Medicare & Dental Implants – Is it Covered?

Medicare and dental implants – what are you actually covered for? 

You’ve done all the grunt work, like finding the dentist and gathering the quotes for dental implants. Then comes the money conversation. Does Medicare cover implants? No. Does that mean you’re paying the full amount yourself? Not necessarily. 

Once you understand why Australia’s dental system works the way it does, and what options actually exist to help you fund treatment, the whole picture becomes less overwhelming. 

Here’s a clear breakdown of what Medicare does cover, what private insurance may offer for dental implant treatment and how to find more information on other payment options. 

Key Takeaways 

• Medicare does not typically cover dental implants. 
• Private health insurance with extras cover may provide partial coverage, usually after a waiting period. 
• A full, itemised quote is provided before any treatment starts, including all the different payment options available to you. 

The short answer: Does Medicare cover dental implants?

Generally no. The Australian Government does not generally cover the costs of dental services, including dental implants. You will need to pay most dental costs yourself. 

Medicare does pay for some dental services for eligible children through the Child Dental Benefits Schedule (CDBS), but this doesn’t include implants or cosmetic dental work.

Why doesn’t Medicare cover dental treatment?

In Australia, dental care falls outside the scope of Medicare’s coverage. While many medical services are subsidised for all Australians, dental services are primarily provided through private dental clinics where patients pay the full cost.¹ 

So while looking after your teeth is genuinely important for your health, the financial burden of dental treatment typically falls to you rather than through Medicare. 

What dental services does Medicare actually cover?

Medicare provides very limited dental coverage. For most Australians seeking dental implants, private payment or private health seems like the only option: 

Child Dental Benefits Schedule (CDBS):

• Covers eligible children with standard dental services, including check-ups, x-rays, cleaning, fillings, root canal treatment, and tooth extractions
• Provides a capped benefit over 2 calendar years
• Available only to families receiving other government benefits
• Most services are bulk billed (no out-of-pocket cost)
• Does NOT cover implants, orthodontics, or cosmetic dental work²

Public dental services: 

• Available through state and territory health departments for children and adults
• Adults need a Health Care Card or Centrelink Pensioner Concession Card to be eligible
• Services vary by state and territory
• May include emergency care or specialist referrals
• Waiting times can be substantial (up to a year or more) 

Other limited coverage 

• The Cleft Lip and Cleft Palate Scheme provides Medicare benefits for people under 28 years old 
• Some Aboriginal Community Controlled Health Organisations (ACCHOs) provide dental services

What about private health insurance?

Private health insurance with extras cover offers the most comprehensive support for dental treatment, though coverage varies between providers. 

How private dental extras work: 

• Major dental cover typically includes implant treatment, though not always the full cost
• Most policies require a 12-month waiting period before claiming
• Some providers offer no waiting period options (usually at higher premiums)
• Annual limits are common, and you may have a maximum annual claim amount
• Coverage percentages vary; many policies cover 50% of costs, leaving you responsible for the remainder 

To find out your coverage:

Contact your provider directly and ask specifically whether your policy covers dental implants, what waiting periods apply and what your annual limit is. 

Are there any other government schemes that can help? 

There are a few schemes that can help in specific circumstances. Here are three government schemes comparing their coverage and eligibility: 

How much do dental implants cost in Australia without cover?

Every patient’s situation is different, and your final quote will depend on your individual needs, the complexity of your case and any preparatory work your dentist recommends. 

Additional procedures such as bone grafting, tooth extraction or sinus lift may affect the overall cost of dental implants.  

We’ll explain what’s happening, what your options actually are, and what each one means for you. By the time you leave your consultation, you’ll know exactly what you’re deciding.

Alternatives to dental implants that may be covered  

If cost is a barrier, other tooth replacement options have different coverage or accessibility. 

Dentures:

• Often available through public dental services for eligible adults
• May be covered under private health insurance extras
• Lower upfront cost than implants
• Require ongoing maintenance and adjustments as your jawbone changes over time
• Don’t preserve jawbone structure as implants do

Dental Bridges:

• Sometimes covered under private health insurance extras
• Require grinding down adjacent healthy teeth for support
• Last typically 10 years before requiring replacement
• Less invasive than implant surgery
• More maintenance-intensive than implants

Removable Partial Dentures:

• More accessible through public dental services
• Lower initial cost
• Require daily removal and cleaning
• May feel less stable than fixed options 

It’s worth discussing all options with your dentist to understand what might work best for your situation and budget.

Tips for reducing your out-of-pocket dental costs 

• Review your insurance — Check whether upgrading to major dental extras cover would be cost-effective for your situation
• Ask about waiting periods — Some insurers offer reduced or no waiting period options; compare premiums carefully
• Plan ahead — Signing up for private health insurance now allows any waiting period to pass before you need treatment
• Ask about payment plans — Many clinics offer staged payment arrangements; ask what’s available before committing to treatment
• Get a detailed quote — A clear, itemised treatment plan helps you compare total costs across providers accurately

What happens next 

Navigating coverage options before treatment starts helps you make the right financial and clinical decisions for you. At Fox Dental Implants, we genuinely understand that cost matters, and so we’re committed to being transparent about every aspect of your treatment. 

When you come in for a consultation, we’ll assess your individual situation and provide a full, itemised quote before anything begins. That quote includes all the payment options available to you. 

Book a consultation at Fox Dental Implants in Melbourne, Adelaide or Brisbane to explore your options and understand what’s available to you. 

Important Disclosure: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Early release of superannuation has long-term financial consequences and should only be considered as a last resort when all other options have been exhausted. We recommend seeking independent financial advice before accessing your superannuation.

References 

1. Services Australia. Dental Care. www.servicesaustralia.gov.au
2. Services Australia. Child Dental Benefits Schedule. www.servicesaustralia.gov.au
3. Department of Veterans’ Affairs. Dental Implants. www.dva.gov.au/what-we-help-with/health-support/dental-services/dental-implants 
4. Department of Health Victoria. Victoria’s public dental care. www.health.vic.gov.au/dental-health/victorias-public-dental-care-fees