You can well imagine how much it would cost you to afford all the Plastic Surgery, the Anesthetists, the E.N.T Specialists and grommets, hospital costs and stays, all the Orthodontic appointments and dentist appointments, let alone the braces, expanders and other items required by a cleft affected child - it is really mind boggling what it would all cost.   If we were in another country you might well be very concerned.  But we are in Australia, and that makes us very lucky!

When your baby is born the hospital will notify Medicare of the birth condition via a Certificate of Cleft Condition form.  You may be issued with paperwork to fill in and send back to Medicare.  What you are signing on for is the Cleft Lip and Cleft Palate Scheme.  This service, provided through Medicare, helps families to meet treatment costs for specialised services for cleft lip and cleft palate conditions*. You will be issued with a special Cleft Palate Scheme card which you will need to carry with you to all appointments in case you need to show it.  You can claim Medicare benefits for cleft lip and cleft palate conditions until the age of 28 years. The cleft lip and cleft palate identification card has an expiry date of the day before the person with the cleft condition turns 28 years.

CleftPALS have been instrumental in getting Medicare to cover most orthodontic work under the scheme. 

Remember, you are a public patient under this scheme and whilst all attempts are made to give timely responses to the child's needs there are the times when going into hospital as a private patient might be a benefit also.  Personally we have paid full costs for grommet insertion several times now, as the wait list via the Government system would just take too long, and our son needs to be able to hear clearly.

Depending on the health fund you are with some see the cleft as a 'present condition' and won't cover the costs.  If you are lucky enough to have private cover prior to the baby's birth and you wish to use it, you should speak to your professional/specialist to see what gap they might require you to cover.

* It does not yet cover the needs of Speech Therapy, a vital service if a cleft palate is involved and therefore requiring the special care of orthodontists etc.  CleftPALS Australia Inc is looking to the Government to add Speech Therapy to the list of specialised services for cleft lip and cleft palate conditions it covers. You can help us!