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Should Kids Dental Be Included on Medicare? (Part 1)

Jonathan November 14th, 2014 0 comments

In Australia, we’re lucky enough to have a fantastic public health care system in the form of Medicare, through which many services are free or subsidised. However, despite the fact that good oral health is seen as being vital for overall wellbeing, Medicare does not currently offer much support in terms of dental services for children.

How Much It Costs

  • In Australia, the fee for orthodontic treatment involving upper and lower braces varies from $4500 to $8000 or even more in severe cases. This figure is cheaper if braces are only needed on either the upper or lower teeth.

The Current Situation

The Child Dental Benefits Scheme (CDBS) covers basic dental services for children aged 2-17 years – provided that they are eligible for Medicare and that a parent, guardian or carer receives certain government payments for at least one day of the calendar year. This includes Family Tax Benefit Part A.

The CDBS covers examinations, x-rays, teeth cleaning, fillings, root canal work and extractions, although there are often restrictions associated with claiming on these. Support is capped at $1,000 over two consecutive calendar years. NB: This is less than a quarter of the typical cost of braces.

Because there is only limited support via Medicare for kids dental, parents need to purchase extras cover that includes dental services to ensure that their children’s teeth are well looked after. Most basic extras policies include general dental services to some degree, although it is common for annual limits to be on the low side. To be covered for major dental and orthodontic work, broader extras cover is needed. Orthodontic and cosmetic dental work is not covered through Medicare at all and a relatively comprehensive level of extras cover is definitely needed.

How Australia Compares to Other Countries

The UK situation In the UK, the National Health Service (NHS) covers dental services for children. There is no charge for dental treatment for those aged under 18, and this includes orthodontic work if the alignment and/or arrangement of the teeth will definitely cause problems if uncorrected. Orthodontic work that is predominantly or purely cosmetic will not be covered on the NHS and will need to be paid for.

The US situation US states are obliged to provide dental benefits to children eligible for Medicaid and the Children’s Health Insurance Program (CHIP). The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit offers a broad range of preventative dental health services for children aged under 21 who are enrolled in Medicaid – and this includes some dental services. Orthodontic is not subsidised and must be paid for privately.

Should There Be More Support for Kids Related Dental Services on Medicare?

We asked various Australians mums for their views on whether they feel that Medicare currently offers adequate support for kids dental services or not. Here’s what they had to say!

My 3 year old son was diagnosed with a congenital condition which caused his baby molars to decay. The pain woke him up, screaming, in the middle of the night. The first question the paediatric dental specialist asked us was, ‘Do you have private health insurance?’ Fortunately our answer was ‘yes’ and he got the treatment he needed immediately. My heart goes out to the parents who have to answer ‘no’ to that question.

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Sarah and Robyna at Mummy and the Minx

We think dental care is vitally important for children, not just for their immediate dental health but because oral hygiene habits are formed early in life. A quick search revealed that about 39% of the Australian population have a healthy dental regime and 61% have a poor regime.

To improve those statistics, habits need to be established early. The Queensland government does offer a free dental service for children aged 4 up to grade 10. However, it is only available at specific clinics and cuts out before children are independent of their parents. A lot of families would feel more comfortable keeping with their family dentist – we certainly would.

It would be of huge benefit if Medicare covered an annual clean and check-up for children up to the age of 18, at a dentist of the family’s’ choice.

For further dental work, a safety net could be implemented, similar to the one that currently exists for medical bills. Orthodontic and other dental bills can pile up quickly, and for some families the financial pressure is too much to bear. With braces costing up to $8,000, some financial assistance, perhaps means tested, would certainly be welcomed by many families.

As a country, we believe that we can afford to support dental health for ALL our kids. It’s also about prevention. Surely investment in children’s dental health will lead to reduced costs in the future and an increase in our nation’s’ overall adult dental health.

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Kirsty at My Home Truths

I believe that kids dental services (particularly x-rays, check ups, preventative services and cleaning) should be bulk-billed through medicare. Ideally everything, including fillings, orthodontics and other services to correct or repair kids teeth should also be included on the schedule to provide parents with some financial relief.

