What if my details have changed?
If your details have changed since you registered with the scheme please call Medicare Australia on 1300 652 492 and provide the new information. Details can be provided in writing to Medicare Australia:
Cleft Lip and Cleft Palate Scheme
Support and Interpretation Section
PO Box 9822
PERTH WA 6001
How do I claim Medicare benefits for treatment?
- If you are claiming at a Medicare office, you need to show your Medicare card and your cleft lip and cleft palate patient identification card.
- If you are claiming via cheque, or your dentist is claiming via bulk bill, you need to show your cleft lip and cleft palate patient identification card to your dentist so they can record your identification number on the account or bulk bill form.
Should I have a new identification card?
Yes, if you haven't already received a new cleft lip and cleft palate identification card, you can request one by calling Medicare Australia on 1300 652 492 .You can also write to Medicare Australia:
Cleft Lip and Cleft Lip Palate Scheme
Support and Interpretation Section
PO Box 9822
PERTH WA 6001
Where can I get more information?
Where can I get more information?
- visit your local Medicare office
- call Medicare on 132 011 or 1300 652 492
Last updated: 28 May, 2008