Cleft Lip and Cleft Palate Scheme

If you have a cleft lip or palate, you may be eligible for the Cleft Lip and Cleft Palate Scheme, a government initiative designed to help individuals with surgical and dental services.

To be eligible for the service, your must:
  • Have a cleft lip or cleft palate condition
  • Be enrolled in Medicare
  • Be registered for the Scheme prior to turning 22
  • Receive treatment prior to the age of 28 (the only exception is for repairs to previously-completed reconstructive work which, with approval, can be done after this age)
If you fit these criteria, you must apply to the Department of Health for inclusion in the Scheme, a process which involves applying by mail with supporting medical documents, with a nominated payment option. If you are eligible, you’ll be registered and will be sent a Prescribed Patient Card by Medicare - you can then seek treatment at a dentist who participates in the Scheme.

At the dentist 

It’s important to check ahead of booking an appointment whether your dentist performs work under the Scheme. If they don’t, you won’t receive any of the benefits and may find yourself with an unexpected bill.

The type of treatments carried out by dentists, and orthodontists (specialists in straightening teeth), under the Scheme includes general dental tooth replacement/restoration services, teeth extraction, straightening or aligning teeth and surgery on the mouth, jaws or face.

It’s also worth noting that, quite apart from any work done under the Scheme, you need to ensure you see your dentist for regular check-ups as individuals with cleft palate have a greater incidence of dental decay than normal.

If you would like further information on the Scheme, please contact Medicare on 132 011 or 1300 652 492 or visit the Department of Human Services website.