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Factsheet HSV17 - Dental Services

Purpose

This Factsheet describes how you can access dental services.

What are dental services?

Dental services involve the prevention and treatment of oral disease and include general dental services, the filling and crowning of teeth, the construction of dentures, and dental implant treatment. For further information specific to dental implant treatment, please see Factsheet HSV97 - Dental Implants for the Veteran Community.

Who is eligible?

If you have a Department of Veterans' Affairs (DVA) Health Card - All Conditions (Gold) or Totally & Permanently Incapacitated (Gold), DVA will fund most clinically required dental services, provided under DVA arrangements. For information about the Gold Card, please see Factsheets HSV59 - Eligibility for the DVA Health Card - All Conditions (Gold) or Totally & Permanently Incapacitated (Gold) and HSV60 - Using the DVA Health Card - All Conditions (Gold) or Totally & Permanently Incapacitated (Gold).

If you have a DVA Health Card - Specific Conditions (White) you may be eligible for clinically required dental services, provided under DVA arrangements, if required for an accepted war or service caused injury or disease. If you have a White Card, some treatment requires DVA prior approval before it is commenced. For more information about the White Card, please see Factsheet HSV61 - DVA Health Card - Specific Conditions (White).

If you are an allied veteran, you are eligible for clinically required treatment of war caused disabilities accepted by your country of enlistment. Please see Factsheet HSV62 - Commonwealth and Other Allied Veterans Living in Australia for information about the services available.

How do I access dental services?

Please check with your dental provider that they accept the DVA Gold or White Health Card before commencing treatment, otherwise you may have to pay for treatment.

You do not need a referral from your doctor to make an appointment with a dentist or dental prosthetist.

Can I access other dental services such as a dental hygienist, dental therapist or oral health therapist?

Yes, dental hygienists, dental therapists and oral health therapists can provide dental services to members of the veteran community if they are:

  • registered with the Dental Board of Australia and comply with approved scope of practice registration standards
  • covered by either their employer's indemnity insurance or maintain their own insurance as mandated by the Dental Board of Australia, and
  • qualified and competent to provide the service.

What happens when I visit the dentist?

Please present your DVA Gold or White Health Card at the beginning of a consultation or before you receive treatment. The dental provider will assess your clinical need and provide treatment if necessary, under DVA arrangements. The dental provider will give you a copy of the treatment record for your reference.

Do I need to sign a treatment record?

Service providers can submit treatment records electronically. If this is not the case, you may be required to sign a record of treatment at the completion of each visit to ensure your treatment is covered by DVA. Before you sign, please check that the treatment record shows:

  • your name
  • your DVA file number
  • the date of treatment
  • the item number for the service provided
  • your accepted disability or condition for which you required dental services and/or supplies (if you are a White Card holder)

If you are unable to sign, a member of your family, or someone else who attends the appointment with you, may sign on your behalf. The dental provider must note that you are unable to sign.

Are there limits to the number of services I can receive?

The number of services you receive depends on your clinical need. Some services are subject to a time limit, for example, periodic oral examinations are limited to one every six months. These limits can be exceeded if your dental provider advises DVA the service is clinically necessary and seeks DVA prior approval. Further information about time limits can be obtained by contacting DVA using the contact details listed under More Information at the end of this Factsheet.

Can I have my dentures replaced?

Replacement dentures can only be provided every six years unless your dental provider advises DVA that replacements are required sooner. Replacement dentures cannot be provided if your existing dentures have been relined in the previous 12 months. You may have your dentures relined once every two years.

If you lose or break your dentures, DVA will pay for a replacement. Please contact your dental provider to arrange replacement dentures. You will be required to complete a signed written declaration stating the reason you need replacements. Further information about denture time limits can be obtained by contacting DVA using the contact details listed under More Information at the end of this Factsheet.

Do I need to pay for treatment?

In most cases you will not have to pay for any dental services provided under DVA arrangements as your dental provider will bill DVA directly. However, an Annual Monetary Limit (AML) applies to certain high cost items, including some bridges and crowns. This means DVA contributes a set amount per calendar year (1 January to 31 December) towards the cost of these items. The current AML is $2,525.30.

The AML does not apply if you are an ex-prisoner of war (POW) or if you are having treatment for an accepted dental disability or malignant cancer (neoplasia) that affects your teeth or jaw.

If a DVA AML applies to the services you need, your dental provider may ask for a co-payment from you. This is a matter for negotiation between you and your dental provider.

More Information

DVA General Enquiries

Phone: 1800 555 254 *

Email: GeneralEnquiries@dva.gov.au

DVA Website: www.dva.gov.au

Factsheet Website: www.dva.gov.au/factsheets

* Calls from mobile phones and pay phones may incur additional charges.

Additional Information

DVA Service Provider Enquiries

Phone: 1800 550 457 *

Service Provider Website: www.dva.gov.au/providers

Transport Bookings

Phone 1800 550 455 *

Veterans' Affairs Pharmaceutical Advisory Centre (VAPAC)

Phone: 1800 552 580 *

Open Arms - Veterans & Families Counselling

Phone: 1800 011 046 *

Email: openarms.coord@dva.gov.au

Open Arms - Veterans & Families Counselling: www.openarms.gov.au

At Ease Website: www.at-ease.dva.gov.au

Related Factsheets

Disclaimer

The information contained in this Factsheet is general in nature and does not take into account individual circumstances. You should not make important decisions, such as those that affect your financial or lifestyle position on the basis of information contained in this Factsheet. Where you are required to lodge a written claim for a benefit, you must take full responsibility for your decisions prior to the written claim being determined. You should seek confirmation in writing of any oral advice you receive from DVA.

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9 July 2018