Cleft Lip and Cleft Palate Scheme
The Cleft Lip and Cleft Palate Scheme helps families meet the treatment costs for specialised services for cleft lip and cleft palate conditions.
Get a cleft lip and cleft palate identification card
A cleft lip and cleft palate identification card will allow you or your child to claim benefits until the age of 28. However, you must be registered for the scheme before you turn 22.
- Your doctor or dentist needs to fill out a Certification of Cleft Condition form
- For more information, call 132 011 or 1300 652 492
Quick links
- Call 132 011 for claims queries or 1300 652 492 about patient eligibility
- Visit your nearest DHS Service Centre
- Certification of Cleft Condition form
If you or your child have a cleft lip or cleft palate condition, the Cleft Lip and Cleft Palate Scheme provides Medicare benefits for a range of dental treatment including:
- a limited range of orthodontic work
- surgical extraction of teeth
- some general and prosthodontic services by your family dentist
- oral and maxillofacial surgery by an oral and maxillofacial surgeon.
If you or your child are eligible for the scheme, you will receive a cleft lip and cleft palate identification card. You can claim benefits until the age of 28. If you or your child is aged 28 years or older, you could still claim for the repair of previous reconstructive surgery. However, you must be registered for the scheme before you turn 22 to be eligible.
Check that your orthodontist is accredited under the scheme before any treatment takes place, otherwise a Medicare benefit may not be payable.
You need to know
Cleft lip and cleft palate scheme age limits
A cleft lip and cleft palate identification card has an expiry date of the day before the person with the cleft condition turns 28. If you are now aged 22 or over and have not been registered for the Cleft Lip and Cleft Palate Scheme, you will not be eligible for registration or benefits under the scheme.
If you, or your child, is aged 28 or older and were registered with the scheme before turning 22, you could still claim for the repair of previous reconstructive surgery.
First steps
Register for the cleft lip and cleft palate scheme
If you, or your child, 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. If you, or your child, are eligible under the scheme, we will send you a cleft lip and cleft palate patient identification card.
Existing customers
Claim Medicare benefits for treatment
If you are claiming at a DHS Service Centre, 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, accredited orthodontist or oral and maxillofacial surgeon is claiming via bulk bill, you need to show your patient identification card to your dentist so they can record your identification number on the account or bulk bill form.
Change your cleft scheme registration details
If your details have changed since you registered with the scheme, call us on 1300 652 492 and provide the new information. Details can also be provided in writing to:
Cleft Lip and Cleft Palate Scheme
Support and Interpretation Section
PO Box 9822
PERTH WA 6001