Dentists and Orthodontists can be very expensive and if you have more than a couple of children those costs mount up rapidly. Early intervention will help prevent further medical issues stemming from dental diseases and will assist in reducing dental costs down the track.

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Amanda at Real Mums

We tend to perceive teeth as being all about the ‘Hollywood Smile’, but the further reaching implications on overall health & wellbeing are considerable. Often overlooked due to cost, the health of the teeth is essential not only for confidence, but also affects the foods consumed, and the flow on effects of lack of adequate nutrition and all that goes with that.

Pressure to obtain orthodontic care for looks alone is an expense we don’t need. However, if it is to correct or encourage healthy behaviours, and for overall health, it’s worth the cost, especially long term. Having assistance for individual families to cover these expenses is important, but the long term savings for public health are considerable.

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Aanika at The Active Mum

I think it’s extremely important that all Australian children have access to health and dental care, and I’m thankful that our local dentist is able to bulk bill my children’s dental hygiene checks. If Medicare didn’t cover children’s dental care, then I’m sure there would be children in the community who were simply not able to access it due to financial reasons. These children would be incredibly disadvantaged being that many problems can be prevented by regular checks and cleans.

As for orthodontic care, I suppose I have always been resigned to the fact that we would need to use our health insurance to cover orthodontic work, as our parents did before us. Of course it would be nice if Medicare was able to cover braces and other orthodontic work, but there are other life-saving prescription medications that are currently available – but not covered by medicare – that I would like to see be covered first.

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Karen at Misc Mum

I think that adequate dental cover is an essential part of any person’s health and wellbeing management plan – and this is especially the case for children. It’s unfortunate that it can be so expensive, and I have known many people who have had to wait a long time for treatment in the public system. Anything that can be done to decrease waiting times, while being less of a financial burden on parents or carers, would be helpful.

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Kelly at Be a Fun Mum

As a parent, I strive to give the best care to my kids in terms of their health and wellbeing. I see dental care as part of this. Being in Queensland, we are fortunate to have the dental vans visit schools, which I think is a brilliant initiative. The regular check ups and education available underpins the children’s dental health for their life. We are just entering the orthodontic period of parenting with, so far, 2 of our 4 kids needing extra work done on their teeth and it does put pressure on the family budget. It would be great to see more funding in this area to help families.

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Kristy at Lou Lou Zoo

Whilst we have to be conscious of the cost to the government, I think it’s so important for a high standard of healthcare to be available to children from all walks of life. Poor dental care as a child could lead to greater costs (and burden) on the health system later in life. Not to mention the lifelong impact to the child from being self-conscious about what their teeth look like! There is so much financial pressure on families just to cover general living expenses and health insurance isn’t affordable for everyone. Covering a broader range of dental services under Medicare will ensure more families have access to an adequate level of healthcare to their children.

Belinda

My children are still young (two and five) but dental costs in the future, particularly if they need orthodontic work, is a bit of a worry and part of the reason we’ve taken out private extras cover.

I feel Medicare could help cover some of the costs of preventative dental checkups for children as the cost of going to the dentist, even for the most basic of visits, is a real deterrent for some families. By helping with the costs of preventative dental, this will hopefully reduce the need for more major dental work in future.

Medicare’s Child Dental Benefit Scheme is a step in the right direction, but $1000 would probably not go very far if a root canal or an extraction was needed. I think providing more financial assistance over a longer time frame would be more beneficial. Orthodontic work is a huge cost to families and with no benefits offered by Medicare, many families simply can’t afford it. Some assistance for orthodontic work would be a big help.

Where do you sit in this debate? Do you think that more dental services should be available on Medicare for kids to ease financial pressure on parents? Or do you feel that the need to purchase relevant Extras cover is the right way to go and that there are more important areas to subsidise on Medicare? We’d love to hear your thoughts!

Disclaimer: The above information is correct and current at the time of publication.

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