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

Eligibility for the Cleft Lip and Cleft Palate Scheme

To be eligible 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

When we register you in the Scheme we will send you a Prescribed Patient card.

Age limits

To be treated under the Scheme you must have registered before turning 22 years of age. Medicare benefits can then be paid for treatment until you turn 28 years of age.

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

If you are aged 28 years or over and were registered under the Scheme, you can seek approval for repairs to previous reconstructive work. You will need to provide clinical details about the need for the repair of previous reconstructive surgery.

Patients aged 28 years of age or over can only receive Medicare benefits for treatment under the Scheme once their application has been approved.

Applications including clinical details should be addressed to:

Cleft Lip and Cleft Palate Scheme
Department of Human Services
GPO Box 9822
PERTH WA 6848

More information can be found on the Department of Health MBSOnline webpage.

Treatment included under the Cleft Lip and Cleft Palate Scheme

The Scheme provides Medicare benefits for a range of dental treatment provided by certain eligible practitioners, including:

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

Before you have treatment, check with your practitioner that they are eligible to provide services under the Scheme, 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 details

Change your details

To update your contact details with the 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