5Monetary limit on medicare benefits

5 Monetary limit on medicare benefits

(1) For subsection 3C (2A) of the Act, the total of all amounts of medicare benefit paid or payable for dental services provided to a person in a relevant 2 year period must not exceed $4 250.

(2) In this section:

relevant 2 year period, for a person, has the meaning given by subsections (3) and (4).

(3) If:

(a) a person received a dental service on or after 1 November 2007; and

(b) the service is the first dental service that the person has received on or after 1 November 2007;

the calendar year in which the person received that first dental service and the following calendar year is a relevant 2 year period for the person.

(4) After that relevant 2 year period, each calendar year in which the person receives a dental health service and the following calendar year is a relevant 2 year period for the person unless the first mentioned year is already part of a relevant 2 year period because of a previous application of this subsection.

Example 1

A person who first receives a dental service on 25 November 2007 will be eligible for not more than $4 250 in medicare benefits for all dental services provided to the person in 2007 and 2008.

A further relevant 2 year period commences for that person in the calendar year when the person first receives a dental service on or after 1 January 2009.

Example 2

A person who first receives a dental service on 15 January 2008 will be eligible for not more than $4 250 in medicare benefits for all dental services provided to the person in 2008 and 2009.

A further relevant 2 year period commences for the person in the calendar year when the patient first receives a dental service on or after 1 January 2010.