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The medicare levy is the 1.5% of taxable income which is paid at tax time - you will probably have been paying out enough tax as pay as you go so that you dont have to pay any more. The surcharge is the added 1% that they sting you if you dont have private medical insurance and your income is over a certain amount (to be changed in the budget tomorrow I think).
If you pay upfront for orthodontics, you will usually get a discount. Also, if you pay in one financial year then you will be over the safety net threshold (think it is about $1500 pa for a family) and so you can claim anything over that as a medical rebate. You wont get much back but it will be better than nothing. It was a long time ago when my son had braces but I recollect having one refund at the beginning of the process and a second one at the end.
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