Cleft Lip and Cleft Palate Scheme

Helps with treatment costs for specialised services for cleft lip and cleft palate conditions.

Eligibility basics

  • be enrolled in Medicare
  • have a cleft lip or cleft palate condition
  • be registered for the Cleft Lip and Cleft Palate Scheme before turning 22
  • have treatment before turning 28

Eligibility & payment rates

Eligibility for the Cleft Lip and Cleft Palate Scheme

To be eligible for the Cleft Lip and Cleft Palate Scheme (the Scheme) you must:

  • be enrolled in Medicare
  • have a cleft lip or cleft palate condition
  • be registered for the Scheme before turning 22
  • have treatment before turning 28

Age limits

You must be registered for the the Scheme before turning 22 to be treated under it. Under the Scheme, Medicare benefits can be paid for treatment until you turn 28.

If you did not register for the Scheme before turning 22, you cannot  register or get benefits under the Scheme.

If you are a parent of a child with a cleft lip or cleft palate condition,  register your child before they turn 22. They will then be eligible to get treatment under the Scheme.

Register for the Cleft Lip and Cleft Palate Scheme

If you have a cleft lip or cleft palate condition, your doctor or dentist needs to complete a Certification of Cleft Condition form and send it to us.

Identification card

We will send you a Cleft Lip and Cleft Palate patient identification card if you are eligible under the Scheme.

Dental treatments included under the Cleft Lip and Cleft Palate Scheme

The Cleft Lip and Cleft Palate Scheme (the Scheme) provides Medicare benefits for a range of dental treatment provided by an eligible practitioner including:

  • a limited range of orthodontic work
  • simple and surgical extraction of teeth
  • some general and prosthodontic services by your family dentist
  • oral and maxillofacial surgery by an oral and maxillofacial surgeon

Check with your dental practitioner that they are eligible to provide services under the Scheme before any treatment takes place, otherwise a Medicare benefit may not be payable.

Claiming

Once you have read about eligibility the next steps are:

  1. register for the Cleft Lip and Cleft Palate Scheme
  2. provide supporting documentation
  3. choose a payment option

Claim

Managing your payment

Change your details

To update your contact details with the Cleft Lip and Cleft Palate Scheme contact:

Cleft Lip and Cleft Palate Scheme
Support and Interpretation Section
PO Box 9822
PERTH WA 6001

Or call us on 132 011 or 1300 652 492

Payments & services